Why GLP-1 Drugs Alone Aren’t Enough for Lasting Weight Loss

Geoffrey Rutledge, M.D., chief medical officer at HealthTap, wants patients to rethink how they approach GLP-1 medications like Ozempic and Wegovy (both versions of semaglutide), as these obesity and some type 2 diabetes drugs have rapidly gained popularity for their role in weight loss.

In a recent conversation with Managed Healthcare Executive, Rutledge warned that the narrative around these drugs is often oversimplified—and potentially harmful.

“Probably the biggest thing people need to recognize is that it’s a journey,” Rutledge said. “It’s not, as you say, a quick fix that happens right away.”

GLP-1 drugs work by suppressing appetite, leading to reduced calorie intake over time. But the effects don’t last without continued use or significant lifestyle changes, he said.

“As soon as you stop the medicine, all of the previous appetite comes back,” he explained.

Even those who lose 15% to 20% of their body weight may regain it if they don’t make lasting behavioral changes.

“When you lose weight, you’re losing both muscle and fat. When you gain it back quickly, you tend to gain back the fat,” he added.

The promise of GLP-1s is real, but only when patients use them with a long-term plan. Rutledge emphasized the importance of building healthier routines around eating, exercise and stress management.

“There is a path to keep the weight off,” he said, “but it involves recognizing that you need to modify your lifestyle, develop healthy eating habits, and more important, develop a lifestyle that includes exercise and management of the stress or the other issues in your life that may be encouraging you to eat more.”

As telehealth platforms increasingly offer GLP-1 prescriptions, Rutledge also stressed that quick online consults aren’t enough.

“The challenge of telehealth is that people expect a quick visit to get the prescription, and that’s all they have to do,” he says.

But when done right, virtual care can mirror in-person programs.

“Participating with the program is the key element,” he said. “The telehealth companies that are doing that well engage their patients in those lifestyle changes, creating a relationship and ongoing care, which is really essential.”

While cost remains a concern—especially in the U.S., where retail prices hover around $1,000 a month—Rutledge believes broader access and affordability are on the horizon as more options enter the market.