GLP-1 drugs like semaglutide and tirzepatide can help regulate your blood sugar, appetite and digestion. Your doctor may prescribe a GLP-1 as a type 2 diabetes or weight loss medication and sometimes to treat both conditions at once. You might recognize some of the common GLP-1 brand names, like Ozempic, Wegovy, Mounjaro and Zepbound.
Christine Lovato, MD, a bariatric surgeon with Banner - University Medicine, said, “GLP-1s are important drugs that can treat diabetes and the cause of obesity. People also love the fact that food noise finally stops with these medications.”
She explained more about how GLP-1 medications can be helpful for some older adults and what to know about possible side effects.
Why GLP-1 medications may affect older adults differently
Compared to younger people, if you’re an older adult:
- You may be more likely to take multiple medications
- You may have kidney disease, heart disease, diabetes, digestion problems or lower muscle mass
- Appetite loss could mean you don’t eat enough
- Side effects like vomiting or diarrhea could make you dehydrated faster
- Muscle loss, which can be part of weight loss, can affect your strength, balance and independence
You may need closer monitoring than someone who is younger and your dose and weight-loss pace may need to be individualized.
Common side effects to know
GLP-1s may cause side effects such as:
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Heartburn or reflux
- Stomach pain or bloating
- Low appetite
- Fatigue
- Headache
- Dizziness
- Reactions at the injection site
“Most side effects improve with time and should be managed by an experienced obesity medicine provider,” Dr. Lovato said. “The goal is finding the right drug and the right dose to get the best outcome and minimize side effects.”
Side effects that may be more concerning with age
Some side effects are easier to manage in younger people but more likely to cause issues if you are older.
Dehydration and kidney strain
Vomiting, diarrhea or eating and drinking less can cause dehydration, which can affect kidney function, blood pressure and dizziness. Call a provider if vomiting or diarrhea don’t stop or you can’t keep fluids down.
Muscle loss and weakness
Weight loss can include both fat and muscle and muscle loss can affect your balance, walking, fall risk and daily function. Ask your provider about protein, strength training and whether you’re losing weight too quickly.
Malnutrition or eating too little
When you don’t have much appetite, it can be harder to get enough protein, vitamins, minerals and fluids. Warning signs that you aren’t eating enough can include weakness, dizziness, fatigue, unplanned rapid weight loss or poor wound healing.
Low blood sugar
GLP-1 medications don’t usually cause low blood sugar but your risk can increase if you are also taking other diabetes medications like insulin or sulfonylureas. Symptoms can include shakiness, sweating, confusion, dizziness or weakness. If you have low blood sugar, your provider may need to adjust your medication doses.
How to manage side effects
Your health care provider can give you advice on managing side effects tailored to your needs. Your provider may recommend that you:
- Take medication to reduce stomach acid
- Drink plenty of water
- Get plenty of protein and fiber in your diet (possibly including some from supplements)
- Take certain vitamin and mineral supplements, including calcium
- Exercise to build and maintain strength, balance and flexibility
Who should be extra cautious?
Because of the risk of side effects, you should talk to your provider about the pros and cons of GLP-1s if you:
- Have a history of pancreatitis
- Have gallbladder disease
- Have stomach-emptying problems
- Have kidney disease
- Are at risk of dehydration
- Take insulin or other diabetes medications that can cause low blood sugar
- Are frail, losing weight unintentionally or already have low muscle mass
- Have swallowing issues, poor appetite or nutrition concerns
- Use compounded or non-FDA-approved versions of GLP-1s
GLP-1s are not recommended for people with severe gastroparesis or with a personal or family history of medullary thyroid cancer or MEN2.
How to use GLP-1 medications more safely as an older adult
Many older adults can take GLP-1s safely. To reduce your risk of side effects and complications:
- Use FDA-approved medications from trusted pharmacies
- Schedule a comprehensive medication review with your provider or pharmacist to check for interactions
- Ask whether you need to adjust any diabetes medicines
- Track any side effects, your appetite, hydration, weight and bowel changes
- Make sure you focus your food intake on protein and nutrient-dense foods
- Drink fluids regularly unless you’ve been instructed to restrict them
- Include strength-building activity as long as your provider says it’s safe for you
- Tell your provider about any dizziness, weakness, falls, confusion or ongoing digestive symptoms
- Keep your follow-up appointments so your provider can monitor your treatment and any side effects
When to call your doctor
Call your provider for guidance if you have:
- Ongoing vomiting or diarrhea
- Signs of dehydration, like dizziness, dark urine or confusion
- Severe constipation or belly pain
- Severe pain in the upper abdomen, especially if it spreads to the back
- Symptoms of low blood sugar
- Weight loss that seems too fast
- Weakness or loss of muscle strength
- New or worsening mood changes such as depression or suicidal thoughts
- Trouble eating enough
- Falls or near-falls
- Signs of an allergic reaction, such as swelling or hives
Get emergency care for:
- Trouble breathing
- Swelling in your face or throat
- Fainting
- Severe abdominal pain
- Confusion
- Signs of severe dehydration
Bottom line
If you’re an older adult, GLP-1 medications may help you manage type 2 diabetes, weight or related health risks; however, you may need a more personalized plan with careful monitoring. Side effects can be more likely to cause complications with age.
Talk with a Banner Health provider about whether a GLP-1 fits your health goals, medications and nutrition needs so you can figure out if a GLP-1 is right for you.
FAQs about GLP-1s in older adults
Are GLP-1 medications safe for older adults?
They may be safe and helpful for some older adults but they require medical supervision and closer monitoring for side effects, hydration, nutrition, muscle loss and medication interactions.
What are the most common GLP-1 side effects?
Common side effects include nausea, vomiting, diarrhea, constipation, stomach pain, reflux, low appetite, fatigue and injection site reactions.
Can GLP-1 medications cause muscle loss?
Weight loss can include muscle loss. Older adults should ask about protein intake, strength training and how to lose weight at a safe pace.
Can GLP-1 medications cause dehydration?
Yes. Vomiting, diarrhea or reduced food and fluid intake can lead to dehydration, which can be more serious for older adults.
Should older adults stop GLP-1 medication if they have side effects?
Do not stop or change medication without talking to your provider, unless you are having emergency symptoms such as trouble breathing, severe allergic reaction or severe abdominal pain.
What should I ask before starting a GLP-1?
Ask why it is recommended, what side effects to watch for, how it may affect your other medications, how to protect muscle and nutrition and when to follow up.
