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Are weight-loss drugs safe for seniors?

July 28, 2023 | Kristina Lindgren
Older Black man consults with Asian physician.

The potential risks of using Ozempic and other highly popular drugs for weight loss can be managed for older adults by careful monitoring, says UCI Health internist Dr. Bavani Nadeswaran.

More than 100 million Americans, including nearly 42% of adults ages 60 and older, are living with obesity, a chronic condition that puts them at high risk for a variety of serious conditions, including heart disease, stroke, diabetes and cancer.

Yet as people advance in years, it gets harder to shed pounds. That's why there is considerable interest among older adults in Ozempic and other GLP-1 drugs that have proven highly successful in helping people lose weight.

Ozempic, which was approved to manage diabetes, is very effective for controlling blood sugar levels and it helps with significant weight loss, says Dr. Bavani Nadeswaran, a UCI Health specialist in weight management and a professor of internal medicine at the UCI School of Medicine.

However, taking the drug may pose other health risks for older adults that aren’t yet well understood because of the small number of participants over age 65 in the Ozempic clinical trials. Even fewer participants were over age 70.

Benefits vs side effects

“Study participants over age 65 did benefit from improved blood sugar levels and had a lower 10-year risk for cardiovascular disease, similar to the effects seen in those under age 65,” she says.

But the drug’s common side effects — nausea, vomiting, diarrhea and constipation — tended to be worse in individuals over 65, which could exacerbate other underlying health conditions.

Nadeswaran also says kidney health needs to be closely monitored in seniors taking Ozyempic or other GLP-1 drugs. “The risk for acute kidney injury in older adults is higher because they tend to have other comorbidities, such as hypertension and chronic kidney disease.”

Another concern is that rapid weight loss is often accompanied by a loss of muscle mass.

“People naturally lose up to 10% of their muscle mass between ages 60 and 70,” she says. “When older people also lose weight rapidly, their muscle loss can be very rapid, causing them to become frail and putting them at risk for falls and fragility fractures.”

Called sarcopenia, this condition can be countered with increased physical activity and exercise to help maintain muscle strength and agility.

Help for chronic obesity

Weighing the benefits against the downsides of Ozempic and other weight-loss drugs for seniors, Nadeswaran says they can be very helpful for patients who are struggling with severe complications of obesity — with close monitoring and coaching.

She points out that obesity, itself, is a severe and chronic disease that carries a high risk for heart disease, strokes, fatty liver disease that could lead to liver cancer, as well as diabetes that can result in kidney disease.

“We need effective medication treatments in addition to lifestyle changes for these patients,” she says. “There isn't a quick fix or one treatment to manage all patients with this disease.”

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