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LISTEN: Taking a GLP-1? Doctors say don\u2019t forget to move your body and tend to your mental health, too.<\/p>\n<\/figure>\n<\/div>\nSevere ankle pain drove Jelon Smart to start taking a weight loss injection a year and a half ago.<\/p>\n
Smart was 285 pounds and worked as a caterer in Savannah, Georgia. After she\u2019d been standing on her feet for long hours, her ankles would be \u201cas swollen as a football,\u201d she said. She was walking with a limp. An orthopedic doctor diagnosed her with Achilles tendinitis and recommended losing weight to mitigate the symptoms. Smart began taking the brand-name GLP-1 Ozempic.<\/p>\n
The appetite suppression resulted in her shedding pounds quickly, at first.<\/p>\n
\u201cI lost 30 pounds initially without changing anything,\u201d said Smart, 48. But then she found herself unable to shed additional pounds.<\/p>\n
GLP-1s have quickly become one of the most popular types of weight loss drug in America. Nearly 1 in 5 people have taken them at some point, according to research from KFF, a health information nonprofit that includes KFF Health News. But doctors say it takes more than a regular shot for patients to achieve their weight goals in the long run.<\/p>\n
Here\u2019s what to know.<\/p>\n
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The Old-School Rules of Weight Loss and Health Still Apply<\/strong><\/p>\nRegular exercise, smart food choices, plenty of sleep \u2014 those basic, healthy lifestyle choices are not only going to help you lose weight on a weight loss drug but also help you keep it off, said Dafina Allen, an \u200aobesity medicine physician who runs a clinic in Saginaw, Michigan. For example, some people find that they eat less on a GLP-1, \u201cbut they\u2019re not improving their health because they\u2019re not exercising. They\u2019re not improving the quality of the food they\u2019re eating,\u201d Allen said. The path to weight loss is also guided by hormones, metabolism, and genetics.<\/p>\n
After her weight loss on Ozempic plateaued, Smart realized she needed to start moving her body, too. \u200a\u201cI\u2019m in the gym now six days a week,\u201d she said. \u201cI went from 285 to 175\u201d pounds. The swelling and pain in her ankle went away as well.<\/p>\nJelon Smart, from Savannah, Georgia, lost 110 pounds after starting on Ozempic \u2014 but only after starting an intensive workout regimen, too.(Christopher Smart, Jennifer Davis)<\/span><\/figcaption><\/figure>\nMental Health Matters, Too<\/strong><\/p>\nThe mind and body are deeply connected. Food and body image can be especially emotional, Allen said. \u201cI can tell you about the patients that I helped lose 50 pounds, that I helped lose 100 pounds, and they still look in the mirror and are not happy.\u201d<\/p>\n
The key is seeking help for mental health along the way, said Gerald Onuoha, who practices internal medicine in Nashville, Tennessee. \u201cMaking sure that you\u2019re talking to people about your problems, whether it\u2019s a family member or a licensed professional, I think goes a long way,\u201d he said.<\/p>\n
Work With a Doctor To Closely Monitor Your Dosage<\/strong><\/p>\nOnuoha said people can run into serious problems if they increase their GLP-1 dosage too quickly or don\u2019t follow the recommended schedule. He\u2019s seen patients come to the hospital with pancreatitis, gallstones, or acute kidney injury. \u200a\u201cI always ask patients that are on GLP-1s: How long have they been on them?\u201d he said. \u201cAre they adhering to the directions? Because those things determine whether or not you\u2019re going to have those complications.\u201d<\/p>\n
Part of the issue, Allen said, is that GLP-1s are relatively easy to access \u2014 and often much cheaper \u2014 through online pharmacies or websites, but those providers may not educate patients about their dosage or side effects. \u201cSo they might just go online, find a random company that will ship it to their house, where they don\u2019t even know what dose of the medication they\u2019re taking, or even if the medicine is safe for them as the patient with the medical conditions they have,\u201d she said.<\/p>\n
People and Policy<\/strong><\/p>\nGLP-1 drugs can be costly, and most insurance programs \u2014 public or private \u2014 don\u2019t cover the medications for weight loss. Medicaid, the government program that covers 69 million Americans, covers GLP-1s for medically accepted conditions like diabetes, but only about a dozen state Medicaid programs cover GLP-1s for obesity treatment, according to KFF. For older Americans with Medicare, the federal government is planning to allow temporary coverage of GLP-1s for weight loss starting in July.<\/p>\n
Katherine Ruppelt at Nashville Public Radio contributed to this report.<\/em><\/p>\nHealthQ is a health series from reporters Cara Anthony and Blake Farmer, approachable guides to an unapproachable health care system. It\u2019s a collaboration between Nashville Public Radio and KFF Health News.<\/em><\/p>\n