Can I Take Ozempic for Menopausal Weight Gain?
My friends are extremely intelligent people who care deeply about very important issues…and lately, most of our conversations wind up something like this:
“Don’t you think the Kardashians must be taking it?”
“I think at least half of all celebrities are taking it.”
“I want some so bad.”
“Oh my God, you don’t need it.”
“I’ve gained 20 pounds since going into menopause, all in my gut!”
“It’s for people with serious weight issues.”
“And Real Housewives.”
“Well, I read that it makes your hair fall out.”
“Well, I read that it’s totally safe.”
“Well, I read that the stuff made Amy Schumer so sick, she couldn’t play with her son. And that it made Sharon Osbourne basically anorexic. And that plus-size model Remi Bader took it, stopped, and gained back all the weight she’d lost—and more.”
“Okay, I googled it. There’s like a million telehealth places selling it online. Pretty cheap.”
“Wait. What?”
“Do you think we can all get prescriptions?”
“My sister’s colorist has a doctor who might hook us up.”
Shallow as they might sound, discussions like these are playing out across the country, and they actually raise important questions—okay, some important questions. For expert answers to your friend group’s FAQs about the new weight-loss drugs, we went to Judith Korner, MD, PhD, director of the Metabolic and Weight Control Center and professor of medicine at Columbia University, and Sarah Adler, clinical associate professor at Stanford University and founder of Wave Life, a digital intervention with live coaching for mental health service. For an overview of the new medications, click here.
Can you get too thin from these drugs?
Adler: Honestly, I’ve never seen it happen. My experience is that if you want to stop losing weight from taking one of these medications, all you have to do is stop taking it.
What about Sharon Osbourne? [The talk-show host says that she got “too skinny” on Ozempic, and that even though she’s stopped taking it, she can’t put any weight back on.]
Adler: I won’t comment on Mrs. Osbourne specifically. What I will say is that disordered eating and body dysmorphia are highly associated with being overweight—and, frankly, with just being female in America. So I think someone with a preexisting condition could easily wind up taking these medicines. I also think that a lot of societal stigma and internalized fat phobia could underlie someone’s decision to take a weight-loss drug. Bottom line: I think it’s possible for the fear of gaining weight back to perpetuate disordered eating or thinking.
Will I regain all the weight if I stop taking one of these drugs?
Korner: Probably. But I really wish people would put this in perspective. We would never tell someone on blood pressure medication, “Wow, it’s working well, so you should stop taking it!” You stay on blood pressure medication for as long as it is needed. And cholesterol medication. And diabetes medication. Like all those conditions, obesity is a chronic disease. Apply the same logic to the medication you take for it.
Can you stop and start taking these drugs?
Korner: If you want to. There doesn’t seem to be any negative health effect—except that you will be at a high risk for weight gain. I’ll say it again: Obesity is a chronic disease. It only goes away when you treat it. Also, if you do stop taking one of these medicines for several weeks, you can’t just restart where you left off. You’ll have to start at the beginning again—that is, with a very low dose that you slowly increase to therapeutic levels.
Can you switch medicines?
Korner: Yes, but be careful if you change from taking semaglutide to taking tirzepatide. The dosing will be different. Why? The semaglutide drugs (brand name Ozempic when marketed for diabetes control and Wegovy when marketed for weight control) mimic one hormone that makes you feel full faster longer, but the tirzepatide drugs (brand name Mounjaro when marketed for diabetes control and Zepbound when marketed for weight control) mimics two hormones that do that. You really need to work with your doctor to get the maximum benefit from these medications with the fewest side effects. And you really need to have a doctor willing to work with you on this. If you don’t have one, change doctors.
Can you take them for menopausal weight gain?
Korner: They’ll definitely enable you to lose weight, but it becomes more difficult to affect the fat-distribution changes associated with menopause—which is more fat around the belly. [In premenopausal women, belly fat accounts for 5 to 8 percent of total body weight, and in postmenopausal women, it accounts for 15 to 20 percent.] Women are always telling me they want their waists back. But we may have to change some of our goals as we get older.
Will they make my hair fall out?
Korner: Possibly. Hair may fall out with any form of weight loss because the body perceives that as a stress. It’s not permanent, though. Your hair will grow back when you stop losing weight, which, theoretically, will happen when you reach a healthy weight. It’s also important to ensure that you are following a healthy and nutritious diet.
What if I have only 15 to 20 pounds to lose?
Adler: First, let me tell you the current rules. The FDA has approved these drugs only for a very specific group of people. Those criteria are a BMI of 30 or higher, or a BMI of 27 or above with an associated health risk such as diabetes, high blood pressure, or high cholesterol.
Now let me tell you what I think. I fundamentally believe that weight loss is a personal choice, and there a lot of reasons a woman who doesn’t meet the FDA’s criteria would want to lose weight: our fat-phobic culture, the fact that thin women earn more than heavy women, the fact that I don’t think there’s a woman in America who hasn’t had some unhealthy relationship with food and/or her body. So if you don’t meet the FDA criteria, but you want to use these drugs to lose a few pounds and your medical doctor okays it, I’m personally fine with that. (But fair warning: No way will insurance pay for your medication.)
When will less-expensive generics be available?
Korner: We hope that as more of these medications come out, there will be more competition within the anti-obesity medicine space, and the manufacturers will start lowering the costs. I mean, that’s certainly one of the hopes.
But semaglutide and tirzepatide are for sale on the internet right now. Pretty cheap, too!
Adler: A lot of companies—especially, online—are selling semaglutide and tirzepatide made by compounding pharmacies. These are not generics. They’re kind of like homemade formulas. The places that manufacture them are not federally regulated. So they might contain the proper ingredients to make the drug, and they might not. They might be properly sterile, and they might not. The doses may be what they say they are, and they might not. You may be getting the right drug, and you may not. Beware of them.
Will I ever enjoy food again?
Korner: If you take one of these medicines, you’ll enjoy food as much as you always did. You’ll just be satisfied by eating less of it. Your tastes might change—some people find they lose their taste for coffee, alcohol, and sweets. One problem people do tell me about is that their mom or their grandma gets upset when they don’t gorge on the food they make for them—especially on special occasions like birthdays and holidays. The fact is, in a lot of cultures, cooking—and overeating someone’s cooking—is a way to express affection. But I’m confident people can figure out lots of other ways to show love.
Any content published by Oprah Daily is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. It should not be regarded as a substitute for professional guidance from your healthcare provider.
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