THE PROMISES & PERILS OF GLP-1 DRUGS ACROSS A LIFESPAN

GLP-1 medications such as Ozempic, Wegovy, Mounjaro, and Zepbound have changed the treatment of obesity and Type 2 diabetes. Today, about 29 million American adults use a GLP-1 medication, and prescriptions for children and teens have increased by 700%.

As use of these drugs continues to grow, important questions remain. How long should people stay on them? What happens when treatment ends? What are the long-term effects on growing children or on aging muscles and bones? And who can afford and access these expensive medications?

Speakers at a July 24th briefing hosted by American Community Media examined the public health impact of GLP-1 medications and the questions they raise as they reshape the treatment of obesity and chronic disease in the United States.

GLP Drugs & Weight Loss

“Individuals for whom weight loss might help improve their health or quality of life, achieving that via lifestyle change, as in diet and exercise, is quite difficult,” said Dr. Jena Shaw Tronieri, an investigator at the Center for Weight and Eating Disorders in the Department of Psychiatry at the University of Pennsylvania.

GLP-1 medications lead to greater weight loss than diet and exercise alone, said Tronieri, explaining that losing weight through lifestyle changes requires people to consistently eat less, even though “your body’s biology is not designed to help you with weight loss.”

Instead, she said, the body is “much better equipped to help prevent starvation,” making sustained weight loss through diet and exercise alone especially challenging.

Tronieri said GLP-1 medications help make weight loss easier by changing the body’s hunger signals, reducing the effort it takes to eat less. Many patients, she said, notice they eat smaller portions, snack less often, and find that “food is still enjoyable, it’s just not on their mind quite as much.”

She also emphasized that changes in eating habits have the greatest impact on weight loss. While physical activity is important, she said, “weight loss does tend to be greater with eating changes than with physical activity, or with both combined.”

The most common side effects of GLP-1 medications for people with and without diabetes are gastrointestinal, including nausea, vomiting, constipation, and diarrhea, said Tronieri. Symptoms are usually strongest during the early weeks of treatment, and people with diabetes may also face known retinal risks; “If someone has a very bad reaction to how they’re feeling,” she said, “I would never want them to continue it.”

“There’s variability in responses,” she said. “These are not medications that would be suitable for everyone.” Some health conditions make these drugs inappropriate, she cautioned. “I don’t want to give the impression that anyone should use them for weight loss.”

Black Women & Access to GLP-1 Drugs

Dr. Fatima Cody Stanford, Associate Professor of Medicine and Pediatrics, Harvard Medical School, discussed the history of obesity among Black women in the United States and the persistent inequities in access to GLP-1 medications. Decades of research show that sustained exposure to stress alters how the body stores fat and regulates appetite.

She argued that today’s disparities in obesity rates among Black women are rooted not in modern diets alone, but in the lasting effects of slavery, chronic stress, and generations of unequal access to education, healthy food, and healthcare. The high prevalence of obesity among Black women is “a predictable outcome of nearly two centuries of accumulated stress physiology, economic exclusion, and a healthcare system that was not designed with Black women’s health in mind.”

Even well-intentioned programs can reinforce these gaps, she warned, if inequities in access to GLP-1 medications are not built into their design, Stanford said. “This is why access to modern treatments matters so much.”

The Medicare GLP-1 Bridge program, launched on July 1, 2026, and scheduled to end on December 31, 2027, allows eligible Medicare beneficiaries to access one of three GLP-1 medications. However, a disproportionate share of black Americans live in states that have historically been slower to expand Medicaid benefits, and could make medications cost-prohibitive to the patients that are most likely to benefit. The program also requires prior authorization, she noted, warning that disparities can quietly re-enter the picture. “It’s a bridge, not a permanent fix.”

Children & GLP-1 Medication

Dr. Dan Cooper, Professor Emeritus of Pediatrics at UC Irvine, discussed the unique challenges of using GLP-1 medications during childhood and adolescence, when bones and muscles are developing rapidly. “We know from studies that when this process is interfered with, the long-term consequences can be quite severe,” he said. He added that reduced bone mineralization between ages 10 and 25 can increase the risk of osteoporosis decades later.

He acknowledged the difficult reality of treating severe childhood obesity. “I see kids who are 12 years old weighing 300 pounds.” Medication may sometimes be necessary, he added, calling for more investment in prevention, including better opportunities for physical activity, especially in lower-income communities.

Cooper described GLP-1s as “behavioral medications” and cautioned that their long-term effects in children are still unknown. “We have to be very careful in using them,” he said. “We certainly cannot use them without intensive lifestyle interventions.”

Jasmyne Cannick, an award-winning journalist, shared her experience using GLP-1 medications for weight loss. At 5 feet 6 inches tall, she weighed 250 pounds two years ago and joined Kaiser’s medical weight-loss program after nearing a diabetes diagnosis. Wanting to avoid bariatric surgery, she started Ozempic and lost 30 to 40 pounds before her weight loss plateaued. After being hospitalized with dehydration, she realized she had not been adequately informed about the importance of fiber and water intake. She switched to Zepbound in early 2026 and now weighs 185 pounds.

“I didn’t want to end up like some of my relatives with amputations,” Cannick said. “It was always about being healthy for me.”

She said the medication helped lower her A1C and resolved her sleep apnea, but she remains concerned about side effects, long-term use, and cost. Her monthly out-of-pocket expense for Ozempic rose from $25 to nearly $800. “I don’t feel like there’s enough information out there for us to know all the pros and the cons of GLP-1s,” she said. “I don’t want it to be a lifetime commitment for my wallet.”

Cannick continues to focus on healthier eating while taking Zepbound and is considering a maintenance dose once she reaches her goal weight. “I’m paying attention to what healthcare providers are covering, but also keeping myself in check about how I want to be and how I want to live,” she said.

Responding to her story, Stanford said most patients require long-term treatment. “If you withdraw these medications, weight gain ensues in approximately 90% of patients,” she said, adding that lifestyle changes, including strength training, remain essential. Stanford also urged a more compassionate approach to obesity care: “We need to treat patients with obesity with kindness, dignity, and respect.”

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2026-08-05T15:04:26Z