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A recent poll of over 1,000 adults revealed that one in four surveyed said they would consider using an injectable weight loss drug without consulting their doctor.
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GLP-1 medications—like Ozempic, Wegovy, and Zepbound—can help you shed pounds, but only if taken properly.
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Obesity medicine professionals identified six common mistakes people make on weight loss drugs—even if obtained with a prescription.
Weight loss drugs like Ozempic have surged in popularity in recent years, and research shows they may help with everything from the heart to the kidneys. But if they aren’t obtained or taken properly, their effects may be limited—or even dangerous.
One trend has medical professionals particularly worried. A poll conducted on behalf of the Ohio State Wexner Medical Center found that of 1,006 adults surveyed, about a quarter said they would consider using an injectable weight loss drug without consulting their doctor.
People interested in these drugs can bypass a consultation with a doctor by buying the medications from online pharmacies, which a recent study found often don’t require a prescription. However, taking these products can be risky. The same study found that many online pharmacies selling semaglutide, the active ingredient in the popular drugs Ozempic and Wegovy, lack a valid license and offer products containing unsafe dosages or ingredients.
Christopher McGowan, MD, a gastroenterologist and obesity medicine specialist, told Health that even if you do receive a drug that contains semaglutide or tirzepatide, the active ingredient in Zepbound and Mounjaro, it would be a major mistake not to consult a doctor before taking it. “Semaglutide and tirzepatide are potent, injectable medications that should not be used without medical supervision,” he said, adding that they can cause serious side effects like severe nausea and vomiting, dehydration, intestinal obstruction, and gallbladder disease.
While turning to non-prescription weight loss medications is a significant concern, it’s not the only misstep people make when it comes to weight management drugs, which belong to a class of drugs known as GLP-1s. Here are six others, according to obesity medicine professionals.
Skipping Doses
Some medications can be taken as needed—but GLP-1s aren’t one of them. “Some people think missing a dose here and there is harmless, but consistency is key with medications like semaglutide to maintain its effectiveness,” Michael Snyder, PhD, medical director of the Bariatric Surgery Center at Rose Medical Center and in-house obesity specialist at personalized weight care company FuturHealth, told Health. “All of the results that you are looking for are based on very regimented dosing instructions.”
Snyder suggests setting reminders or using a medication organizer to avoid missed doses. “Staying consistent helps ensure that the medication works as intended, leading to better outcomes,” he said.
Not Eating Enough Protein
Even when not taking prescription GLP-1s, getting enough protein can be a game-changer for weight loss because it builds muscle and is the most satiating of the three macronutrients.
But when someone takes a weight loss medication, protein becomes even more important. “It’s critical to eat enough protein to maintain skeletal muscle,” said Elizabeth Sharp, MD, a board-certified internal medicine physician and CEO of Health Meets Wellness. “If you lose weight but lose too much muscle, you can actually end up with a higher body fat percentage after weight loss.”
A 2024 systematic review supports this, finding that semaglutide was highly effective at lowering body weight but also caused noteworthy decreases in lean body mass, which includes everything except fat.
Semaglutide and tirzepatide slow down stomach emptying, making people feel fuller faster, and for longer. But even if you don’t feel very hungry on a GLP-1, try to build your meals and snacks around a plant- or animal-based protein source. “I tell my patients to prioritize protein first, and if they aren’t hungry at all, to turn to easy-to-consume and dense proteins, like protein shakes and cottage cheese,” obesity medicine physician Alexandra Sowa, MD, founder of GLP-1 support system SoWell, told Health.
Related: Ozempic vs. Mounjaro: Head-to-Head Study Shows Weight Loss Winner
Not Eating Enough Fiber
Fiber is another nutrient you won’t want to skimp on while taking GLP-1s. “A common mistake is not consuming enough fiber to help prevent constipation, a common side effect of semaglutide,” registered dietitian Su-Nui Escobar, DCN, RDN, told Health.
Escobar acknowledged that getting enough fiber can be challenging when your appetite is low. Still, she encourages making high-fiber choices when possible. “Foods like beans, lentils, and smoothies can provide fiber without significantly increasing meal volume.”
Not Exercising
Going on weight loss medication doesn’t mean exercise should fall by the wayside. In fact, you may want to work out more while on these medications to combat muscle loss. “Exercise is critical to preserving muscle mass and metabolism,” McGowan said. “The goal isn’t to drop as rapidly as possible. We want to lose fat, not muscle, and exercise will ensure this.”
While a combination of cardiovascular and weight-bearing exercise is ideal, both McGowan and Sowa recommend a more significant focus on strength training. “It is important to build up your muscles as you lose weight for general health, functionality, and long-term metabolic gains,” Sowa said.
Stopping Too Early
When getting on weight loss medications, McGowan said it’s critical to know that they’re not a temporary “kick-start” to a weight loss journey. “Anyone starting a GLP-1 medication for weight loss should plan to stay on it indefinitely. These are not designed for short-term use, and patients need to understand that weight regain is guaranteed after stopping the medication,” he said.
If you do stop taking the meds, expect to have some challenges. “Rebound hunger” may increase your appetite for months after discontinuing GLP-1s, McGowan explained. And weight is near-guaranteed to come back on. “Many patients are rapidly regaining the weight that they lost, plus more.”
Finally, don’t expect the drugs to change the root causes of excess weight. “Some of the most important work I do with patients isn’t with nutrition or fitness, but with their brain,” Sowa said. “I ask people to examine their habits and to use the medications to create new experiences with food, alcohol, and relaxation.”
She encouraged looking within—via journaling or other reflective practices—to understand your core beliefs about food. “Identifying these belief tendencies is the first way to rewire [your] thoughts.”
Skipping Meals
While on GLP-1s, it’s likely you won’t feel very hungry—so do you really have to eat? “Skipping meals is a big mistake,” Escobar said. Avoiding regular food intake may lead to low nutrient levels, she explained. Or, if you pile all your daily calories into a single too-large meal, you could have unpleasant gastrointestinal side effects.
There’s another downside you might experience, too. “For some patients, it may seem thrilling to not have to eat at all, but this approach will backfire through both a lowered basal metabolic rate (BMR) and disproportionate muscle-to-fat loss,” said Sowa.
“Make sure to eat at least two meals a day and one snack a day,” Escobar advised. “I often suggest trying foods that are easy to eat during low-appetite days, such as high-protein smoothies or mini-meals.” Eating at regularly scheduled times could also help keep you on track with your intake.
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