Rethinking weight loss in the Ozempic era

In the world of obesity research, the arrival of GLP-1 drugs like Ozempic feels seismic. At a recent conference, Martin Binks, a leader in obesity research, found himself marveling with a colleague: “Can you believe we finally reached this moment, that we lived long enough to see this?”

Touted for their dramatic weight-loss effects, GLP-1s—drugs that regulate appetite and blood sugar—have fueled intense hype and demand. Medications including Ozempic, Mounjaro, and Wegovy have “changed the game for metabolic systems disrupted by obesity,” said Binks, professor and chair of the Department of Nutrition and Food Studies (NFS).

But the medical reality is complex. Raedeh Basiri, NFS assistant professor and dietitian, has seen patients successfully lose weight on GLP-1s then struggle with nutrient deficiencies that impact their energy levels, hormone regulation, and even hair. Rapid weight loss can also lead to muscle loss, especially if patients aren’t eating healthy enough to support lean tissue.

Both Basiri and Binks stress that GLP1s are not a standalone solution, but one piece of the puzzle. They advocate for highly personalized weight-loss strategies—in close consultation with medical professionals—that account for nutrition, physical activity, and often psychological support.

“In a perfect world, these medicines would be dispensed in multidisciplinary clinics, and everybody would get a medical consult, an exercise physiologist consult, and a registered dietitian,” Binks said.

In reality, though, most GLP-1 patients aren’t receiving or even seeking that level of support. “They’re just seeing a physician, getting a prescription, and that’s it,” Basiri said.

And in some cases, people who don’t medically qualify for GLP-1s are still managing to get prescriptions, often through loosely regulated online services.

Meanwhile, others who do meet the criteria and stand to benefit most are shut out by cost, with insurance coverage remaining uneven. “Access to obesity care is essential for all who live with obesity. For those who are economically disadvantaged, these medicines are largely out of reach,” said Binks, who has long advocated for Medicaid and Medicare to cover weight-loss prescriptions.

Binks believes access could expand significantly once GLP-1s are available in pill form, a shift he says is already on the near horizon.

Public buzz may cast GLP-1s as a miracle fix, but Basiri urges a broader view. “Without a holistic, team-based strategy that treats the whole person,” she said, “we’re only solving part of the problem for a small segment of those in need.”

As a registered dietitian and researcher, Basiri says her own field is not sidelined by GLP-1s but called to action. “I think the spotlight on these medications only enhances the role of nutrition and dietary recommendations for people with obesity,” she said.