Health
Patients taking weight-loss drugs often make 5 critical mistakes, doctor warns
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GLP-1 drugs (glucagon-like peptide-1s) have exploded in popularity in recent years – initially as a way to control diabetes and then as tools for weight loss.
Growing research suggests that these drugs – which include semaglutide and tirzepatide – potentially have benefits beyond weight loss, with stronger evidence for cardiovascular and kidney health.
Even so, experts caution that these medications are not foolproof — and using them the wrong way can undermine results or even create new health problems.
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Dr. Meena T. Malhotra, MD, a functional medicine doctor and weight-loss specialist in a suburb of Chicago, confirmed that she has seen myriad health improvements in patients taking GLP-1s – particularly those with diabetes who were “very sick.”
Growing research suggests that GLP-1s potentially have benefits beyond weight loss, with stronger evidence for cardiovascular and kidney health. (iStock)
“We observed that this sick population was doing better than the diabetics who were on other diabetes medicines,” she shared with Fox News Digital, noting that she observed improvements in brain health, memory, heart health, circulation, and liver and kidney function. “We realized there was more to the drug than just sugar control and weight loss.”
Malhotra said she believes many people can safely microdose GLP-1s, but she cautions against the following common mistakes.
Mistake No. 1: Taking GLP-1s before making lifestyle changes
Anyone considering GLP-1s should first focus on adopting a healthy lifestyle, Malhotra emphasized – a view widely shared by endocrinologists and obesity medicine specialists.
GLP-1 medications work by slowing gastric emptying, reducing appetite and improving insulin signaling. People with preexisting GI symptoms may be more prone to discomfort or intolerance, though responses vary, and formal evidence is limited.
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Before beginning the medication, Malhotra recommends improving basic nutritional habits, such as increasing intake of whole, minimally processed foods, and prioritizing protein and fiber to support satiety and gut health.
Even small improvements in diet can lead to early weight loss, reduced fluid retention and improvements in insulin sensitivity, doctors agree. (iStock)
Even small improvements can lead to early weight loss, reduced fluid retention and improvements in insulin sensitivity, doctors agree.
Once GLP-1 medications are started, these lifestyle modifications may reduce the necessary dose amount, result in fewer side effects and help preserve lean muscle mass.
Mistake No. 2: Starting without proper medical evaluation
The growing trend of obtaining GLP-1 medications online without proper medical oversight can pose serious health risks, Malhotra warned.
“Nobody examines the patient – they just fill out a form and the medicine shows up at their door,” she said.
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Patients should see a medical provider for a thorough exam and blood work before starting the drugs, the doctor emphasized.
“If something is off, it needs to be addressed,” she said. “Whether it’s a thyroid issue, a heart condition or another factor slowing your metabolism, any underlying problems should be fixed first.”
The growing trend of obtaining GLP-1 medications online without proper medical oversight can pose serious health risks, the doctor warned. (iStock)
During treatment, Malhotra recommends that her patients come in once a month to make sure they are losing fat and not lean muscle mass. “That’s very important, because if you lose lean mass, your body is not getting healthier,” she said.
This ongoing monitoring also helps to ensure that the patient is following a balanced diet, getting adequate protein and adhering to strength training. “There’s more to it than just giving yourself a shot,” Malhotra added.
Mistake No. 3: Not getting enough protein
One of the biggest mistakes people make when taking GLP-1s is cutting calories but not getting sufficient protein, according to Malhotra.
“If you are decreasing the calories but not fixing the nutritional foundation, you will lose lean mass,” the doctor said. “But if you’re eating a balanced diet with adequate protein and doing strength training with a smaller dose of the drug, you will get better results and your health will improve.”
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Most people need about 0.5 to 0.8 grams of protein per pound of body weight each day to maintain muscle and support overall health, according to medical experts. For a 200-pound person, that would equate to roughly 100 to 160 grams of protein daily.
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Higher amounts may be needed for those who are physically active or trying to build strength. “The amount of protein you need will depend on the frequency and intensity of your workouts,” Malhotra said.
Mistake No. 4: Increasing doses too quickly
Another common mistake is rushing the process and increasing GLP-1 doses too quickly in hopes of faster results, according to the doctor.
“You may start to see results within the first week or month, but some people do need a higher dose over time,” she said. “The key is to be patient and increase it gradually — typically month by month.”
Another common mistake is rushing the process and increasing GLP-1 doses too quickly in hopes of faster results. (iStock)
If a patient doesn’t see results after the first injection, that doesn’t mean the dose should be doubled right away, according to Malhotra.
“That’s a recipe for problems, including side effects like pancreatitis,” she said. “Your body needs time to adjust and adapt.”
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“You can go up if you hit a plateau or if it’s not helping, but we usually wait a month to increase the dose.”
While many expect “instant gratification,” health is about balance, Malhotra added. “It won’t take 20 years, but give it two months, I think that’s fair.”
A general rule of thumb, according to the doctor, is “don’t start too soon, don’t stop too soon.”
Mistake No. 5: Not managing side effects properly
GLP-1 side effects can often be prevented by building a strong foundation of health and keeping everything in balance, according to Malhotra.
“That said, some people will still have side effects, and there are ways to manage them,” she said.
“If you are decreasing the calories but not fixing the nutritional foundation, you will lose lean mass.”
The doctor recommends eating smaller, more frequent meals instead of large portions — ideally about the size of your fist.
It’s also important to keep fat intake low, she advised – GLP-1 medications already slow stomach emptying and fat can slow it even further, which may worsen nausea.
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For nausea and constipation, simple strategies can go a long way, according to the doctor. Some patients find ginger helpful for nausea, she said, though it is not a substitute for medical guidance.
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Incorporating more liquids, such as shakes, soups and broths, can be easier on the stomach, she suggested. Prunes and other fiber-rich foods can help support digestion and prevent constipation.
“These little lifestyle hacks can help a lot with managing the side effects, instead of stopping and then finding that your weight is yo-yoing,” Malhotra said.
CDC official outlines severity of cyclosporiasis as cases surges across US
Cases of Cyclosporiasis, a foodborne parasitic illness, are skyrocketing across 34 states, with nearly 7,000 confirmed or under investigation cases. CDC Deputy Director Gwen Biggerstaff highlights that symptoms like diarrhea and cramping can be severe, urging affected individuals to consult doctors about specific antibiotic treatments. The CDC anticipates identifying the outbreak’s source soon.
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Health officials are warning that what many people dismiss as a routine summer stomach bug may actually be cyclosporiasis, as the U.S. experiences one of its largest foodborne parasite outbreaks on record.
The Centers for Disease Control and Prevention has confirmed more than 1,600 domestic cases of cyclosporiasis since May, with over 5,100 additional cases currently under investigation.
The intestinal infection is caused by Cyclospora (Cyclospora cayetanensis), a microscopic parasite that spreads through contaminated food or water.
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The outbreak has sickened thousands of people, particularly in Midwestern states such as Michigan and Ohio, causing prolonged bouts of severe gastrointestinal illness.
Symptoms usually begin about one week after consuming contaminated food or water, although the incubation period can range from about two days to two weeks, according to the CDC.
Patients should seek diagnostic testing through their primary care physician, saving the emergency department for the treatment of severe dehydration. (iStock)
Early symptoms can overlap with those of a common viral stomach bug, including abdominal pain, nausea and watery diarrhea. Some patients also experience loss of appetite, fatigue and weight loss.
The primary differences lie in how long the illness lasts and how severe the symptoms become, according to Dr. Kenneth Perry, an emergency physician based in South Carolina.
HIGHLY CONTAGIOUS STOMACH BUG SPREADS FAST, HITTING CERTAIN PATIENTS HARDEST
Routine stomach bugs are typically short-lived, resolving within 24 to 48 hours, the doctor said. Even if mild symptoms linger, patients generally feel better after two days.
“Cyclospora is different in this regard,” Perry told Fox News Digital. “It lasts longer, with far more profound watery, foul-smelling diarrhea and abdominal cramping.”
A massive surge in Cyclospora cases means people may be mistaking this parasitic foodborne infection for a standard summer stomach bug. (iStock)
It is possible to test for Cyclospora, but healthcare providers must specifically request it, as the parasite is not routinely included in standard stool testing and many gastrointestinal PCR panels do not detect it, according to the CDC.
Diagnosis is made by examining stool specimens, although patients may need to submit several samples collected on different days, as even symptomatic people may not shed enough of the parasite for it to be readily detected, per the above source.
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If symptoms strongly suggest Cyclospora despite an initial negative test, the screening may need to be repeated, Perry noted.
A primary care physician is often the best point of contact for patients seeking a diagnosis, as most routine stool tests performed in emergency departments do not screen for Cyclospora. A family doctor can order the specialized test if it’s suspected.
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“The emergency department is the appropriate setting for treating downstream symptoms, such as nausea, diarrhea and dehydration,” Perry told Fox News Digital.
People who suspect they have contracted the parasite can also check FDA and CDC food safety alerts to see whether they may have been exposed to a recalled or implicated product.
While routine stomach viruses usually resolve within 48 hours, Cyclospora infections linger much longer with severe, watery and foul-smelling diarrhea. (iStock)
Patients should also focus on staying hydrated by monitoring their urine output. Perry recommends using over-the-counter pediatric formulas, which offer a more effective salt-to-sugar ratio than commercial sports drinks.
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Anyone whose diarrhea lasts more than two to three days, worsens or is accompanied by signs of dehydration should contact a primary care physician.
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Unlike most viral stomach bugs, Cyclospora is treatable with prescription antibiotics. The CDC recommends trimethoprim-sulfamethoxazole (TMP-SMX) as the standard treatment, while people who cannot take sulfa drugs should discuss alternatives with their healthcare provider.
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Neurologists are warning that popular weight-loss medications could have severe negative effects on neurodegenerative conditions like ALS.
Jinsy Andrews, MD, a neurologist and director of NYU Langone’s ALS Center, says the very mechanism that makes these drugs popular — rapid weight loss — can go against the biological needs of patients with neuromuscular disorders.
GLP-1 agonists have shown to be highly effective at managing diabetes and obesity, which are major health concerns across the population. However, the doctor emphasized that the clinical rules shift when dealing with amyotrophic lateral sclerosis (ALS).
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In addition to mitigating some of the inflammation related to obesity and diabetes, GLP-1 medications have been linked to other protective effects.
The therapies have been helpful in reducing cardiovascular disease, stroke risk, liver disease and addiction, according to Andrews.
Neurologists are warning that the rapid weight loss caused by popular GLP-1 medications can severely worsen neurodegenerative conditions like ALS. (iStock)
However, when it comes to an incurable neurodegenerative disease, losing weight and body fat can accelerate a patient’s physical decline.
For an ALS patient, losing weight can cause the condition to progress faster, Andrews said, because the disease’s unique traits make it dangerous to be in a caloric deficit.
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In fact, standard clinical care guidelines for ALS often recommend that patients actively maintain or even gain weight to help preserve their remaining nerve and muscle function.
While GLP-1s effectively treat obesity and cardiovascular risks in the general public, those same afflictions have been shown to slow ALS progression. (iStock)
“In certain conditions where hypermetabolism is something that negatively affects the disease […] losing weight actually makes the disease worse and move faster,” Andrews told Fox News Digital..
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“So, in the setting of a person with ALS — whether they have diabetes or not — using GLP-1s may actually worsen the disease and make for a rapid progression.”
A peer-reviewed case study revealed that an ALS patient experienced a massive, 10-fold acceleration in physical deterioration after starting semaglutide. (iStock)
In a 2025 case report published in the medical journal Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, a 52-year-old ALS patient was prescribed semaglutide to treat her type 2 diabetes.
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Prior to starting the medication, her physical functions were declining at a predictable rate on the standard ALS rating scale.
According to the case report, the patient lost 25 pounds in three months. At the same time, she experienced a sudden, dramatic shift in her disease trajectory, with symptoms worsening significantly.
“GLP-1s may actually worsen the disease and make for a rapid progression.”
Once the semaglutide was discontinued at the advice of medical professionals, the patient’s rapid physical decline stabilized.
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Andrews pointed out that this published documentation, alongside retrospective cohort data of ALS patients with diabetes, provides growing evidence that clinicians must be careful and thoughtful about who they treat with GLP-1 receptor agonists.
While weight-loss medications offer significant benefits for many patients, experts say maintaining body weight and muscle mass remains an important consideration for people with neurodegenerative diseases.
Healthcare providers should be highly cautious and context-aware when prescribing GLP-1 receptor agonists to patients with underlying neurodegenerative diseases, a neurologist cautioned. (iStock)
“Patient safety is of utmost importance to Novo Nordisk, and we take all reports about adverse events from the use of our medicines very seriously,” Ambre James-Brown, global head and AVP of global media at Novo Nordisk, maker of Ozempic and Wegovy, told Fox News Digital.
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“It’s important to note that ALS and other neurodegenerative diseases are not listed adverse reactions or warnings and precautions in the prescribing information for our semaglutide products, including Ozempic or Wegovy,” he added.
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Millions of Americans with high cholesterol now have a new treatment option, as the FDA has approved the first once-daily oral PCSK9 inhibitor.
Merck, the New Jersey-based manufacturer of Lipfendra (enlicitide), announced the approval on Thursday.
Lipfendra blocks the action of PCSK9, a naturally occurring protein that affects how the liver removes LDL (“bad”) cholesterol from the bloodstream.
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“PCSK-9 is a protein that works in the liver, preventing the recycling of LDL receptors, as a result increasing bad cholesterol in the blood,” Dr. Marc Siegel, Fox News senior medical analyst, told Fox News Digital.
Millions of Americans with high cholesterol now have a new treatment option, as the FDA has approved the first once-daily oral PCSK9 inhibitor. (iStock)
“In the caveman days, this was useful when we were hunter-gatherers and didn’t always have food, but now it mainly forms plaques that lead directly to heart disease.”
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The pill is approved as an add-on to diet and other LDL-lowering therapies in adults with high cholesterol, including inherited forms of high cholesterol, Merck stated.
In phase 3 clinical trials, Lipfendra was shown to reduce LDL cholesterol by roughly 56% to 60% when combined with statin therapy.
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“This is around double the impact of statins,” Siegel noted.
The pill was generally well-tolerated in the trials, Merck reported. The most common side effects were diarrhea and dizziness, while serious side effects and treatment discontinuations occurred at rates similar to those in the placebo group.
The pill was generally well-tolerated in the trials, Merck reported. The most common side effects were diarrhea and dizziness, while serious side effects and treatment discontinuations occurred at rates similar to those in the placebo group. (iStock)
Statins, which work by blocking an enzyme in the liver that the body uses to make cholesterol, are the most commonly prescribed cholesterol-lowering medications, according to the American Heart Association.
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For many people, statins are effective on their own. But for some patients who have very high cholesterol levels, inherited forms of high cholesterol or adverse side effects when taking statins, another medication — such as a PCSK9 inhibitor like Lipfendra — may be necessary, per the AHA.
Lipfendra blocks the action of PCSK9, a naturally occurring protein that affects how the liver removes LDL (“bad”) cholesterol from the bloodstream. (iStock)
Until now, PCSK9 inhibitors — such as Repatha and Praluent — have only been available as injections, a factor experts say may have contributed to their underuse.
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“Repatha, the injectable form, is very useful, with few side effects,” Siegel noted. “The oral form, Lipfendra, is also well-tolerated and just as effective.”
Additional research is needed to determine whether Lipfendra also reduces the risk of heart attacks, strokes and cardiovascular deaths. Results from a large clinical trial are expected to be available in 2029, Merck stated. (Merck & Co.)
Additional research is needed to determine whether Lipfendra also reduces the risk of heart attacks, strokes and cardiovascular deaths. Results from a large clinical trial are expected to be available in 2029, Merck stated.
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“Steve Nissen, longtime head of preventive cardiology at Cleveland Clinic, tells me that the lower the better when it comes to LDL cholesterol, especially in those at risk for heart disease,” Siegel added.
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