Part 2: What are the common side effects of these medications?

The Risks and Concerns About Using GLP-1 Agonists for Weight Loss

Potential Side Effects While Using Them:

While Ozempic (and others) have undoubtedly been effective for many people, there are notable risks. Like any medication, there are potential side effects and you have to weigh the pros and cons. However, the GLP-1 medications have some pretty intense side effects. The most common side effects include nausea, vomiting, and diarrhea, which can subside as the body adjusts to the medication but some people report each time they take an injection there are miserable days they just try and endure. People also report feeling extremely lethargic, fainting episodes, gas and belching and a general feeling of malaise. More severe side effects include pancreatitis (inflammation of the pancreas), gallbladder issues, and potential interactions with other medications. Again, side effects from medication are always a consideration and the effects vary widely. 

The ‘Ozempic Rebound’ Effect:

A big concern for most people is the dreaded ‘Ozempic Rebound’ effect. In a recent study, researchers found that most users regain two-thirds of the weight they lost within 6 to 12 months after stopping the drug​.

This happens because GLP-1 medications help suppress appetite and slow digestion while in use, but once stopped, the body returns to its pre-medication state—leading to a rapid return of hunger and a slower metabolism due to weight loss. Unfortunately, this often leads to feeling out of control around food as hunger and cravings increase and food noise returns. 

Harm to our natural GLP-1 pathway?

Some studies are looking at the possibility these medications could negatively impact our natural GLP-1 pathway. We see this with other medications. If the body learns to rely on an exogenous source, it could potentially stop producing it on its own, therefore when you go off the drugs it could potentially make the problem worse than when you started. 

Weight regain is not a new phenomenon for anyone with a complicated history with their weight. For me, the concern is around how this type of rebound effect leads to learned helplessness, a mental state in which a person gets conditioned to believe they can’t control or change a situation, so they stop trying even when opportunities for change are available. This is common for people who have repeatedly tried something without success, often leading to worsening depression and anxiety. 

Some doctors are trying to reduce the negative effects of this by titrating off the medications (giving a lower dose for a period of time to help ease the transition), but ultimately it boils down to this; the drug's effects only work if you’re taking them. Your natural response might be, “well, I’ll just take them for the rest of my life, then!” Before you decide to go that route there are a couple of other things you should take into consideration. 

Unknown Long-Term Impact:

Another concerning aspect of these medications is that we don’t know the long-term effects of taking them. While these drugs have been on the market quite a while for the treatment of Type 2 diabetes, they are a fairly new medication for the purposes of weight loss alone and for those just looking to lose a few pounds. If the drugs only work while taking them, we can confidently predict that people will take them off and on for long periods of time, or perhaps continuously for years on end. 

Our medical system has long made the mistake of treating the human body as a silo, each system independent of one another. And these drugs seem to be no different. I don’t have the scientific evidence to prove it (yet), but as I look at the extreme side effects many people experience (nausea, fainting, pancreatitis, dampening reward systems, gas, etc.) it’s clear to me that the drugs are fighting the natural order of how our bodies function and I have major concerns for how this will impact us in ways we don’t yet see.

The human body is an intricate and complex organism. Think about the incredible things it does with such precision and efficiency. It regulates our body temperature to a precise degree, it regulates our breathing and heart rate with precision and accuracy, all outside our conscious awareness. It seems irresponsible to assume that if we pull one level over here, it would not impact another lever over there. For example, when your body detects a foreign bacteria it mounts an immune response to increase body temperature that kills the bacteria and brings the body back to homeostasis - that’s one side of the lever. The other side is that we experience a fever, lethargy, muscles aches and more - that’s the other side of the lever. 

How can we think that manipulating our GLP or GIP production in such drastic ways would not have a downstream impact somewhere else? My concern is that we don’t know where that somewhere else is…..yet. 

Mental Health Side Effects: Anecdotal Reports and Emerging Studies

Initial reports of mental health side effects are starting to emerge. Though these side effects are not officially listed on the drug's label, anecdotal evidence is building around depression, anxiety, and suicidal thoughts among users. For example, in 2023, the European Medicines Agency began investigating over 150 reports of suicidal ideation and other psychiatric symptoms linked to GLP-1 receptor agonists, including Ozempic and Wegovy. Additionally, the FDA's adverse event reporting system received 489 reports of patients experiencing mental health issues, including depression and anxiety, while on semaglutide (Ozempic's active ingredient). 

Some experts caution that a clear causal link has not yet been established between the medication and these mental health issues, but in my view whether it’s causation or correlation doesn’t really matter. Whether the drugs CAUSE mental health issues, or just exacerbate what is already there by stripping away a coping strategy is irrelevant. The impact is the same, worsening mental health issues for many.  

Let’s explore this. 

My clients have started to report this very thing. “I just didn’t feel like myself”, a client told me. “I can’t explain it. I was losing weight, and that was great, but at the same time I just didn’t feel good. I felt listless, and apathetic”. 

Increasingly, I am hearing from people who feel mentally and emotionally WORSE, even as their waistlines are shrinking - something some of them have wanted for decades. 

I have a couple theories as to why this is happening. After studying the brain and the nervous system for over 20 years, it’s clear to me that we can’t address our weight in a vacuum. When we try to control one area, we have to look at the impact on another area. Let’s explore further. 

Impact on the Brain’s Reward System:

GLP-1 receptor agonists, like Ozempic, interact with the brain’s reward system, which regulates appetite and pleasure. By suppressing appetite and reducing cravings, these drugs alter the brain's normal reward responses to food. However, this modification may come with unintended consequences. Some users report experiencing anhedonia (a lack of pleasure in previously enjoyable activities), as their brain's normal pathways for reward and satisfaction are disrupted. Not ironically, we’ve seen what happens when we disrupt our natural reward systems before. It’s reminiscent of how ultra-processed foods manipulate the brain’s reward system, leading to excessive consumption and negative long-term effects​. Have we not learned our lesson that disrupting our reward system creates consequences?

Addressing the Root Causes of Weight Gain:

My second theory gets to the heart of my biggest concern with these medications. If we never address how we gained weight to begin with, those root causes get transferred to something else - in this case increased anxiety, depression, agitation, listlessness and more. We have pulled one lever (we’ve lost the weight), but that means there is an equal and opposite reaction on the other side until the levers are balanced again (why did we gain it to begin with?).  

The body will continue to send the cues and signals it wants to send, in whatever form it needs to send them until it communicates what it wants you to know. This can take the form of anxiety, depressed mood, a general feeling of malaise or like “something is just off”. It can also take the form of chronic pain, autoimmune issues, digestive issues and more. When we don’t learn to tune into our bodies' cues, it finds a different way to communicate. Overeating was a cue, weight was a symptom, a signal that we needed to pay attention. If we block that signal and override it with medication, it doesn’t stop the signal - it just redirects it. 

For millions of people who struggle with weight, food was wired in as a coping strategy to deal with life’s circumstances. Binge eating, stress eating, compulsive overeating, eating until stuffed, eating while numbing out - are all patterns of eating that have a significant psychological root. Weight loss medications may make you lose your appetite and cravings for food, but they won’t touch the underlying root causes of why you turned to food to soothe. For many, this means coming face to face with deep-seated triggers they’d been using food to avoid facing. 

You might then ask, is it possible to take weight loss drugs, lose weight, keep it off AND be happy? 

The short answer is YES! But there are crucial pieces of this puzzle that have to be addressed. 

While GLP-1 receptor agonists have revolutionized the way we approach weight loss and diabetes management, their impact goes far beyond a number on the scale. These medications offer undeniable benefits for many, but they come with complex trade-offs—physical, emotional, and even psychological—that deserve thoughtful consideration.

The weight-loss journey is never just about weight; it’s about untangling the deeper threads that connect food, emotions, and coping mechanisms. These drugs may quiet the appetite and curb cravings, but they don’t silence the underlying signals our bodies and minds are sending. Ignoring these signals—or overriding them with medication—can lead to unintended consequences, whether it’s a resurgence of old symptoms or the emergence of new ones. The levers of health are interconnected, and when we pull one without understanding the others, we risk upsetting the delicate balance our bodies work so hard to maintain.

Ultimately, success with these medications isn’t about taking a magic pill—it’s about addressing the root causes of weight gain, and creating sustainable habits that honor both your physical and mental health. 

Stay tuned for part 3 of this series where I will discuss the benefits of using these medications! In case you missed it, here is a link to part 1 of this series. 

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