Prescriptions for weight loss drugs are skyrocketing, especially among young women. Experts think they know why. - chof 360 news

Starting in 2022, Haley Sipes lost 75 pounds over 10 months with diet and exercise alone. On TikTok, where the 31-year-old mother of three chronicled her weight loss journey, commenters speculated that she was using Ozempic or another weight loss drug. “It put a bad taste in my mouth. My ego was like, ‘No, I did this without it,” Sipes tells chof360 Life. That turned her off from the idea of using medications — until she found that maintaining her new weight was even harder than reaching it. In fact, Sipes’s weight was creeping back up. After diagnosing her with polycystic ovarian syndrome (PCOS), her doctor prescribed Zepbound to help with symptoms of the condition as well as maintaining a healthy weight. Since starting the medication 15 weeks ago, Sipes has shed all the weight she’d regained. The medication “has just given me the power back,” she says.

Young women like Sipes have been fueling the popularity of treatments such as Wegovy, Ozempic and Zepbound, known collectively by the scientific name glucagon-like peptide-1 receptor agonists (GLP-1s). Between 2020 and 2023, the number of prescriptions for these drugs written each month for women ages 18 to 25 spiked by more than 650%, according to research published in May 2024.

GLP-1s are considered safe and unprecedentedly effective aids to weight loss and associated health risks, such as type 2 diabetes. But for young women, they also carry a particular set of unknowns: How safe are they during pregnancy? Will they have to be taken for the remaining 50-plus years of someone’s life? What happens if and when someone wants to get off the medications?

We spoke to experts researching these very questions to better understand the trend and where it may be headed.

A massive surge in prescriptions

Ozempic wasn’t the first-ever GLP-1 approved by the U.S. Food and Drug Administration (FDA). But by 2020, a few years after its 2017 approval, patients and doctors noticed Ozempic’s desirable side effect: weight loss. Health care providers began prescribing the drug off-label to help patients shed pounds, and patients began posting about their rapid weight loss on social media, fueling Ozempic’s popularity and paving the way for a slew of similar drugs.

In 2020, 8,722 monthly prescriptions for GLP-1 agonists were written for adolescents between ages 12 and 17 and young adults aged 18 to 25, according to an analysis of a database that tracks about 94% of prescriptions filled at retail pharmacies. By 2023, that figure for young adults had risen nearly seven-fold to 60,567 prescriptions per month, a May 2024 study published in JAMA found. And women made up the majority of that increase. Prescriptions for women soared from 4,886 to 37,111 that year. That means women accounted for about 75% of GLP-1 prescriptions written for adults under 26 in 2023.

What’s behind the surge?

Young adult women are more likely to be obese than young adult men, but the margin is slim. Per the Centers for Disease Control and Prevention’s (CDC) 2023 data, obesity was only about 9% more common among women than among men in all age groups.

Dr. Joyce Lee, a University of Michigan pediatric endocrinologist who led the research on prescription rates, says that obesity rates simply don’t explain the gap between women and men taking GLP-1s. While her study looked at medications prescribed to treat type 2 diabetes as well, “I would speculate that [the surge of prescriptions for women] would have been because of weight loss or obesity,” says Lee. “There is a societal bias or extra burden that women take upon themselves to maintain [a certain] weight, in excess of how male individuals would be focused on that,” Lee tells chof360 Life.

There is both societal pressure for women to be a certain weight and scrutiny of how they achieve that. Weight loss drug companies have been criticized for marketing their products to plus-size influencers. And the internet loves to speculate whether a woman who loses weight has been on GLP-1s and whether using these medications is taking “the easy way out.”

Sipes questions whether it’s realistic — or fair — to expect someone on a weight loss journey to be immune to societal pressure. “Diet culture can be super toxic, but it’s okay to have a little bit of pride in your appearance,” says Sipes. “I wish I could say I don’t care about what I look like in the mirror, but I don’t think there’s a woman alive who doesn’t care about what pants size she wears,” she adds.

Men perhaps face less judgment of their use of medications that may alter their looks. But they’re not immune to societal pressures either, notes Lee. She says that growth hormones are a good example of this phenomenon. These treatments are crucial for people with rare hormone deficiencies. “But they are also approved for short stature, and I can tell you that the number of boys being evaluated and treated for short stature is two-to-one compared to girls,” Lee says.

For some women, it’s about more than how you look

Weight-related health considerations unique to young women may also drive them to take GLP-1s. PCOS, which affects 7-10% of women between 18 and 44 in the U.S., including Sipes, is one of them. Excess body weight can be both a risk factor and a result of the condition. Since starting Zepbound, which is FDA-approved to treat PCOS, Sipes has noticed her symptoms — heavy periods, cramps and inflammation — ebb. The condition can also cause insulin resistance, raising risks for type 2 diabetes. GLP-1s can help with that, too.

The medications also seem to turn down the volume of “food noise,” or intrusive thoughts about eating, including cravings and preoccupation with trying to control portions and make healthy choices. Before Sipes started taking Zepbound, “my brain would not shut off about what am I going to eat, when am I going to eat,” she says. “Those food thoughts had also turned into shame until I started GLP-1s because I wasn’t shaming myself all day long to stop thinking about food.” Being free from food noise has given Sipes back a sense of control and freedom in her life, she says.

Anecdotal evidence also suggests that by helping control weight, GLP-1s may improve fertility. They may also improve conception chances for people with PCOS, which “can result in someone not ovulating and dealing with infertility,” Dr. Alyssa Dominguez, an endocrinologist with the University of Southern California’s Keck School of Medicine, tells chof360 Life. “If they do lose weight and ovulation resumes, their fertility can come back.”

Looking ahead: A continuing but uncertain trend

Experts see no signs of the upward trend slowing. In fact, the use of drugs such as Zepbound and Wegovy “is probably going to continue to increase,” says Lee. By September of 2024, one in every 10 prescriptions written for adults was for a GLP-1, according to health care data company, Truveta.

For young women, there are also questions about fertility that remain unanswered. On the one hand, GLP-1s may improve fertility, as Dominguez notes. On the other hand, patients are advised not to take the medications while pregnant or trying to conceive because animal studies suggest the drugs may raise risks for low birth weights and birth defects.

As of now, Sipes has no plans to stop taking Zepbound, and says she and her doctor will cross that bridge when they come to it. Endocrinologists have cautioned that Zepbound and similar drugs are intended to be taken indefinitely. Yet, “one of the most common misconceptions that I see is that this is a medication that is intended to be taken until an individual reaches their goal weight and then they can stop,” says Dominguez. Data suggests Wegovy and other GLP-1s are safe and effective for up to five years — but there isn’t yet data on how they perform beyond that. There also aren’t yet studies about the effects of "cycling on and off of the medication,” says Dominguez.

Despite the high cost of GLP-1s, it’s clear they’re extraordinarily popular, effective and even life-changing for women like Sipes. “It’s good that there’s effective therapy that people are willing to adopt,” says Lee. Obesity rates declined for the first time in a decade in 2023, and experts think it may be thanks to GLP-1s.

Still, a big question remains: “Are you band-aiding the bigger problem of what led to the obesity epidemic in this country in the first place?” notes Lee. For now, that question — how to prevent obesity in future generations — is still being researched.

In the meantime, Zepbound isn’t just a quick fix to keep weight off for Sipes; It’s a full reset. Before starting the medication, “I was missing a piece of the puzzle,” even when she was exercising and eating carefully, she says. Now, “my body finally feels like I’m functioning properly. I’m walking around thinking, ‘Is this how other people feel normally?’” says Sipes. “It’s very liberating. It’s freedom.”