In a world obsessed with the latest diet and fitness craze, new weight loss drugs are having a moment.

Oprah just dedicated an hourlong show to the shots — Ozempic, Wegovy, Mounjaro and related injectable medications — and how people “shame” and “blame” and think about obesity.

The drugs have become popular to drop large amounts of weight, but Ozempic was specifically approved to treat diabetes. And the drugs are being considered, and studied, for other medical conditions such as a common fertility issue called polycystic ovary syndrome, menstrual regularity and cardiovascular problems.

The rush to get them for a serious medical malady or to drop 10 or 20 pounds, however, means there are regular shortages, and counterfeits abound. The drugs also come with side effects and have big price tags, which affects who gets and stays on them.

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A panel of experts from the University of Maryland, Baltimore tackled some questions about the drugs during a webinar this week. Here’s what they think the public should know.

Do weight-loss drugs work?

Semaglutide (sold under the brand names Ozempic and Wegovy) and tirzepatide (sold as Mounjaro) are approved by the U.S. Food and Drug Administration to treat obesity and diabetes. They mimic a hormone that tells your brain you’re full, curbing cravings to eat.

“The result is unprecedented weight loss,” said Dr. Rozalina G. McCoy, an endocrinologist in the University of Maryland Medical Center’s Center for Diabetes and Endocrinology and an associate professor at the University of Maryland School of Medicine.

The majority of people who take the drugs lose 10% to 20% or more of their body weight in a year, which is not usually possible without the drugs or surgery. However, they risk regaining up to two-thirds of the weight if they stop taking the drugs.

Obesity can lead to, or worsen, health issues including diabetes, heart disease, strokes and cancer, McCoy said. Those conditions improve with weight loss.

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There are a few other types of weight loss drugs, but McCoy said none are considered effective as the new drugs, though there isn’t information yet on long-term use.

Another option has been bariatric surgery, which is considered as effective as the drugs. But such a serious procedure can put off some people because it comes with complication risks and a commitment to new eating patterns, such as small meals.

How bad are the side effects?

If you’re taking a weight-loss drug, you can expect some gastrointestinal issues, specifically nausea or diarrhea, which may lessen over time, panelists said. Reducing portion sizes, and reducing fatty and spicy foods, can help. The drug’s dosage, or even type, can be adjusted, too, panelists sad.

“We tell them to look at their diet,” said Charmaine Rochester-Eyeguokan, a professor of practice, sciences and health outcomes research at the university’s School of Pharmacy.

“If they eat a lot of bacon, sausage and eggs and all that in the morning, and take Ozempic, they’ll have lot nausea,” she said. “We teach them to eat in a different manner, a low-fat and not high-caloric diet.”

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What about mental health?

McCoy said some people stop enjoying eating, causing “loss in your quality of life.”

Those who’ve suffered stigma from their body size may feel pressured to take the drugs, which have been called a “miracle” for weight loss, said Vashti Adams, a doctoral candidate in the university’s School of Social Work. “If you’re not taking advantage, you can be viewed as irresponsible.”

If people don’t lose weight or regain weight, their sense of their social value can be further diminished and lead to new eating disorders or other conditions.

How expensive are these drugs?

McCoy said about 27% of employer-based insurance plans cover the average $1,000 monthly cost, but people with coverage still can face co-pays of hundreds of dollars a month. Some cover the drugs for a limited period of time, though they need to be taken over a long term.

Medicare, federal health insurance for seniors, doesn’t cover any weight loss treatments. Diabetics needing glucose control can get coverage, but again, McCoy said, there are high co-pays.

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She said Medicaid, the program for low-income residents, covers weight loss surgery, but only 10% to 20% of the state programs cover the medications. While weight loss can stave off other expensive health conditions, the drug price is considered budget-busting.

“The biggest thing to get these drugs covered by insurance is decreasing their price point and making them much more affordable and accessible,” she said, in addition to de-stigmatizing obesity treatment and making clear it’s a chronic disease.

Also, McCoy said, “demonstrating to health plans the benefit is immediate.”

What happens when there are shortages?

The drugs are in such high demand that it’s spurred counterfeit products that look similar but won’t work, or could even be dangerous, the panelists said.

Consumers need to beware of online advertisements and other means of bypassing regulated supply routes, said Masha Yemets, a clinical toxicology fellow in the Maryland Poison Center housed in the university’s School of Pharmacy.

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“A major red flag is if there is no prescription required, or if you don’t see a prescriber or provider,” she said. “It does take a few extra steps to make sure what you’re getting is safe and effective.”

Yemets says to make sure pharmacies where the drug is acquired is listed on the state board of pharmacy website. The FDA also maintains a list of pharmacies licensed and in good standing, she said.