The Latest Wasteful Trend

The $1,600-a-Month Weight Loss Shortcut That Isn't

Semaglutide is the hottest thing in weight loss right now. Here's why I don't prescribe it.

Every decade or so, a new weight loss craze takes hold. Right now it's semaglutide and liraglutide — glucagon-like peptides, originally developed to treat diabetes, now being widely promoted for weight loss under brand names like Wegovy and Ozempic.

Injectable. In short supply. Roughly $1,600 a month.

Let me tell you what I actually think about them.

What They Do — and What They Don't

These medications work primarily by creating a sense of fullness. They slow gastric contractions, which causes the stomach to stay fuller longer, which reduces how much you eat. That's the mechanism.

Here's the thing: that's the same thing we've been talking about this entire time. Eating less. Creating satiety. Managing hunger. The medication achieves it through a weekly injection rather than through knowledge, behavior change, and the occasional use of appetite suppressants — but the underlying goal is identical.

The research doesn't support the mechanism as something that fundamentally changes body chemistry. It makes you feel full. That's it.

The Results Are Underwhelming

The clinical success rates I've seen for these medications don't match the enthusiasm around them. We're talking about roughly 5 to 10 percent body weight loss over six months.

In my practice, I hope for 5 to 10 percent body weight loss per month — not over six months. That's not an unrealistic expectation. A patient who comes in at 250 pounds and comes back a month later having dropped 10 pounds is a routine outcome, not an exceptional one.

So we have a medication that's in short supply, costs $1,600 a month, requires weekly injections, and produces results in six months that a properly managed weight loss program can achieve in one. I'm having a hard time seeing the value proposition.

The Marketing Arrangement

The manufacturers of these medications are careful about how they position them publicly. Officially, they're diabetes medications. But they're not discouraging the wave of social media content promoting their use for weight loss — and the clinics and physicians jumping on this bandwagon are doing the advertising for them.

That's not a coincidence. It's a strategy. And the people paying $1,600 a month are making it very profitable.

The Weight Comes Back

Here's the part that matters most: when patients stop taking the shots, the weight comes back. Rapidly.

That's predictable. The medication was suppressing appetite and slowing gastric response. None of that changes the underlying behavior, the food choices, the habits, or the knowledge that would allow someone to maintain their weight independently.

Stop the medication, and you're back where you started — except you're also out whatever you spent, which at $1,600 a month adds up quickly.

This is my fundamental objection. A weight loss intervention that requires you to continue it indefinitely, at significant cost, to sustain any results — while leaving you no better equipped to manage your weight on your own — isn't a solution. It's a dependency.

My Recommendation

If a physician is prescribing you semaglutide primarily for weight loss, I'd encourage you to ask hard questions. Not because the medication is dangerous, but because there are better approaches that produce comparable or superior results without the cost, the injections, or the inevitable rebound.

What you need is knowledge. A plan. The understanding of how your body works and what it responds to. Those things don't expire when you stop taking them.

That's what we build in this practice. And it doesn't cost $1,600 a month.

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