Are Weight Loss Drugs Right for Seniors?

Recently, the news and social media have generated a lot of buzz about new weight loss drugs achieving miraculous results. These results are confirmed by celebrities and members of the medical community with astounding photos and testimonials. Does this mean you, too, can finally fulfill your weight loss resolution?

Not so fast. Although the results achieved when taking these drugs do point to better overall health for most people, including seniors, there are also drawbacks to their use, including cost, side effects, possible drug interactions, and a need for continued use.

So, what are these new drugs and how do they work? They were derived from existing medications used to control Type 2 diabetes, explains Andrea Brody, Physician Assistant, Certified (PA-C), at Allina Health Weight Management and Bariatric Medicine in St. Paul, MN. “Ozempic (semaglutide) and Mounjaro (tirzepatide) are two medications used for diabetes but also promote weight loss. To use these specific medications, you must have Type 2 diabetes. Ozempic has been around for years and Mounjaro was approved in 2022.”

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The newer FDA-approved medications being used for weight loss for people who do not have diabetes are Wegovy, similar to Ozempic, and Zepbound, similar to Mounjaro. Some studies show Wegovy users lost an average of 35 pounds over 68 weeks and Zepbound users lost an average of 48 pounds over 72 weeks. Although these drugs are approved by the FDA to be prescribed for weight loss, a potential user must have a BMI (body mass index) of 27 or higher with a comorbidity factor such as high blood pressure, high cholesterol, pre-diabetes, sleep apnea, or GERD, among others, or a BMI over 30 without a comorbidity, Brody said.

“These medications all provide appetite suppression by slowing the stomach emptying so you stay full longer with each meal,” said Brody. “You tend not to snack or feel hungry in between meals.” She added that the medications also work on hormones (peptides) that affect lowering glucose (blood sugar) and can increase insulin sensitivity or uptake.

Mounjaro, Zepbound, and Wegovy are injectable medications. “These are called auto-injectors that come in a pen without you needing to see the needle,” Brody explained. “You inject this weekly at home, either by yourself, a nurse, or a loved one, into your abdomen or thigh.” Ozempic differs slightly in that it comes with separate needles to put in the pen for multiple uses.

For some people, the cost may be prohibitive. “The medications are between $1,100 to 1,600 per month without insurance coverage,” Brody noted. “Medicare does not generally cover weight loss injectables but will cover the formulations used for Type 2 diabetes,” she said. (See more about Medicare coverage of weight loss drugs at Medicare.gov.) “There are drug savings programs that offer assistance to those who qualify, but, unfortunately, those with Medicare or any government insurance do not qualify for manufacturers’ coupons.” Like original Medicare, supplemental policies parts C and D do not normally cover the drugs either.

An essential part of any weight loss program even while on injectable drugs, Brody notes, is to have a comprehensive approach to wellness.

“If they are using a weight loss injection like Wegovy or Zepbound and engaged in a weight loss program that looks at nutrition, exercise, good hydration, adequate sleep, mental health, and social connection, seniors could safely use these medications,” Brody stressed. She added that a goal with weight loss is to control and improve other conditions like high blood pressure and cholesterol, sleep apnea, and pain, which can lead to reduction in the use of other medications or CPAP machines.

One of the biggest barriers to safe use is the side effects. The most common side effects include nausea, vomiting, diarrhea, and constipation. These can lead to dehydration, dizziness, and the risk of falls (especially in older people) and fatigue. Users must be medically monitored while on the drugs with labs and checkups, said Brody, and meet with their dietitian and medical provider regularly to make sure they are tolerating the medication. Side effects may resolve over time or with dose adjustments. Fortunately, these medicines do not have many interactions with other common medications older adults may be taking, except for those with pancreatitis, thyroid cancer, and a few other conditions.

Finally, when someone does stop these medications after reaching their weight loss goal, they will most likely gain back some weight, Brody said. “How much weight gain depends on how well the patient has done with lifestyle changes. Some patients will need to continue taking the medication for many months or years to maintain their weight.”

As with everything in life, individuals must decide if the positive effects outweigh the negatives when considering using weight loss medications.

Always seek the guidance of your doctor or other qualified health professional regarding your health or a medical condition. Never disregard the advice of your qualified medical professional because of anything you have read on this website.