Weight-Loss Drugs: Risk, Results & Recovery

Today, everyone seems to be taking a GLP-1 medication to lose weight. Recently, even Serena Williams admitted to using them through her partnership with the telehealth company Ro. Her husband, Alexis Ohanian, is an investor in Ro and serves on its board, which may play a role in her endorsement deals. Ro partners with Eli Lilly (maker of Zepbound) and Novo Nordisk (maker of Wegovy) to diagnose patients and provide access to GLP-1 weight-loss prescriptions through its platform.

There is a lot of controversy around Serena’s endorsement. She has long celebrated diverse body types, yet she is now promoting a drug to achieve a “more desirable” physique. She has stated that losing weight after having children was difficult and that she needed medication to do so. But is it ethical to promote GLP-1s for vanity rather than for treating severe obesity or diabetes? And is the campaign downplaying the risks?

Keep in mind: Serena Williams is a professional athlete with an entire team of experts—including personal trainers, nutritionists, dietitians, and chefs—to guide her safely through her fitness, nutrition, and weight-management journey. Everything she does is closely monitored to support peak health and performance. For the average person, these medications carry very real risks despite their popularity and perceived “ease.”

If you are considering a GLP-1, here’s what you need to know:

1.      Your body can produce GLP-1 naturally. GLP-1 (glucagon-like peptide-1) is naturally produced by the body through diet. Eating healthy proteins and fats slows digestion and stimulates GLP-1 release from the gut, which increases feelings of fullness, regulates blood sugar, and slows stomach emptying.

2.      Exercise builds natural weight-loss power. Strength training is one of the most effective—and risk-free—ways to promote natural weight loss. Muscle burns more calories than fat and supports a healthy metabolism.

3.      Weight-loss drugs are not magic. Even if medication helps reduce health risks, it should never replace proper nutrition and exercise. Relying solely on GLP-1s often leads to muscle loss, fat gain, and long-term frustration as body composition changes—making maintenance much harder. Most of us are not Serena Williams; we don’t have professional guidance, carefully planned meals, or daily workouts designed to maintain and build muscle. If you are generally healthy and only want to lose a few “vanity pounds,” I strongly recommend avoiding semaglutides. Your health is not worth the risk of looking better in a bathing suit. It’s just not.

4.      The muscle-loss problem. During these medication cycles, calorie intake often becomes too low, and muscle mass decreases—even as weight drops. When muscle is lost, metabolism slows, making long-term maintenance much harder. Once the medication stops, the body clings tightly to calories.

5.      Regaining the weight back. The majority of people regain much of the weight they lost because of calorie restriction, muscle loss, and metabolic slowdown. After stopping a GLP-1, the goal shifts from rapid weight loss to metabolic restoration. Prolonged calorie restriction often leads to muscle loss, slowed metabolism, and disrupted gut balance—making weight regain highly likely. Most people regain 50–70% of the weight they lost within a year. About 15–20% regain all the weight (or more), while 30–40% maintain some of the weight loss.

When weight returns, it comes back as fat—not muscle. GLP-1 medications are associated with a higher proportion of muscle loss compared to dieting alone: 25–39% of weight lost may be lean mass (muscle + other non-fat tissue) for GLP-1 users, versus 10–30% for diet-only interventions.

Example: Jim weighs 250 lbs. He loses 50 lbs on a GLP-1—32.5 lbs is fat, 17.5 lbs is muscle. Jim goes off the medication and regains 40 lbs (80%) of the weight—but it’s all fat. He has now gained 7.5 lbs more fat than he had before, even though he is still 10 lbs down overall.

With proper diet (adequate protein), resistance training, and moderate weight loss, you can preserve much of your muscle and maximize fat loss.

The hidden side effects of muscle loss:

• Digestive Health: Muscles in the digestive tract help move food and waste. Loss of muscle can slow digestion, leading to bloating, constipation, or irregular bowel movements.

• Heart Health: The heart is a muscle. Loss of lean tissue throughout the body can reduce cardiovascular strength and endurance, affecting circulation and recovery. Unlike most tissues, heart muscle cells regenerate very slowly—less than 1% are replaced each year.

• Metabolic Function: Muscle burns calories even at rest. Losing muscle slows resting metabolism, making it harder to maintain or lose weight.

• Mobility and Strength: Legs, back, and core muscles support posture, balance, and movement. Loss of muscle in these areas increases fatigue, weakness, and injury risk.

Rebuilding lean muscle, stabilizing metabolism, and fueling your body with real food—rather than starving it—is essential during and after GLP-1 treatment. Protecting heart muscle integrity is especially critical because damage is largely permanent. Lifestyle factors—exercise, nutrition, and stress management—are vital for maintaining the heart you were born with.

Before considering semaglutides (Wegovy, Ozempic), consider these points:

• Expense: Some cost over $1,000/month unless covered by insurance.

• Muscle loss: Muscle, including vital organs like the heart, is too valuable to lose.

• Side effects: Potential thyroid tumors and cancers have been observed in rats; human data is ongoing.

• Digestive issues: Can be long-lasting or permanent.

• Weight regain: Most people regain lost weight after stopping. Have a plan before starting.

GLP-1 medications can help some people, but they are not a shortcut to health. Protecting your muscle, metabolism, and overall well-being will always provide better, longer-lasting results than any quick-fix solution. Invest in a personal trainer or nutritionist to ensure you’re building a strong foundation for sustainable health. And remember—true wellness requires participation. You have to be an active player in your own journey. Relying on medications alone is a dangerous road, and believe me, your body keeps score.