Ozempic, Zepbound, and New Obesity Meds: What You Need To Know

Obesity Treatment Is Changing Fast. But Let’s Slow Down for a Moment.‍

If it feels like the world of obesity treatment is changing by the hour, you're not wrong. Medications like Ozempic, Wegovy, and Zepbound have shifted what many thought was possible when it comes to weight and health. And more medications are on the way (CagriSema, retatrutide, MariTide to name a few) each offering new outcomes and new data to explore.

But of course, there are always many sides to a story. As mental health providers working closely with people navigating these treatment options, we hear the questions, the concerns, and the lived experiences that don’t always make it into headlines or clinical trials. From our point of view, weight isn’t just a medical condition. It’s a deeply personal experience shaped by years of judgment, stigma, shame and often fraught with anxiety.

So before we get swept up in the hype, here are a few things worth pausing to consider.‍

Medications like Ozempic/Zepbound are powerful tools, but they’re not the whole toolbox.

There’s no question that medications like Ozempic and Zepbound have opened new doors. They can help regulate appetite, reduce food noise, stabilize blood sugar, and for many, lead to significant weight loss and improved metabolic health. These are real and meaningful outcomes. And contrary to what your internal (biased) voice may be telling you, it is not ‘the easy way out.’ People will continue to benefit from regular and joy-based movement, sound nutrition, well-managed stress (yup, it is possible) and good sleep routines. For some, working with a mental health professional with expertise in obesity care is a critical step to help navigate negative self-talk, body image concerns, trauma exposure, disordered eating and more. Afterall, we’re focused on your total health, not just your weight.

And it is also true that medication isn’t for everyone. Some people find them helpful and life-changing. Others can’t access them, don’t tolerate the side effects, or simply don’t feel aligned with using them. And that’s okay. Health is complex. And people, like you, deserve care that honors your values, your history, and your right to choose what works best for you.

New Medications Show Promise, But Real-World Answers Are Still Emerging‍

You may be hearing about new meds in the pipeline. It is true that lots of new medications are currently under investigation. As of May 2025, it is estimated that there are between 40-60 compounds in phase 2/3 clinical trials, with about half of them being GLP-1 based. A few you might hear about sooner rather than later include: CagriSema which combines two hormones and is showing around 15% weight loss after about 16 months, Retatrutide, which is showing over 24% weight loss in early trials and MariTide which may offer up to 20% weight loss at the one-year mark. And in early phase 2 trial data, trevogrumab mixed with semaglutide (Wegovy) was preliminarily shown to help preserve muscle mass loss that is sometimes associated with weight loss using one of the GLP medications alone. While these are all weekly injectable medications, scientists are also working on alternatives such as a monthly injectable (MET-233i) which is in Phase 1 trials, as well as oral medications such as orforglipron which completed phase 3 trials in April 2025.

But it is important to remember that despite these data, percentage weight loss is by no means the only outcome that matters. This recent paper is just one example of a growing push to look beyond percentage weight loss in favor of whole-person outcomes. In fact, appreciating broader health outcomes (beyond the scale) may be a factor in helping the scientific and patient communities from medication discontinuation or disappointment and frustration when the scale outcomes in real-world settings don't match the statistics we see in strictly controlled clinical trials.

What does a medication "off-ramp" look like?‍

Speaking of discontinuation, we’re still learning how people feel on obesity medications, how long the benefits last, and what happens when people stop taking them. While the medications are indicated for long-term use, we’re seeing that many, if not most, people discontinue treatment using the current medications after about a year. We still don’t fully understand why. Is it internalized weight bias (e.g., the belief that you shouldn’t ‘need’ a medication?) or is it cost (after all, out of pocket expenses of $4-500/month isn’t doable for most people in the short run, let alone for life), is it side effects, or changes to effectiveness, personal choice, or something else altogether? And what happens when people discontinue such medications? We know some data show the expected weight recurrence (you don’t treat your high blood pressure and then discontinue your medication once it reaches a normal range, right?), yet the idea of being on a medication for life doesn’t sit well with some folks. While we work on helping to shift the narrative around the chronic nature of obesity, we also realize that some people will stop taking medications and we have to understand what to do when that happens.

To explore what happens when people discontinue a GLP-based medication, new innovations are under investigation. For example, Revita recently received FDA breakthrough device designation, meaning it is considered a promising technology that could address unmet need. A treatment described as an “outpatient endoscopic procedure that involves resurfacing the mucosal lining of the duodenum, the first part of the small intestine just after the stomach, which is responsible for breaking down food into absorbable nutrients” is being explored. Aimed at treating the ‘underlying causes of obesity,’ this procedure is the tip of the iceberg and reflects the push to understand how to support people over the long run. But of course, there are many more questions that need answering. This is a field in motion and we need space for nuance, questions, and thoughtful consideration. ‍

Access isn’t just about the science. ‍

Just in the last few months, we have been tracking a number of important changes and issues that have affected our clients. While many major obesity organizations had warned people against using compounded medications, people were still turning to compounding pharmacies due to difficulty with medication access or affordability. So the new FDA crackdown on compounded versions of GLP-1 medications like semaglutide and tirzepatide, which took effect on May 22, 2025, has left some scrambling to figure out how to get their medications.

Even more recently, CVS Caremark, one of the country’s largest pharmacy benefit managers, announced it will stop covering Zepbound for many of its plans starting on July 1, 2025. This shift will likely make it harder for some people to get or stay on the medication, even if it’s working well for them. We asked some of our obesity medicine physician colleagues what this means for our patients, and we heard a lot of “this isn’t great.” People will end up making a switch to another medication in some cases (which may or may not be as effective or tolerable), or people will have to pay higher out-of-pockets costs. Such outcomes leave us worried about access and equity issues to say the least.

There is little worse than feeling that a life-changing medication is just out of reach, yet it is increasingly feeling that way for users of obesity medications. However, it isn't all doom and gloom. In one very recent and exciting step, the Treat and Reduce Obesity Act (TROA) was reintroduced in the Congress on June 5, 2025, by US Senator Dr. Bill Cassidy from Louisiana. This bill expands Medicare Coverage for behavioral treatments for obesity along with offering coverage for other treatments, too.  

These kinds of policy and supply changes aren’t always visible from the outside, but they have real consequences for real people like our patients. Access to care isn’t just about what works medically or what is available in a lab. It’s also about what’s available, affordable, and sustainable for real people.

And finally, mental health still matters.‍

As we talk about weight loss, risks, and benefits, the emotional impact often gets left out. But it shouldn’t. Starting a medication, adjusting to body changes, facing new attention (or the same old criticism), and wrestling with complicated feelings about identity and worth are all very real experiences. Other experiences like anxiety about weight regain, frustration with outcomes, or disappointment about individual responses are all very real.  While treatments are changing, the culture around weight hasn’t shifted as quickly. Weight stigma remains alive and well in healthcare, in workplaces, in families, and in daily life. People are still blamed for their weight, criticized for seeking help, and second-guessed no matter what path they choose. So it is no surprise that we see people feeling hopeful, empowered, uncertain, and overwhelmed, often all at once. That’s normal. And it’s something that deserves support and space, not silence.

Whether you’re thinking about medication, actively taking it, or choosing a different path entirely, your story matters. You deserve care that sees the full picture of who you are, not just your weight. If you’re looking for support as you navigate these changes, or if you just need a place to process what all of this means, we’re here to help.

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Photo by Marta Branco

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