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GLP-1 drugs like Ozempic, Wegovy, and Mounjaro can pose greater risks for people over 65 and older. vorDa/Getty Images
  • GLP-1 drugs like Ozempic have become quite popular, especially as weight-loss aids.
  • However, they can cause a number of side effects.
  • People over 65 tend to be more prone to drug side effects in general.
  • Experts say, with proper supervision, these drugs are “truly remarkable” in this population.

GLP-1 drugs include the various brands of semaglutide (Ozempic, Rybelsus, Wegovy) as well as dulaglutide (Trulicity), exenatide (Bydureon, Byetta), liraglutide (Victoza, Saxenda), lixisenatide (Adlyxin), and tirzepatide (Mounjaro).

These medications, which are generally given via injection, work by mimicking glucagon-like peptide 1, which triggers the pancreas to make more insulin after meals, lowering blood sugar in people with Type 2 diabetes.

Ozempic and other GLP-1 drugs have also become increasingly popular for weight loss, thanks to endorsements from celebrities like Dolores Catania and Charles Barkley.

One thing that isn’t clearly understood, however, is how these medications might affect adults ages 65 and up who are using them long-term.

Clinical trials for these medications have not included large numbers of older adults so the data is simply not available, according to reporting done by The Washington Post.

The National Institute on Aging notes, however, that older adults tend to be using multiple medications while also having multiple medical conditions, which puts them at greater risk for drug side effects.

Dr. Dina Peralta-Reich, MD, FAAP, FOMA, and Director of New York Weight Wellness Medicine said that the gastrointestinal side effects of these medications, like nausea and vomiting, may be worse in older people, which “may set them up for dehydration, weakness, or nutritional deficiencies.”

“Monitoring water intake can be challenging, and it is crucial to avoid dehydration, which may result in dizziness, falls, fainting, and possibly fractures,” she said.

Additionally, Peralta-Reich pointed out that GLP-1 drugs can trigger rapid weight loss, which can lead to muscle loss. This is one of the many reasons she says anyone using these medications should be supervised by a specialist.

“As an obesity medicine specialist, our primary objective is to ensure successful weight loss while also safeguarding against the loss of muscle mass,” she explained.

Jill Barat, Pharm.D., a licensed pharmacist with Pharmedico Pharmacy, added, “Muscle loss isn’t a good thing for anyone, but this can be especially dangerous for older people as it may put them at higher risk of falls which can lead to broken bones.”

According to research, resistance training can help mitigate the loss of muscle mas in older adults that occurs durring calorie restriction.

Eating between 25-30 grams of protein per meal can also help maximize muscle preserfations during active weight loss.

Peralta-Reich suggests that close monitoring is important for older patients — especially if they have other health conditions, such as high blood pressure, diabetes, and hormonal deficiencies — since dosage may change over the course of treatment.

As a person’s weight drops, their dosage must also be adjusted accordingly so that it is not too much for their current body size.

Peralta-Reich commented that she feels these drugs are “truly remarkable,” provided the patient has oversight from a board-certified obesity medicine specialist.

“Regardless of age, the risks associated with being overweight or obese remain significant,” she said. “By effectively reducing body fat percentage and visceral fat, people can substantially lower the chances of developing other comorbidities.”

Dr. Michael Russo, a Bariatric Surgeon at Smart Dimensions in Orange County, California, cautioned, however, that drugs like Ozempic are not a quick fix.

“This medication needs to be coupled with lifestyle changes in order to not only get the best results but to minimize the chance of weight regain in the future,” he advised.

As a word of encouragement, Peralta-Reich noted that the age of 65 is no longer considered to be old. “[I]t presents an excellent opportunity to take charge of one’s health and weight in a safe and effective manner,” she said.

“Embracing a healthier lifestyle can lead to positive outcomes at any age!”

It should be noted, however, that drugs like Ozempic are not always available to patients due to their expense and the fact that many insurance companies are not opting to cover them, especially for weight loss.

When it comes to the management of Type 2 diabetes, Dr. Kezia Joy, Medical Content Advisor for Welzo, said there are several alternatives to the GLP-1 drugs, including:

However, she said, “Lifestyle modifications, including a healthy diet, regular physical activity, and weight management, remain the cornerstone of diabetes management at any age.”

Russo added, that when it comes to weight loss, “people need to know that there’s an assortment of different medication options available, endoscopic procedures, and also extremely safe weight-loss surgery options that people can consider.”

GLP-1 drugs like Ozempic have become quite popular, especially as weight-loss aids. However, they can cause people to experience a range of side effects.

Not much is known about their side effects in older people. However, people over 65 tend to be more prone to drug side effects in general.

Experts say, with proper supervision, these drugs are “truly remarkable” in this population.