GLP1 (and GIP, tirzepatide is different than semaglutide, liraglutide, and other GLP1 agents as it works on both) moderate hunger/satiety. These agents help patients feel full quicker and stay full longer, helping to cut down on portion sizes, snacking, etc.

We’ve had Saxenda approved for years (liraglutide) and recently got Wegovy approved in 2021 (semaglutide), and hopefully will see tirzepatide approved for a weight management indication soon - currently is only approved under a diabetes indication. Wegovy, and tirzepatide for weight loss (see SURMOUNT clinical trials if interested) have demonstrated much greater weight loss than other indicated agents for weight management, approaching the amount of weight loss we see from some types of bariatric surgery.

These agents are a big deal in the management of overweight/obesity due to long term safety- patients stay on these agents for potentially their lifetime in the diabetes indication, and they are safe and continue to be effective. It’s truly a turning point in seeing and treating overweight/obesity as a chronic medical condition- not just a moral failing that quick diet/diet pill schemes can fix in a few weeks. As a provider that manages patients with chronic medical conditions, my patients on this class of medications for weight management are doing incredibly well- but as stated above, it HAS to go along with lifestyle modifications (exercise, dietary modification) and appropriate check ins with the medical team, just like any other chronic medical condition.

As a patient myself, I’ve lost a significant amount of weight with Wegovy over the past year and a half, and it has completely changed my outlook on my health, both physical and mental. I’m the healthiest I have ever been because I’ve been able to get control of the processes in my brain that encouraged me to eat, treat stress with desserts, and I finally feel in control of something I have never felt in control of before.

The issue is several insurance plans (including any government plans - Medicare, Medicaid, etc) do not cover treatment for weight management, as it was seen as ~cosmetic~ when these rules were initially put in place. That’s where the diabetes backorders came from- providers knew these agents would be clinically beneficial in their patients, but couldn’t get the “weight loss “ branded version, so prescribed the diabetes version.

I certainly wish the pharmaceutical companies (looking at you, Novo) would quit advertising Ozempic, Rybelsus, etc here on Reddit, and use that money to lobby Congress (why else are y’all employing Queen Latifah to be a spokesperson) to allow coverage of weight management treatments, now that we have safe and effective ways to manage it as a chronic condition.

Soapbox over.