FDA Approves First GLP-1 Pill for Weight Loss

This year, GLP-1 medications, which focus on weight management, have gained significant attention, yet there’s a noticeable trend among older Americans opting out. A study released in January 2025 analyzed over 125,000 individuals classified as overweight or obese. It revealed that around 47% of those with type 2 diabetes and 65% without diabetes ceased their GLP-1 prescriptions within a year of starting them.

Dr. John Batsis, a geriatrician and expert in obesity at the University of North Carolina, pointed out that the drug primarily targets seniors, noting that about 40% of older adults face obesity issues.

These GLP-1 medications replicate a hormone from the intestines, specifically glucagon-like peptide-1, and serve functions for type 2 diabetes and weight control. They’re also being explored for other health challenges, such as cardiovascular issues and sleep apnea.

However, starting or discontinuing these drugs can lead to weight gain, heightened appetite, and a loss of related health benefits—like improved blood pressure and cholesterol levels—according to various health experts, including those at Stanford. This can increase the risk of related conditions like heart disease and sleep apnea.

Despite the possible health risks, a number of older adults have chosen to stop using these medications for various reasons, including severe side effects and rising costs. Here are the main factors influencing older adults’ discontinuation of GLP-1 treatments:

Cost

The expense of GLP-1 drugs plays a substantial role in whether individuals continue their treatment, especially given recent shortages affecting availability. A profile in The New York Times shared the story of Mary Bucklew, a 75-year-old public transit employee from Delaware. At one point, she was only paying $25 a month through insurance for Ozempic, her weight-loss medication.

Bucklew reportedly lost 25 pounds over six months and felt more energized. But then her insurance company decided to stop covering the drug, a move made despite her insistence on its necessity for her health. As a result, without insurance support, she’d face potential costs exceeding $1,000 per month, leading her to discontinue the medication.

Some companies that manufacture GLP-1 drugs are making efforts to ensure their medications are more accessible. For example, in December 2025, Lilly announced that they would lower the price of single-dose vials of Zepbound.

Ilya Yuffa, an executive at Lilly USA, emphasized that many individuals needing obesity treatment struggle due to financial and coverage hurdles, reiterating their intent to enhance access to obesity care.

Side Effects

Dr. Sue DeCotis, a weight loss specialist based in New York City, noted that over half of older adults discontinue GLP-1 medications due to costs and side effects after an interview with Fox News Digital. The common adverse effects often include nausea, vomiting, diarrhea, and more.

Older individuals may have heightened sensitivity to these gastrointestinal side effects, suggesting that careful monitoring by knowledgeable physicians is crucial.

Dehydration Symptoms

Dr. DeCotis pointed out that many older patients may already face dehydration and often don’t drink sufficient water to mitigate the side effects of GLP-1 drugs. Ensuring adequate hydration is essential, especially for those with pre-existing kidney concerns.

Muscle Loss

Muscle loss can also be a concern for older adults using GLP-1 medications, and it may worsen if they don’t maintain enough hydration or protein intake. A review from the American Heart Association in October 2024 identified that a substantial portion of the weight loss from GLP-1 drugs can be attributed to muscle mass rather than fat.

As muscle mass diminishes with age, the risks of falls and fractures can rise. After the age of 35, adults may lose up to 2% of muscle mass each year, escalating to 3% yearly after 60.

To mitigate the potential muscle loss related to semaglutide, experts advocate for increased attention from healthcare providers, ensuring both patients and doctors closely monitor health progress and adjust treatments as needed.

Finding Success

Healthcare providers who authorize the use of these drugs without thorough oversight may inadvertently contribute to medication failure. Effective patient care could allow many to continue their GLP-1 regimens with improved outcomes and manageable side effects.

Properly tailored dosing can also play a significant role in achieving optimal results, emphasizing the necessity of personalized healthcare approaches to enhance patient experiences.