Prescribing Ozempic and Mounjaro just for Weight Loss is Unethical

The GLP-1 agonists have been commercially successful primarily as weight loss agents. Although the medical and diet industries are bent on making this class of drugs solely about weight, I believe in time we will see this period of wanton prescribing for weight loss as unethical except in the most extreme cases of very high weight and concomitant serious health concerns.

These drugs are the first widely used class of drugs which alter the hormonal control over metabolism ranging from blood sugar levels, hunger/fullness, digesting and absorption and utilization of energy.

The powerful effects of the drugs range widely through the body and in ways we have yet to understand. The variety of medical effects already mentioned in this blog are only the earliest signs of what these drugs can do. As our knowledge of metabolic hormones and our experience with these medications grows, we will better understand the potential uses of the GLP-1’s.

Some people have clear beneficial effects which include regulation of metabolism and hunger, normalization of blood sugar, decreased inflammation and control over compulsive urges to name a few. For many of these people, there is associate weight loss, often to a lesser degree. For some, weight does not change or changes minimally even when health clearly improves.

Many people who take the GLP-1’s solely for weight loss experience something very different. They take a larger dose typically and have significant decrease in hunger and increase in fullness. Over time, they eat very little, lose weight rapidly and develop signs of malnutrition.

Often after a couple of years, they stop the drug due to the inability to digest food and severe constipation. Off the medication, they usually gain weight rapidly. It appears that these people don’t have a metabolic disorder helped by this class of medication. Instead, the drugs decrease food intake and weight but only to harm one’s health.

From my vantage point, these patients often see online doctors or primary care doctors who ramp up the dose quickly for the immediate desired effect without paying attention to the medical consequences. These patients should not be on these medications since there is no medical indication. In the end, they experience only damage to their body.

GLP-1’s need to be prescribed to treat medical conditions like diabetes or metabolic dysfunction. Using them just for weight often causes long-term harm. It’s hard not to believe the weight loss indication was a reaction to the societal and medical myth that larger bodies are a sign of poor health. Instead, let’s use these drugs for medical benefit, not for the problematic focus on weight loss.