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ASK THE DOC
Weight Loss Medications: A Good Fit for Older Adults?
GLP-1 medications such as Ozempic and Wegovy, and GLP-1/GIP medications like Mounjaro and Zepbound are changing how physicians think about weight loss, diabetes and chronic disease prevention.
For many older adults, these medications may offer other meaningful advantages, too. We spoke with Dr. James Saul, internist at MetroHealth, about their risks and benefits.
Who is an ideal candidate for these medications among older adults?
Dr. Saul: GLP-1 is best suited for people who are fairly active and able to stick with a consistent, healthy routine.
What potential benefits do older adults experience beyond weight loss?
Dr. Saul: GLP-1 medications have been shown to lower the risk of major cardiovascular events like heart attacks and strokes, and even reduce the risk of death from these conditions. They can also help protect kidney function in people with kidney disease.
In addition, there’s growing evidence that they may help with conditions such as sleep apnea and Metabolic Associated Steatotic Liver Disease (MASLD), formerly known as fatty liver disease.
Are GLP-1 medications safe for older adults?
Dr. Saul: Overall, these medications are considered safe, but they can cause side effects like bloating, nausea, vomiting, abdominal pain, constipation or diarrhea, and sometimes worsening acid reflux.
One important consideration for older adults is the possible loss of muscle mass and strength, known as sarcopenia. This risk is higher in people who are more sedentary and those who are not getting enough protein in their diet.
What are the biggest concerns older patients should consider before starting treatment?
Dr. Saul: There are a few key things to think about. One is whether someone already struggles with issues like chronic constipation, diarrhea or significant acid reflux, since these can sometimes get worse with treatment. Another is activity level. Staying physically active helps reduce the risk of muscle loss.
Insurance coverage is also a major practical consideration. Many of these medications aren’t well covered unless there’s another condition present, such as diabetes, sleep apnea or knee arthritis.
What questions should patients ask their doctors before considering a GLP-1 medication?
Dr. Saul: First, they should ask whether they are a safe candidate for these medications. They should also have a detailed conversation about the side effects they might experience.
