Episode 2129 notes I've wanted to do this show for a long time. It's personal to me. This is on what I call the big four weight loss drugs. Ozempic, Wegovy, Zepbound and Mountjaro. And the reason I wanted to do this show was because I was struggling with some weight issues and went to see my primary care doc, and she goes, well, let's just go ahead and give you Wegovy. And I thought, you know, I think I'm going to go find a weight loss clinic. I'm going to get into a program and see what I can do. And I did. So I’ll let you know how that went, but also that it made me think about these products and I started doing a little research, started looking around, and I'm like, you know what? We don't know what we don't know. And it gave me, some significant hesitation about using these, so this show today is about that. It's about what do we know? What don't we know? What do we know that are side effects, potential problems down the road for other kinds of diseases and comorbidities because most studies go back only 3.5 years or less. Some additional questions are: What are the long-term effects and what happens if you’re on them on them for a lifetime? I’ll also review the manufacturer country Green List, so if you are getting one of these from another country to save cost, which are considered safest. We have the research, and I'll lay it out in detail in this episode and I’ll let you know what I think. The studies we've referenced are listed below. This is episode 2129 of America's Healthcare Advocate. I'm Cary Hall.  As always, if you need help or have something to share contact me with this form on my website and let me know what's on your mind, issues you are dealing with, or other health, healthcare, and health insurance questions and concerns. Visit: https://www.americashealthcareadvocate.com/contact-us Episode Producers: Audio: Garner Cowdry Camera: David Thiessen Research - Nathan Haldeman Research for this episode: Semaglutide and tirzepatide basic info: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf Timing of risks involving weight loss drugs : https://pubmed.ncbi.nlm.nih.gov/37952131/ Info related to weight regain with weight loss drugs: https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252/ Info about suicidal signals with weight loss drugs (no signals found): https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type/ Gastrointestinal complications with weight loss drugs : https://gi.org/journals-publications/ebgi/phil_paul_nov2023/ https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf Thyroid risks with weight loss drugs: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf Pancreatitis, gastroparesis/obstruction caution: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf Human relevance with thyroid issues: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf Success stories with meaningful weight loss using the drugs: https://www.nature.com/articles/s41591-022-02026-4/ Findings regarding weight loss drugs helping heart health: https://www.fda.gov/news-events/press-announcements/fda-approves-first-treatment-reduce-risk-serious-heart-problems-specifically-adults-obesity-or/ Findings regarding weight loss drugs ability to help prevent diabetes: https://www.reuters.com/business/healthcare-pharmaceuticals/eli-lilly-says-weight-loss-drug-cut-diabetes-risk-by-94-trial-2024-08-20/ Basic side effects of weight loss drugs: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf Warnings regarding who should and shouldn’t take these drugs: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf Specifics with body composition during weight loss drug use - how to maintain the loss and what you're actually losing: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183/ Cost and healthcare surrounding weight loss drugs: https://aspe.hhs.gov/sites/default/files/documents/127bd5b3347b34be31ac5c6b5ed30e6a/medicare-coverage-anti-obesity-meds.pdf More regarding prices and utilization pressure: https://kffhealthnews.org/news/article/glp-1-weight-loss-diabetes-drugs-cost-deprescription-medicaid-north-carolina/ Real- world persistence about weight loss drugs: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823644 How to take the drugs and dose them properly: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf Lifestyle tips to help the drug’s effectiveness: https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.16275 Planning timelines for weight loss with and without the weight loss drugs: https://pubmed.ncbi.nlm.nih.gov/35441470/ Necessary things to do prior to taking the drugs that can improve your safety with them: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/215256s011lbl.pdf How do these drugs actually work: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf Warnings about lack of long term data for these drugs: https://www.nejm.org/doi/full/10.1056/NEJMoa2307563 Stopping often leads to weight regain: https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252 Drug warnings about pulmonary aspiration: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf Signals about serious GI events: https://jamanetwork.com/journals/jama/fullarticle/2810542 Suicide relations to these drugs, how it’s a misconception: https://www.fda.gov/drugs/drug-safety-and-availability/update-fdas-ongoing-evaluation-reports-suicidal-thoughts-or-actions-patients-taking-certain-type Patients with diabetes may have retinopathy complications: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/209637s025lbl.pdf Pregnancy cautions: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/215256s024lbl.pdf These drugs can affect your ability to digest other medications: https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/217806Orig1s020lbl.pdf We need more data about the effects of body composition: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183 Warnings about unapproved versions of these medications: https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/fdas-concerns-unapproved-glp-1-drugs-used-weight-loss