Patients evaluate GLP-1 drugs in a revealing article published online today in JAMA Open Network (See here). Thirty U.S. patients weighed in on what they experienced while taking one of the popular weight loss drugs. The study was performed by researchers from Stanford University and the University of Oxford.

The experiences of these patients will interest anyone curious about GLP-1 drugs, so here we’ll focus not on the clinical data but on what the patients themselves had to say. Further information on the drugs is available from a couple of my earlier posts (See here and here).

Not surprisingly, the patients talked about what the researchers called food noise, psychological hunger, or appetite. They also talked about lifestyle changes they had made, side effects of the drugs, the possible stigma of taking these amazing medications, and even whether their doctors had properly informed them about what to expect. Some of the quotes follow:

Reduction in hunger:

     “Being clear-headed kind of made me be like, ‘oh, I don’t need to feel sad and eat food. Actually, let’s just not eat food at night. That’s not going to make me feel good’ and actually have the ability to do so because I didn’t have that intense craving.” (Participant 2, previously taking tirzepatide, stopped due to cost)

     “I think it’s affecting my appetite in a good way. I’m not as physically hungry. And I think a lot of the hunger was psychological, but it just seems to be very helpful with that.” (Participant 10, currently taking semaglutide)

     “I don’t crave the way I used to. I call it almost frenzied…it’ll start with like, ‘I’m hungry. So I’m going to eat this.’ And then I’ll see other foods. And it’s almost like my body is like, ‘I can’t let you leave the kitchen before eating this.’ And it’s a psychological thing.…And I just don’t get that way anymore.” (Participant 26, currently taking semaglutide)

Other lifestyle changes:

     “I have to shop differently. I have to plan differently. And then I have to cook and eat differently. I don’t eat out just because it’s hard to get the right foods.” (Participant 22, currently taking semaglutide)

          “It kind of motivated me to exercise more because I was taking the medicine. I knew I was losing weight, so I wanted to exercise more and stuff to go with it. So I guess it motivated me more than anything.” (Participant 15, currently taking semaglutide)

Adverse effects:

            “I can honestly say I really had no major bad side effects from taking the medication.…Maybe some nausea at the beginning, but after that, everything else was fine.” (Participant 18, currently taking semaglutide)

            “I was having a lot of diarrhea and stomach upset. And I put up with it for a few months, and then I just told her I wanted off.…I probably would have stayed on it had I not had the diarrhea and stomach cramping.” (Participant 16, previously taking semaglutide, stopped taking due to gastrointestinal tract adverse effects)

            “[I] look at it as a good sign whenever I do feel upset or indigestion or feeling too full too fast. It’s warning me before I realize too late that, ‘Hey, this is the time to stop.’ So I kind of welcome that feeling.” (Participant 29, currently taking tirzepatide)

            “The nausea was an issue. And then with the nausea, I’m thinking to myself, ‘But this is a good thing. This is the good nausea, like when you’re pregnant.’” (Participant 24, currently taking tirzepatide)

Stigma involved?

            “I think that there is kind of a stigma that it’s a cop-out, that you’re just taking the easy way out rather than doing it with diet and exercise like you should.” (Participant 1, currently taking semaglutide)

            “I’m careful about who I tell that I’m on it because I do know some people just look at it so negatively.…And sometimes I say like, ‘I’m on [semaglutide] for diabetes,’ because I feel there is a difference in how it’s viewed for diabetes vs for weight loss.” (Participant 26, currently taking semaglutide)

            “Articles say there are people who would look down on you for relying on medications for weight loss. I don’t really care what people think about how I lost weight. If the subject comes up, I’ll shout it from the rooftops that I found it very effective.” (Participant 4, currently taking tirzepatide)

Bad, and good, clinical support:

     “Because the first time the vomiting and the diarrhea happened, I had no idea it was from the drug. It took happening a couple times. I’m like, ‘This is not like me.’” (Participant 3, previously taking semaglutide; stopped taking the medication during pregnancy)

     “With all medications, they’ll say, ‘Here’s a list of side effects,’ up to including dying or your feet catching on fire, and your eyes pop out of your head…but to have a real conversation of, ‘Now, you’re going to get nauseous.…We’re going to give you a practical list and some ideas to discuss with your dietician.’” (Participant 22, currently taking semaglutide)

     “She [the clinician] answered all of my questions and spent time with you and stuff. And most doctors, blah, blah, blah, out the door they go, before you can ask them anything. But she wasn’t like that. She was pretty good about answering everything, explaining stuff to you in layman’s terms.” (Participant 15, currently taking semaglutide)

Summing up of “Patients evaluate GLP-1 drugs”:

Clearly, GLP-1 drugs are far from perfect for individuals seeking to lose weight, but they have produced remarkable success for many individuals. Unfortunately, many patients rapidly regain weight after stopping treatment. Moreover, long-term use of the drugs conceivably could produce side effects as yet unknown. Additional drugs with similar mechanisms of action are being developed. More will be learned.