Are Weight Loss Drugs Safe for Seniors?

Sometimes, a drug is developed for one purpose but found to be useful for something else entirely. This is true for a class of medications called glucagon-like peptide-1 receptor agonists, also known as GLP-1s. 

The first GLP-1 was approved in 2005 to treat type 2 diabetes, but as more GLP-1s were developed, researchers learned that many people who used them lost weight.

As with all medicines, it is important to carefully review and discuss the benefits and risks of these drugs with your medical provider.

How they work

GLP-1s are very effective for weight loss because they mimic the actions of a hormone naturally produced by your small intestine that makes you feel full and slows the rate of stomach emptying. 

Patients taking a GLP-1 report that they experience fewer cravings, feel less preoccupied with food, and are able to eat less. 

This is relevant for seniors, as over 25% of adults age 65-plus have diabetes and over 40% are overweight. However, GLP-1s have a host of side effects. 

Weigh the side effects

The side effects are primarily gastrointestinal--nausea, vomiting, abdominal pain, and diarrhea. They affect up to 70% of users, and older adults have a higher risk of experiencing severe side effects and other GLP-1-related adverse events. 

In the two years after semaglutide (Ozempic and Wegovy) was first approved, side effects were the main reason for about 25,000 emergency room visits. And side effects are cited as a reason why over half of people stop taking GLP-1s within one year of starting. 

Another notable problem: Studies show that, along with body fat, at least one-third of GLP-1-related weight loss consists of lean body mass--mostly muscle tissue. Loss of lean body mass can have serious consequences for older adults, including an increased risk of falls and fractures as well as weakness and fatigue. In addition, lean body mass is not easily replaced, so many who stop the medicine will never return to their baseline level of muscle. 

It's also important to note that if you stop taking GLP-1s, the benefits stop too. Research shows that two-thirds of the weight you lose (mostly fat tissue) is regained within one year of discontinuing the drug. Staying on GLP-1s indefinitely, however, is an unpleasant thought for many people. We also don't know whether long-term use of GLP-1s is completely safe or effective for seniors. 

The best approach

For older adults, the safest and best way to lose weight is through lifestyle modification. Work with your doctor and a dietitian, if needed, to set a goal and make a healthy meal plan. Create a physical activity or exercise routine with the help of a fitness specialist. 

While it can be very challenging to get started, a lifestyle change remains the best way to achieve a weight that will improve your well-being for years to come.

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