The weight-loss drug market is exploding—and it's expected to keep rising in popularity. In fact, analysts predict that 2024 is going to be another stellar year for these drugs, including Novo Nordisk's diabetes and weight-loss options, Ozempic and Wegovy, as well as Eli Lilly's comparable options, Mounjaro and Zepbound, per CNBC. However, because of their uptick in popularity, these drugs are often very difficult to find, with Ozempic and Wegovy currently in shortage, according to the U.S. Food and Drug Administration (FDA). As a result, some patients are seeking older weight-loss treatment options, which are reportedly much easier to procure.
RELATED: Ozempic Patients Say It "Stops Working" for Weight Loss—How to Prevent That.
Christy Nguyen is one of these patients, speaking exclusively with CNN about her journey with different weight-loss drugs. After not seeing results from dieting and joining WeightWatchers, she started taking GLP-1 receptor agonists, including Ozempic and Mounjaro. However, she ran into ongoing issues with insurance coverage, resulting in financial strain.
According to Jody Dushay, MD, an endocrinologist at Beth Israel Deaconess Medical Center and Nguyen's provider, on top of insurance struggles, many people just can't get their hands on these drugs.
"People come in the door seeking treatment with a GLP-1, and then for whatever reason, they can't get it or change their mind," she told CNN.
There's been a significant uptick in prescription rates for semaglutide, the active ingredient in Ozempic and Wegovy, and tirzepatide, the active ingredient in Mounjaro and Zepbound. Just last year, the prescription rate for semaglutide doubled and tirzepatide's spiked by 141 percent, CNN reported, citing data from Epic Research exclusively provided to the outlet.
With these options in shortage (the FDA website notes that Mounjaro is currently in shortage, but all doses are listed as "available"), ongoing insurance struggles, and other factors, patients are now considering other options for weight loss, including older meds like phentermine, metformin, and bupropion, Dushay told CNN.
In fact, prescription rates for the older medications are going up as well, even though they're lower than those for the newer options, Epic's data shows. Between 2017 and 2023, rates for bupropion were up 29 percent, while phentermine rates were up 34 percent.
RELATED: Ozempic Patient Reveals "Repulsive" New Side Effect.
Dushay ended up prescribing bupropion for Nguyen. It's better known by its brand name, the antidepressant Wellbutrin, first approved by the FDA in 1985. In 2014, it received another approval for weight loss when combined with naltrexone and branded as Contrave. Dushay explained that bupropion can help with cravings, much like how it helps people stop smoking (which it's also approved for).
Another option for these patients is phetermine, which was approved for weight loss when combined with topiramate, branded as Qsymia.
During clinical trials, patients on Contrave and Qsymia didn't lose as much weight as those who took GLP-1s, CNN reported. However, these drugs can also be more cost-effective (even if you have to pay out-of-pocket), aren't as likely to be in shortage, and are pills instead of injections, Dushay said.
RELATED: New Data Shows How Much People on Weight-Loss Drugs Are Saving on Groceries.
Both Dushay and Louis Aronne, MD, director of the Comprehensive Weight Control Center at Weill Cornell Medicine, agree that the older options can be effective when you find the right kind for each person. For a patient with cardiovascular disease, for example, Aronne told CNN he wouldn't prescribe phentermine, which can raise heart rate and blood pressure.
Dushay pointed out that newer drugs produce different side effects, which patients have cited as painful and debilitating. They can also result in muscle loss, malnutrition, and vitamin deficiencies, Zhaoping Li, MD, professor of medicine and chief of the Division of Clinical Nutrition at the University of California, Los Angeles (UCLA), told CNN.
Another deterrent is the newness of GLP-1 drugs, meaning experts don't have as much information on how they affect patients in the long run, which is compounded by an upward trend in overdoses related to semaglutide use.
Still, doctors point to the benefits of newer medications, with Wegovy demonstrating positive effects on heart health in recent studies. For Nguyen, the new drugs are still her preferred approach. Following the success she saw on Mounjaro, she's now starting treatment on a lower dose of Zepbound, which was recently approved and may offer increased access to patients.
Nguyen's insurance coverage was again denied, but Eli Lilly is also offering a coupon to decrease out-of-pocket costs, helping her financially before she can switch to a higher dose of Wegovy, which is covered.
Best Life offers the most up-to-date information from top experts, new research, and health agencies, but our content is not meant to be a substitute for professional guidance. When it comes to the medication you're taking or any other health questions you have, always consult your healthcare provider directly.
