Dr. Sarah has focused passion for gut health and sustainable weight loss. She believes that true metabolic transformation begins in the digestive system, and she works to uncover root imbalances that impact inflammation, hormones, and body composition. By combining evidence-based strategies with personalized nutrition and lifestyle guidance, Dr. Sarah helps patients restore gut integrity, rebalance metabolism, and achieve lasting, healthy weight loss—without quick fixes or extremes. upstream contributors metabolic stress, immune disregulation, hormonal imbalance, environmental load, and nervous system dysfunction, and developing personalized strategies that restore function and build long-term resilience.
With the mass pharmaceutical marketing and celebrity influencer endorsements the past couple of years, who hasn’t heard of the semaglutide diabetic “weight loss” drugs Ozempic, Wegovy Zepbound, semaglutide, retatrutide and terzepitide. These medications have quickly become household names, but the conversation around them is often much more promotional than practical.
What many people don’t realize is that GLP medications didn’t just suddenly appear. The story actually goes back nearly two decades to the discovery of glucagon-like peptide-1 (GLP-1), a gut-derived hormone that helps regulate blood sugar, insulin release, and appetite. The first GLP-1 medication was approved in 2005 for type 2 diabetes. Years later, in 2014, the first version approved specifically for weight loss came to market, but adoption remained limited because the results were modest. Everything changed in 2021 when semaglutide (Wegovy) was approved for weight loss and demonstrated something we hadn’t really seen before—double-digit weight loss approaching 15% on average. Then in 2023, tirzepatide pushed that even further, with studies showing 20%+ weight loss in some patients. That jump in effectiveness is what shifted GLP-1s from “diabetes medications” to mainstream weight-loss solutions—and why adoption has exploded over the past few years.
But have you also heard about reported side effects including “Ozempic Face and Butt”? This is often attributed to the fact that not all weight loss is fat. Studies suggest that lean mass can account for roughly 25–40% of total weight loss (bone and muscle) depending on the individual and how the process is managed. With rapid weight loss, especially without adequate protein intake or resistance training, you can lose metabolically valuable muscle along with fat.
New research also shows that after discontinuing these medications, a significant portion of the weight is regained. In fact, data suggests that about two-thirds of the weight lost can return within a year, often with a shift toward higher fat mass relative to lean mass. Meaning, body composition can move in the wrong direction over time if there isn’t a strong long-term plan in place, leading to worsening cardiometabolic function such as hypertension, hyperlipidemia, and diabetes. Essentially, you may keep about 25% of your weight loss but put yourself in a more concerning overall health position.
To be fair, these medications can be very effective when used appropriately. They were originally designed for type 2 diabetes and can also help curb obesity. They work by helping your pancreas produce more insulin when blood sugar is elevated, preventing your liver from making and releasing too much sugar, slowing down how quickly food leaves your stomach, and helping regulate appetite and satiety. Tirzepatide takes this a step further by also activating GIP receptors, enhancing metabolic signaling.
I’ve been around long enough to remember previous weight loss drugs: the original Dexatrim (pulled from the market due to hemorrhagic stroke risk), Ephedra (pulled due to heart attacks and seizures), Fen-Phen (pulled due to heart damage), Olestra (pulled due to… “anal leakage” 
), and the current diet drug Phentermine/Adipex, which is essentially an amphetamine-like stimulant.
Current estimates suggest that millions of Americans are now using GLP-1 medications, with surveys indicating roughly 1 in 8 adults have used one. A growing number of lawsuits have also been filed against manufacturers over reported side effects.
Common side effects include nausea, vomiting, diarrhea, abdominal pain, and constipation. More rare but serious side effects include pancreatitis, gallbladder disease, kidney issues, hypoglycemia, allergic reactions, and a potential thyroid tumor risk based on animal data.
Many users have also anecdotally reported hair loss. In many cases, this appears to be related more to rapid weight loss and nutritional deficiencies than a direct effect of the medication itself. This is why adequate protein intake and a quality multivitamin, including B vitamins, can be important to support overall physiology during weight loss.
While these drugs may be an effective short-term option to help reverse diabetes and kick-start weight loss for some higher-risk individuals, there is a clear benefit-risk analysis that must be made. It is so important to understand what is being injected into your body and the potential long-term implications.
Per the manufacturers, these medications are designed to be used alongside dietary changes and exercise. As we share with our patients, there are so many different short-term diet fads, shots, supplements, shakes, powders, and pills that can help you lose some weight… then what?
We operate in the space of “then what.”
Our weight loss program is designed to focus on dense nutrition within a safe lower-calorie framework to create a new pattern of eating for a lifetime. Not only do our patients most commonly lose between 25–40 pounds in about 16 weeks (while learning how to keep it off with an individualized approach), we often see post-lab work show significant improvements in blood sugar and cholesterol and regularly see patients reduce or eliminate the need for blood pressure, cholesterol, and diabetic medications.
This week, one of our patients celebrated a major win. After trying so many “diets” over the years, by focusing on delicious anti-inflammatory whole food meals, she has lost 12 pounds and 25 inches. A side benefit is that her entire family has enjoyed the same meals, and her supportive husband has lost 6 pounds in just the past two weeks.
That’s the kind of result that matters most—not just weight loss, but sustainable change, improved health, and a plan that still works long after the hype fades.
1. Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183
2. Rubino D, Abrahamsson N, Davies M, et al. Effect of continued weekly subcutaneous semaglutide vs placebo on weight maintenance in adults with overweight or obesity (STEP 4). JAMA. 2021;325(14):1414-1425. doi:10.1001/jama.2021.3224
3. Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: the STEP 1 trial extension. Diabetes Obes Metab. 2022;24(8):1553-1564. doi:10.1111/dom.14725
4. Wadden TA, Bailey TS, Billings LK, et al. Effect of subcutaneous semaglutide on body composition in adults with overweight or obesity: STEP 1 substudy. Obesity (Silver Spring). 2021;29(11):1749-1758. doi:10.1002/oby.23293
5. Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216. doi:10.1056/NEJMoa2206038
6. Novo Nordisk Inc. Ozempic (semaglutide) injection prescribing information. Revised 2025. Accessed April 2026. https://www.accessdata.fda.gov
7. Novo Nordisk Inc. Wegovy (semaglutide) injection prescribing information. Revised 2025. Accessed April 2026. https://www.accessdata.fda.gov
8. Eli Lilly and Company. Mounjaro (tirzepatide) injection prescribing information. Revised 2025. Accessed April 2026. https://www.accessdata.fda.gov
9. Eli Lilly and Company. Zepbound (tirzepatide) injection prescribing information. Revised 2025. Accessed April 2026. https://pi.lilly.com
10. American Diabetes Association Professional Practice Committee. 9. Pharmacologic approaches to glycemic treatment: Standards of Care in Diabetes—2024. Diabetes Care. 2024;47(Suppl 1):S158-S178. doi:10.2337/dc24-S009
11. Kushner RF, Kahan S. Introduction: the state of obesity in 2023. Med Clin North Am. 2023;107(1):1-11. doi:10.1016/j.mcna.2022.09.001
12. KFF (Kaiser Family Foundation). 1 in 8 adults say they’ve taken a GLP-1 drug. Published 2024. Accessed April 2026. https://www.kff.org