Ozempic, Wegovy, Mounjaro, Oh My!

Last updated 02.21.2024 | by Dr. Karen Pike | 4 Minutes Read

This article has been reviewed and fact checked by Dr. Karen Pike, a senior physician administrator and board-certified emergency room doctor actively working in northern California. Read more at our medical disclaimer page.


Weight loss medications have been hitting the prime time. Seems like every celebrity and their mother has been coming out with radical body transformations. Oprah is on it, the Kardashians are on it, and even Elon Musk had a stint on Ozempic. Should we, as women in menopause be taking these drugs? What are the medical side effects and considerations? It is hard to cut through the mire of what is marketing and what is medicine, with this post I will be diving into these blockbuster drugs from a medical professional POV. Let’s explore a few of these medications and discuss how they may be useful for women both in general and specifically concerning menopause.

What Do They Do, and How Do They Work?

All 3 medications are GLP-1 agonists, meaning they are drugs that mimic the natural protein produced by the body, GLP-1, one of the hormones responsible for appetite control and blood sugar regulation, They were initially introduced over 20 years ago for the treatment of diabetes, but are now being used with success with weight loss.

Ozempic and Wegovy are essentially the same drug, semaglutide, which is given by weekly injection. They have been FDA approved for different conditions (Ozempic for diabetes and Wegovy for weight loss). Ozempic is currently being prescribed off-label for weight loss as well. Mounjaro (also an injectable) contains tirzepetide, which binds to both GIP-1 cell receptors as well as a GIP receptors (glucose-dependent insulinotropic polypeptide) to affect appetite and glucose control. There are other medications (both oral and injectable) in the pipeline.

Why Would Doctors Prescribe These Drugs To Patients?

Obesity is a major health problem that increases the risk of type 2 diabetes, high blood pressure, breast cancer, joint pain, and cardiovascular disease. Societal bias around obesity can also result in mental health issues. We now know that obesity is a complex medical condition that is based on genetics, brain and gut hormonal regulation, lifestyle, and nutrition. Research shows that the maintenance of a healthy weight is a delicate metabolic dance. There are many factors involved that are beyond a person’s control. The old adage in weight loss of eating less, and exercising more (the medical advice we learned in training), just isn’t a successful strategy. These medications fill the gap that has been missing in weight loss management.

Who Is Eligible To Receive These Medications?

These medications are NOT indicated to keep someone “Hollywood thin” or to help someone with a healthy BMI drop a few pounds.

For weight loss, there are very strict criteria:

  1. BMI greater than 30 or greater than 27 with specific medical conditions
  2. No contraindications—history of pancreatitis, gallbladder issues, thyroid cancer, stomach emptying issues (gastroparesis)

What Are The Potential Side Effects?

  • Nausea and vomiting (very common, seems to be dose-dependent)
  • Low blood sugar
  • Gastroparesis (poor stomach emptying)
  • Pancreatitis
  • Theoretically, thyroid cancer, but that was only shown in mice
  • Reports of hair loss (but this may also be related to nutrition or other factors).

In my ER practice, rarely see patients coming in with side effects. I know of only ONE patient with pancreatitis (and this was due to the patient inadvertently taking too much of the medication).

Weight Loss Drugs In Menopause

As we well know, menopause often triggers weight gain due to shifts in hormonal balance as well as a potential loss of muscle mass, and a decrease in movement due to age-related health issues. Taking one of these weight loss medications may be appropriate. Importantly these drugs are NOT for a person who just wants to lose 10 lbs to get back into their premenopausal-sized jeans. Using these medications for this type of weight loss is relatively new and has not been rigorously studied. We do not understand the drug safety profile in healthy, normal-weight women looking to drop a few pounds.

Also, at this time, Medicare does not cover these drugs for weight loss (does cover for diabetes), which can restrict access in the menopausal women over 65.

So, if you are thinking about using medications to assist with weight loss, please seek medical consultation. There are risks and benefits to various strategies. Your physician should be able to come up with an individualized plan that is safe and works for you.

Author

  • Dr. Karen Pike

    Dr. Pike is a senior physician administrator and board-certified emergency room doctor actively working in northern California. She received her undergraduate degree at Dartmouth College, where she graduated Phi Beta Kappa and played collegiate soccer. She attended Georgetown University for medical school and performed her residency in emergency medicine at Stanford University. She was part of the first-ever, women-majority emergency medicine program in United States. Dr. Pike is also the primary medical consultant for “Grey’s Anatomy,” a role she has held since the pilot episode when she partnered with Shonda Rhimes as the show’s original medical consultant. At her hospital, she was the second woman Chief of Staff. Today serves as the Director of the Emergency Department. Whether in leadership or direct patient care, her dedication to excellence in communication, quality, and collaboration is unwavering.