Obesity is a growing public health concern across the United States, with the state of California being no exception. According to a GlobalData report, obesity can have profound economic implications in California, with the reduction in the economy amounting to $89.5 billion or about 2.5% of the state’s gross domestic product. Since obesity is a progressive condition that can decrease the quality of life and increase the risk of other chronic diseases like type 2 diabetes and cardiovascular disease, these economic costs mainly come from healthcare expenses and workforce productivity losses. For instance, there are 353,600 fewer adults in the workforce due to obesity-related unemployment and preventable deaths. Employers also spend $6.3 billion more on weight-related absenteeism and disability among overweight or obese employees. Considering the staggering costs of obesity on health and quality of life, obesity prevention, and management interventions must become accessible among Californians. Weight loss drugs emerge as an increasingly available option for overweight and obese residents, demanding a closer look at how they work and what patients must consider before taking them.

How weight loss drugs work

In a previous article from the ongoing Ask the Experts series, primary care physician Dr. David Nazarian explains that a class of drugs called glucagon-like peptide-1 (GLP-1) agonists is now being used for weight loss. Although GLP-1 agonists were originally used to treat type 2 diabetes, they can also be prescribed for chronic weight loss and management.

GLP-1 agonists mimic the brain receptors and gut hormones responsible for satiety and appetite control. By binding to GLP-1 receptors, these medications can curb hunger and slow down stomach emptying, thus preventing overeating and promoting weight loss.

Weekly injectables that aid weight loss

Weight loss drugs typically come in the form of weekly injectables, which means they are liquid medications administered with a needle and syringe. Among the GLP-1 agonists available to Californians enrolled in the Medicaid program is the liraglutide Saxenda, which may be used by adults with obesity or adults who are overweight and have a weight-related complication like diabetes or hypertension.

Likewise, Novo Nordisk’s Wegovy is approved by the US Food and Drug Administration for heart health and chronic weight management. After a House Bill was passed this year, California is now among the states whose Medicaid program covers Wegovy as weight loss drugs with added health benefits, such as improved blood sugar levels.

Another increasingly accessible GLP-1 agonist is Ozempic, which is also a semaglutide like Wegovy and can lower blood sugar and reduce appetite. However, since Ozempic is only approved by the FDA for type 2 diabetes, there have been concerns about its side effects on overweight or obese individuals.

Side effects of weight loss drugs

One of the most visible side effects of taking Ozempic for weight loss is Ozempic butt, which is characterized by the loose, sagging appearance of the buttocks. This phenomenon can be attributed to how Ozempic induces rapid weight loss of about 5.9% after three months and 10.9% without six months.

Losing a significant amount of weight within a short period means the skin can barely adjust and becomes less elastic, leading to wrinkly, sagging, and even aging skin. Other side effects of Ozempic include headache, dizziness, fatigue, and gastrointestinal symptoms like nausea, vomiting, diarrhea, and stomach pain. In 2023, about 12% of reported overdose exposures to semaglutide were from California, which also highlights the need for medical supervision when using weight loss drugs.

Other weight loss approaches

While weight loss drugs can be effective, overweight or obese individuals can reduce the risk of their side effects by looking into other weight loss approaches. A notable example is bariatric surgery, which manages obesity and related conditions through medical procedures like the alteration of gut hormones, reduction of stomach size, and modification or bypass of the intestines.

A news article reports that 4.4% of the severely obese children in southern California qualify for pediatric bariatric surgery, with children’s hospitals Children’s Hospital Los Angeles, UCLA Health, and Stanford Children’s Health offering the procedure.

Beyond these medical approaches, healthy and sustainable weight loss can also be achieved through lifestyle modifications like a reduced-calorie diet and regular exercise.