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The meteoric rise of GLP – one receptor agonist medication, including Wegovy® and ZepboundTM for weight loss and Ozempic in Mounjaro for diabetes, is visible just about everywhere. Throughout 2023 and now 2024, there isn’t a week that goes by when weight loss drugs are not discussed. It seems that just about every drug manufacturer is trying to find the newest, safest, and most effective weight loss option, and you likely know one or several people who are actively taking these drugs either for legitimate health concerns or purely to look better. While there is some stigma associated with weight loss medications, it has started a conversation that we’ve all needed. And before you discount the value of these GLP-1 medications, I implore you to think about the consequences of living with obesity – and the often debilitating physical and psychological ailments that go with it.
Let’s Dive Into GLP-1s a Little Further
GLP-1 receptor agonist medication comes in pill and injectable form (though the injections are far more effective). Typically, patients are started on a low introductory dose that allows their bodies to get used to it. Patients may feel some reduction and hunger during this low-dose phase, but typically, there is no noticeable change over the first month or so. At this point, patients usually step up their dose until they begin to lose some weight. Usually, patients feel fewer hunger pangs and consequently eat far less. In doing so, they lose weight, but they also lose muscle and bone mass, which is problematic in middle age and older. As such, I strongly counsel my patients to eat plenty of high-quality protein, like chicken, fish, and shellfish, or soy, beans, and legumes if they’re vegetarian, to ensure they experience as little muscle wasting as possible. Resistance training, such as body weight exercises or weightlifting, is also important here.
Of course, the other big concern about GLP medication is the side effects. Most side effects are relatively mild and may include nausea, vomiting, and upset stomach. However, there is the possibility for more significant side effects, including gallbladder concerns, pancreatitis, and gastric motility issues that necessitate stopping the medication. As with any drug I prescribe, I expect my patients to report back and ensure that they are tolerating it well with good effect. While we are still in the early days of the GLP-1s for weight loss (and we don’t know the longer-term effects of higher doses), it’s heartening to know that patients have been taking these medications, albeit at a relatively lower dose, for many years to treat diabetes, and they have been well tolerated.
When I Prescribe GLP-1 Medications
As we’ve talked about in other articles around the Aayla website, it’s essential to understand that excess weight and obesity have significant ramifications beyond the well-known obesity-related diseases like type-2 diabetes, high blood pressure, high cholesterol, and even sleep apnea. Sexual wellness is an essential component of mental and physical health and is affected by one’s weight. Patients with an active and fulfilling sex life often find their mental health improving, which can also positively influence their physical health. On the flip side, patients who are not sexually fulfilled can usually feel depressed, suffer from low self-esteem, gain weight, and suffer from a host of follow-on effects. Seeing a vicious cycle, anyone?
To that end, before suggesting GLP-1 medication or any of the surgical or non-surgical vaginal rejuvenation and labiaplasty options that we offer here at Aayla, we have a candid discussion about mental and physical health to understand the options available and how a patient can benefit from each. Ultimately, my goal is to offer the very best for my patients, with shared decision-making and a thorough review of the options.
So, Does a GLP-1 Injection Make Sense For You?
When determining why a patient needs a GLP-one weight loss drug, we must consider the lifestyle impediments and obesity-related concerns that the patient is experiencing. Of course, we all want to lose weight and look great, but ultimately, we’re trying to reduce the risk of conditions and diseases that come with excess weight.
To that end, if exercise has consistently failed and structured medically supervised weight loss programs have not been successful, a GLP–1 regimen may be appropriate. On the other hand, if you are only looking to lose a few pounds and are otherwise very healthy, we can discuss other concerns that may preclude that last bit of weight loss, including hormone replacement.
Regardless, GLP–1 medication can be a great way to improve hormonal balance and libido and reduce the risk of heart disease, cancer, and, ultimately, early death in certain patients.
What About My Intimate Health?
Weight loss, when necessary, is critical to overall health, including sexual health. However, in patients who lose a significant amount of weight rapidly, as many do when using GLP-1 weight loss medication, the intimate areas can be affected aesthetically. First, we can’t control how the fat stores in and around the labia will be affected by the weight loss. But we do know that after significant weight loss, the labia majora and minora may take on a more deflated look, which patients may wish to reverse and can often do so with a labial puff or reduce the appearance of excess labial skin with a labiaplasty. The most important next step is seeking help by scheduling a consultation with a cosmetic gynecologist like me who has experience in women’s urologic and sexual wellness concerns. This is a significant step in ensuring proper care for our overlooked and often untreated concerns.
