There's a good chance someone you know is taking a shot to lose weight. Are these miracle drugs?

Some know these drugs through brand names such as Ozempic, Wegovy, Mounjaro or Zepbound. Others know it as semaglutide.

They all belong to the GLP-1 agonist class of drugs.

GLP-1 stands for glucagon-like peptide 1, which is a naturally occurring hormone that triggers an insulin release in your pancreas when you eat. That release in turn lowers your blood sugar.

But GLP-1 also slows your digestion and helps you feel fuller for a longer period of time.

GLP-1 agonists, such as these medications, mimic the action of this hormone.

Initially, doctors viewed them as treatment for diabetes. That's how Ozempic gained FDA approval in 2017.

Then, in 2021, the FDA approved Wegovy for weight loss. Zepbound followed in 2023.

And things took off from there.

The analytics firm Trilliant Health tracked a 300-percent increase in Ozempic prescriptions nationwide from 2020 to 2022, and a 132 percent increase in patients on these drugs from 2021 to 2022.

“I’ve been treating obesity at UT Southwestern since 2012 and using these medications since the start of my career,” said Dr. Jaime Almandoz, medical director of UT Southwestern’s Weight Wellness Program and assistant professor of internal medicine. “From what I’ve seen, these medications are largely very safe and effective, and are used very well for treating not just obesity but controlling complications related to obesity.”

Watch our full interview with Dr. Jaime Almandoz here:

While these drugs have been successful in treating obesity, they are not without side effects. Granted, some some patients don’t experience anything. But others deal with nausea, vomiting, diarrhea, dizziness, increased heart rate, indigestion or headaches.

Severe side effects are rare, according to the Cleveland Clinic, but they can include pancreatitis or kidney injuries.

Still, the risks might be worth it. While obesity isn’t historically treated as a chronic disease like blood pressure or cholesterol, many doctors now argue that it should be.

“Obesity is not a personality disorder,” said Dr. Jill Waggoner, a family practice concierge physician in Dallas. “Seeing it in that cosmetic realm is so frustrating for me as a physician. I’m not worried about the size of your hips. I’m worried about the size of your liver. Does your liver have fat? That fat on your hips is not going to kill you. That fat in your liver will.”

These drugs mostly seem to help people shift their eating patterns. Instead of feeling forced to cut out food they enjoy -- which is often unsustainable, but a core tenet of many diets -- patients can still eat things they like, but feel satisfied with less.

"There’s so much talk in the media about what happens when we stop these medications to treat obesity," Almnadoz said. "People do regain weight, but what happens when we stop medications to stop hypertension? People’s blood pressure goes back up. When we have people living with obesity who have their disease treated and get their weight to a healthier range, we need to continue treatments that are working -- rather than stop something that’s working and expect people to maintain a healthier weight."

Mark Jones had always been known as “Big Mark” -- and he was good with it.

When he gained weight, he’d just buy bigger clothes.

“I’d get a bigger X --  like XXL, XXXL,” he said.

Working out was always part of his life.

He said he walked five miles each day during COVID. Still, it wasn't enough to get the number on the scale to drop.

He weighed 350 pounds, was pre-diabetic and knew he needed to make a change.

Jones is married to Dr. Waggoner. His struggle is just like that of countless other patients in her practice.

"Those chronic illnesses -- obesity, diabetes, heart disease -- just about everybody struggles with that," Dr. Waggoner said. "And I say it is one issue. It’s metabolic dysfunction."

According to the Centers for Disease Control, nearly 48 percent of Black Americans are clinically obese. The CDC also says 43.5 percent of Black Texans have obesity. The same is true of almost 41 percent of Hispanic adults in Texas.

Study after study also reveals higher rates of heart disease, hypertension and diabetes in communities of color.

“This is not good,” Dr. Waggoner said. “We’ve got to do something.”

First, she and her husband changed their diets -- and they started to lose some weight. But after extensive research, Dr. Waggoner decided her husband might find more success with tirzepatide, which is sold as Zepbound or Mounjaro.

"This is not a magic bullet," Dr. Waggoner said. "I know what people are saying. It is not the truth."

She said the weight loss shots are just one tool in a toolbox she’s now using to treat patients. And she doesn’t like that some people consider it cutting corners to lose weight.

“This is medicine," Dr. Waggoner said. "And you treat this like you treat anything else -- that’s with experience, care, information, follow up -- all the things that are necessary for patients to be well."

Waggoner says the key to success is understanding that a shot, exercise and overhauling a diet can combine to form a solution.

Jones has been on tirzepatide for nine months, and he said he's lost more than 50 pounds. Better yet, he said he feels healthier than he has in 40 years.

"To be able to sit on an airplane and cross your legs -- that doesn’t seem like much, but it’s a big deal," he said. "To just cross your legs on an airplane or not to need a seatbelt extension."

He said he has a new relationship with food, too. He eats smaller portions. His cravings are gone.

“My kryptonite was sweets," Jones said. "I’m not a drinker, but sweets are a love affair I’ve had all my life.”

Now he’s eating more fruit. which he says tastes sweeter now that he’s not regularly eating snickers or consuming soft drinks.

He's had so much success, actually, that he recently bagged up all of his old, big clothes and donated them to charity.

“I didn’t keep one thing that I could slide back into,” he said. “I gave it all away.”

The success stories are all over the internet. Men and women shedding dozens of pounds -- and fast -- on the GLP-1 drugs. 

But how long does that weight really stay off? What does it take to keep it off?

“So that’s the part nobody really talks about,” Dr. Uma Gunasekaran said. 

Dr. Gunasekaran is the endocrinologist at the top of Parkland’s diabetes program. She is also an associate professor at UT Southwestern. 

“Weight loss stops at about 12 to 14 months,” she said, explaining how studies for Ozempic and Trulicity so far have indicated that's the time period when patients' weight often slows or plateaus. “I’ve met people who don't change the way they live. They get really excited and eat out four times a week. They eat a lot of high-calorie, high-fat foods, and they’re like, 'Yeah, but I can do that and just take my medication!' And I’m like... 'But the medication will stop.'"

The drugs can stop working because Ozempic and its sister GLP-1 drugs work by reducing a person’s appetite. But about a year in, Dr. Gunasekaran explained, the body reacts to the sudden weight loss and essentially gets very hungry. 

"The appetite suppression feeling starts to go away, [and] you get this insatiable hunger," she said. "So if you have incredible hunger, and you didn’t change the way you eat, you’re going to eat even more high-calorie, high-fat foods. And you’ll gain the weight back -- most of the time more than you did before.” 

Often, Dr. Gunasekaran explained, people try up their dose of the medication when their weight loss plateaus. But when a patient gets to the highest dose, you can’t push it any higher. 

Some patients will try to switch to a similar but different version of the drug in order to keep the cycle alive. But not everyone can afford to do that.

"Your insurance might not cover it, so you may be at the end of the road," Dr. Gunasekaran said. "And you want to be able to transition to something that helps you hold onto that weight loss. 

Dr. Gunasekaran said GLP-1s are a terrific piece of a weight loss program. But she said their progress is only sustainable if patients adjust diet and exercise once they get on them.

"That’s kind of the way I look at these weight-loss medications," she said. "Are you ready to put in the work to figure out what you’re going to do when this medication is no longer really supporting you the way it has before?”

And what about long-term effects? With these drugs being so new, the jury remains out. 

"I don’t know," Dr. Gunasekaran said. "I think that’s the thing we’ll hopefully know over the next few years as we get longer-term data for people who have taken it over multiple years. At this point, people have taken it for maybe 2, 3 years maybe."

Stories of weight gain and weight loss saturate the internet and social media.

One account you might come across on TikTok belongs to Shantaquilette Carter-Williams, who speaks openly about her journey taking the diabetes and weight loss drug Ozempic.

"I hardly have an appetite!" you might hear her tell her followers in one clip. "I'm a size medium y'all!" she celebrates in another. 

She posts often, despite the fact on some videos, her comment section and inbox are "full of women, ridiculing me, calling me lazy," she explained.

Carter-Williams started to gain weight after she developed a heart arrhythmia. At 39-years-old she had a heart attack, then a stroke.

"My focus wasn’t how much I was eating…my focus wasn’t exercise," she told WFAA.

It was to be a mom to her seven kids and get back to work after two serious medical crises. But the risk of another episode, one that could kill her, was high, according to her team of doctors. 

"Dying was the biggest concern," she told WFAA.

"I didn’t want to die."

Carter-Williams was then also diagnosed with diabetes. Her doctor prescribed Ozempic to manage that and help with weight loss.

"I know a lot of people think [we're] just taking this to lose weight," Joelle Potter told WFAA. She's another North Texas mother who shares her weight loss journey on the drug with the world.

"[People think we're] taking the easy way out. And for some people, it wasn’t easy."

Potter struggled with Polycystic ovary syndrome (PCOS,) insulin resistance, high cholesterol, and obesity for years. She said people mocked her weight and called her a cow.

"I’m fat and I’m ashamed. And then I’m trying to lose weight 'the easy way' and I’m shamed." 

Undeterred by the online hate, Potter has lost 55 pounds. She said her hormones are normal and she feels great.

"I’m as healthy as I can be, and that’s what I wanted."

Carter-Williams, meanwhile, is down 120 pounds. Her blood pressure and cholesterol are good, and she’s alive. That matters much more to her than the strangers who make fun of her online. "

"I think everybody should have the freedom of choice without being judged…especially when it comes to making life-changing decisions," she said. 

Despite being shamed, neither of these women is ashamed of the decisions they made with their doctors.  

"I want people to know what's right for you," Carter-Williams said.

"Do what’s right for you."

Once Hollywood discovered the shots that can lead to weight loss, the rest of the world wanted in.

Demand skyrocketed, supply plummeted, and patients who rely on the drugs to control life-threatening diabetes faced devastating shortages.

Even now, diabetics say shortages remain a problem in North Texas.

One WFAA viewer said she made a 30-mile drive to a pharmacy because it was the only location with Mounjaro in stock.

And as is predictable -- a spike in demand meant a hike in price.

Ozempic and Mounjaro, both FDA-approved to treat diabetes, went up in price in 2024.

An analysis by 46 Brooklyn shows Ozempic, manufactured by Novo Nordisk, rose 3.5% for a month's supply.

Mounjaro, made by Eli Lilly, rose 4.5%.

The list price for Ozempic on its manufacturer’s website is $935.77 per package. Mounjaro’s is $1,069.08.

However, most people do not pay the list price – it’s the original price before insurance coverage, discounts, or rebates are applied.

Wegovy and Zepbound have FDA approval to treat obesity.

Wegovy has a list price of $1,349.02 per package.

Zepbound’s list price is $1,059.87.

All four require a prescription and there is no generic version.

Insurance companies often cover the drugs that treat diabetes, but less commonly cover shots for weight loss, according to doctors.

“Some patients make a decision to try to afford it,” said Waggoner, the concierge family practitioner in Dallas.

Her practice will assist patients in finding savings cards and coupons – which are often available on manufacturer’s websites.

“Anything we can to help them,” she said.

But doctors don’t trust spas, wellness centers, and websites advertising deep discounts with no prescription necessary. Many of them claim to be selling semaglutide, which is in Ozempic and Wegovy, or tirzepatide, the ingredient in Mounjaro and Zepbound.

But doctors say it’s simply not possible to know the exact ingredients in the products they advertise.

Compounding pharmacies also offer compounded versions of semaglutide or tirzepatide at cheaper costs. However, the FDA has raised concerns about compounded versions.

When a drug is in shortage, the FDA allows compounded versions of that drug “if they meet certain requirements in the Federal Food, Drug, and Cosmetic Act.”  

But in 2023 the FDA warned state and national pharmacy and medical boards about reports of semaglutide being compounded with salt.

“The FDA has received an increased number of adverse event reports and complaints concerning these compounded drug products,” the agency wrote.

The FDA website warns that “the agency does not review compounded versions of these drugs for safety, effectiveness, or quality.”

Eli Lilly and Novo Nordisk have sued wellness centers, spas, and compounding pharmacies they claim have falsely advertised the drugs they are selling as brand-name medications.

“These are patented medications that are the intellectual property of large pharmaceutical companies, and they are not providing the medications to compounding pharmacies to be compounded and sold to the public at lower prices,” explained Almandoz, the UT Southwestern weight management and metabolism specialist.

“We’re really not sure what it is that patients are accessing when they go to compounding pharmacies. So, this is not something we recommend in practice.”

He does offer one tip for people who want the drugs, but don’t have coverage through insurance and can’t afford them.

“Many people are not aware it’s not the insurance companies that determine coverage, but their employers,” he said. “So, talk with someone at the company where they work, perhaps in the human resources department, about are these medications approved benefits for employees. Or are there things we can do to improve access?”

Access and costs matter, but safety matters most.

Tahra Monroe-Campbell has gained and lost the same 100 pounds more times than she can remember. But now, she vows, it’s gone for good.

“I have been classified as, or would have fit the classification of, super morbidly obese for almost my entire life,” she said.

Almost is key.

Tahra was born in Austin but moved to DFW about a decade ago.

Her parents were overweight. She was an only child - an overweight child - and thought she was destined to be an overweight adult.

About 20 years ago, she weighed 450 pounds. She was exhausted.

She had gastric bypass surgery and lost 260 pounds.

Then she gained back 160.

“So, I made it down to 190 and I tell people it was probably for a day. And then I yo-yo’d back up to 350 where I rode -- living in embarrassment,” she said.

She’d bought into society’s long- and wrong-held belief that obesity is someone’s choice. A personal problem. A flaw.

She knew how to lose weight, but she gained it back because she hadn’t worked through personal issues.

“You know, there’s the perfectionist part of me that feels like if I mess up, if I gain 10 pounds, I may as well through in the towel. I’m a complete and total failure. That was my issue before,” she said.

Tahra found Dr. Almandoz’s weight clinic at UT Southwestern after a primary care physician referred her in 2017.

That’s when she realized obesity is a disease, and she and Almandoz began treating it with a drug.

She started Ozempic in 2022 before it became trendy.

She says it’s helped her maintain a constant blood sugar, which she says curbs her cravings and hunger.

She’s certain that is part of the reason she’s experiencing success, but not the only reason.

“The medication isn’t always necessarily a magic bullet,” she said. “I walk, I exercise, I lift weights, I do what I have to do to invest in myself to stay where I need to stay. Where I want to stay.”

She’ll work with her doctors to determine whether she can stop taking it, but she’s not afraid to stay on it forever.

She and Almandoz compare it to taking medication for blood pressure.

“You do what you have to do to maintain your health,” Tahra said.

She’s now down to 165 pounds.

“I used to feel like I had this 450-pound monster chasing me that I was trying to outrun because I didn’t want it to catch me,” she said. “And then at some point, I don’t know when it happened, but at some point that just went away. And it stopped being a fear that i have.”

Tahra has now walked four half marathons. Her fifth is scheduled for June in Alaska.

And got help defeating those old perfectionist tendencies. She now gives herself grace.

“If I’m up five pounds, it’s not the end of the world,” she said. “Make some adjustments, get those five pounds off. That five will not become 50.”

The yo-yo is still and steady.

And she vows to keep it that way.

When we hear the drug names, Ozempic, WeGovy, Munjaro, we often think about how they can change a person’s body. But there are also psychological effects to consider, UT Southwestern psychiatrist Dr. Carrie McAdams told WFAA.

"I think they’re actually a good thing for mental health," she said. 

Dr. McAdams said she sees lots of patients who are on or have tried drugs that work by reducing appetite. She said people who have struggled with binge eating, specifically, can make great candidates.

"There’s benefits for some patients, where these medications feel like they’ve finally enabled them to kind of have control. I think it can help with some impulsive behavior."

But the effects are not all positive, not for everyone. Even when people lose the weight they want to and slim down fast, Dr. McAdamas said there can be real challenges associated with that change people often don’t consider.

"I’ve had patients that have gotten very depressed, very anxious because the things they enjoyed were going out to a meal with friends or hosting a meal with people, and losing that, is actually a pretty substantial hit on mental health"

Dr. McAdams also said some patients can become mentally dependent or fearful of life without the drugs.

"People will want more and more of it, they won’t taper the doses, they get afraid of being hungry, so those are some of the negative effects."

Perhaps importantly, Dr. McAdams said, despite what we may expect or believe, losing weight from these drugs or in any other way will not, alone, make people happy. 

Dr. McAdams said that psychologists often see this misconception in patients who get bariatric surgery.

"A lot of people say that as soon as I lose x number of pounds, I’ll be happy, it really doesn’t work like that. The process of learning how to be content and satisfied with life is really multifactorial. Losing ten or fifteen pounds is not going to change someone’s sense of self-worth in a permanent kind of way."  

Dr. McAdams said the drugs, for the right patients, can be a very successful piece of a broader mental and physical health plan.