Severe ankle pain pushed Jelon Smart to begin a weight loss injection about a year and a half ago.
At 285 pounds, Smart worked as a caterer in Savannah, Georgia. After long hours on her feet, her ankles became “as swollen as a football.” She walked with a limp until an orthopedic doctor diagnosed her with Achilles tendinitis and advised weight loss to ease her symptoms. Consequently, she started using Ozempic, a GLP-1 medication.
Initially, she experienced rapid weight loss. “I lost 30 pounds without changing anything,” said Smart, who is now 48. However, her progress stalled after that.
GLP-1s are among the most popular weight loss drugs in the U.S., with nearly 20% of people trying them at some point. Experts suggest, though, that achieving sustained weight loss requires more than just medication.
The Old-School Rules of Weight Loss and Health Still Apply
Regular exercise, balanced food choices, and sufficient sleep are foundational to not only losing weight on medication but also maintaining it, said Dafina Allen, an obesity medicine physician in Saginaw, Michigan. While GLP-1s can suppress appetite, she noted that some users still don’t improve their overall health due to lack of exercise or poor dietary choices. Factors like hormones, metabolism, and genetics also play a significant role in weight loss.
Realizing her weight loss had plateaued, Smart knew she had to be more active. “I’m in the gym six days a week,” she shared. She has since dropped to 175 pounds, and the swelling and pain in her ankle have subsided.
Mental Health Matters, Too
The connection between mind and body is significant. Allen pointed out that body image issues can linger even after significant weight loss. “I’ve seen patients lose 50 to 100 pounds, yet they still look in the mirror and feel unhappy,” she remarked.
Gerald Onuoha, an internal medicine practitioner in Nashville, emphasized the importance of addressing mental health alongside physical health. “Engaging in conversations about your struggles, whether with family or a professional, can be very beneficial,” he indicated.
Work With a Doctor To Closely Monitor Your Dosage
Onuoha warned that complications can arise if people increase their GLP-1 dosage too quickly or fail to adhere to their prescribed schedules. He’s treated patients for pancreatitis, gallstones, and acute kidney injury. “I always ask my GLP-1 patients: How long have you been using it? Are you following the directions? Those are crucial factors,” he explained.
A possible concern, Allen mentioned, is that many find GLP-1s accessible and affordable online, but may lack guidance about their dosages or potential side effects. “They might order from random websites without knowing if the medication is suitable for their health conditions,” she stated.
People and Policy
GLP-1 medications can be expensive, and both public and private insurance plans generally don’t cover them for weight loss. Medicaid covers them for certain medical conditions like diabetes, but only a small number of state programs include them for obesity. For older Americans on Medicare, the government plans to offer temporary coverage for weight loss with GLP-1s starting in July.
