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Losing 80 pounds was nothing short of priceless and life-changing for Melissa Floro. The 38-year-old mother of two from Sunnyside, New York City, tried diet and exercise for years to try to slim down — which often ended in frustration and weight gain. She finally lost all that weight in less than a year with the help of Ozempic (semaglutide). 

How GLP-1s Help Shed Pounds 

“Obesity is driven by biological and hormonal drivers. That’s why it is hard for patients to stick to an eating plan. Their biology makes it hard because of hunger and cravings,” said Caissa Troutman, MD, physician founder of Midlife reMDy/WEIGHT reMDy in Mechanicsburg, Pennsylvania, and member of the Obesity Medicine Association.

Drugs like Ozempic mimic glucagon-like peptide 1 (GLP-1), which is produced naturally when we eat. This substance binds to places in the body where there are cells with a GLP-1 receptor. This includes the pancreas, brain, heart, and the gut and fat tissue.

They help improve type 2 diabetes by signaling the pancreas to make insulin and help fight insulin resistance in body fat cells.

In the brain, GLP-1 decreases appetite and increases satiety — the feeling of fullness. In the gastrointestinal (GI) system, it slows down gastric emptying so you feel full faster and longer. “My patients tell me that before, I could have a full plate of pasta or a full burger, but now, I eat half a burger and I feel full,” Troutman said.

Floro is an emotional eater and would eat in response to stress, sadness, or even happiness. “I love food, and I was constantly thinking about it,” Floro said.

Now, her next meal isn’t always on her mind. “It just feels like magic — there’s something in these medications that just turned that off,” she adds.

Now the food script has been flipped. “I have to make sure I’m eating and drinking enough because I just don’t think about it.”

Obesity and Patient Health 

Floro said at almost 230 pounds, her obesity weighed her down in body and spirit. “I was just miserable physically all the time,” she said.

Joint and back pain made moving around very difficult. Finding summer clothes that fit was nearly impossible — which took a toll on her self-esteem. “My confidence and feelings of self-worth went through the floor,” she added.

“As a larger-bodied person, I just didn’t want to go out into the world.”

Floro has a family history of heart disease. So, when blood work showed very high cholesterol and blood glucose dangerously close to turning prediabetic, it was like a flashing red warning light. “When I saw those numbers, I knew I had to do something. I was scared to death,” Floro said.

Floro’s weight loss reversed all her risk factors for heart disease and diabetes. Her back and knee pain improved as well.

Susan (last name withheld for privacy concerns) has a similar story. At 200 pounds, the 63-year-old from western New York was prediabetic and had signs of metabolic dysfunction–associated steatotic liver disease (MASLD). 

Exercise and weight loss programs like Weight Watchers didn’t result in significant weight loss.

“I thought I was going to be that weight forever,” she said. When her doctor suggested Wegovy in May 2023 — the semaglutide approved to treat obesity — Susan jumped at the chance.

“I felt like it was my last chance and saw it as a blessing from God,” she said.

She lost 25 pounds over several months, but then her weight loss stopped.

“I wasn’t doing anything different, but it just stalled.” Susan switched to weekly injections of Zepbound (tirzepatide) in November 2024 and lost another 30 pounds over the next few months.

This medication works differently than semaglutide. It activates GLP-1 and another hormone called glucose-dependent insulinotropic polypeptide.

Susan is now at a healthy weight, has a normal glycated hemoglobin, and has no signs of MASLD.

These medications are powerful tools that treat the biological disease of obesity, said Troutman. But it’s just one in the weight loss toolbox. The rest are exercise, healthy eating, stress management, and proper sleep.

Susan participates in a local crew team — and rows and trains all year.

Floro said instead of having to be obsessed with cutting weight, she focuses her exercise on strengthening her legs and back.

Who’s a Good Candidate and Who Is Not?

The Food and Drug Administration (FDA) approved Wegovy, Zepbound, and an older GLP-1 called Saxenda (liraglutide) for weight loss for people with:

• A body mass index (BMI) ≥ 30
• A BMI of 27 (overweight) with at least one obesity-related condition like high blood pressure or elevated cholesterol.

Saxenda is not really prescribed anymore unless that’s the only one a patient’s insurance will cover, said Leonid Poretsky, MD, chief of Endocrinology at Northwell Lenox Hill Hospital in New York City. “It’s a daily injection, and patients don’t really like that.” The other two medications are injected once a week.

Watch Out for Side Effects

Most side effects are mild and GI-related, like constipation, nausea, and sometimes diarrhea, Poretsky said.

Both women have experienced some of these side effects but agree it’s a small price to pay for their results.

To keep side effects manageable, patients should drink plenty of water and eat plenty of fiber. Consider adding a stool softener to get ahead of constipation, said Susan.

Muscle loss is another thing to watch out for, Poretsky added. “Up to a third of weight loss is muscle loss, which is undesirable.”

A high-protein diet and strength-training exercises can help maintain muscle mass. 

The Hefty Cost of Weight Loss

GLP-1s are expensive. Monthly costs can be $1500 if insurance doesn’t cover the medications. Medicare and Medicaid won’t cover these drugs when used solely for weight management, either.

Encourage patients to file an appeal with their insurance company if they’re denied.

Floro was lucky that she didn’t have to go through insurance at all. She worked at an endocrinology office, and the doctor provided samples of Ozempic. That’s considered an off-label use since Ozempic is FDA-approved for those with type 2 diabetes. Otherwise, Floro says her insurance probably would not pay for a GLP-1 approval to treat obesity without diabetes.

Weight-Loss Drugs for Life?

Without hesitation, both women say they would stay on the drugs for the rest of their lives if that’s what it takes to keep the weight off.

Although shopping for smaller sizes is fun and gratifying, looking thin is not their most important priority.

Susan is an endometrial cancer survivor — a disease closely linked to obesity. “I want to know I am doing everything I can to keep the cancer from coming back,” she said.

Floro said health, feeling good, and regaining her self-confidence are at the top of her mind as well.

“To know that I am working on being my healthiest self so I can be here for my kids — for as long as I can be — is priceless.”