Tia Timmer was always “on the heavier side,” but her weight never held her back – until she had to keep up with two grandchildren.
Now in her mid-50s, Timmer began using weight -loss medication to help.
“I had to do it for them,” she said. “They would race ahead of me up the flight of stairs to my apartment. And I would have to catch my breath just from walking up to the door.”
Timmer never anticipated being a single mom for a second time. But amid the first months of the COVID-19 pandemic, her daughter fell further into drug addiction and could no longer care for her children. The ensuing custody battle was hard on the whole family, and Timmer found comfort in food.
“During that whole process, I just nose-dived. And I ate and I ate and I ate. I just self-medicated with food because I realized I couldn’t save my daughter,” she said.
Once the dust settled, Timmer was at her highest-ever weight, prediabetic and facing an onslaught of medical issues.
“I felt horrible. I felt miserable. I could hardly move. My body hurt. And I was only 52,” she said.
So, in 2023 Timmer began taking the GLP-1 medication Zepbound and has lost 110 pounds .
The subject of both apprehension and hype, semaglutide medications have been at the center of weight loss discourse in recent years. Millions of Americans have taken one form of the drug or another. Recent surveys have found upwards of 10-12% of Americans had taken a GLP-1 medication at some point in their lifetime. A survey from KFF (formerly Kaiser Family Foundation) last year found 6% of Americans are currently taking it.
Timmer is among the most likely demographic to use the drug. A 2025 survey from the RAND corporation found 1 in 5 women between the ages of 50 and 64 were currently taking a GLP-1 medication.
In the first month of the new year, many people are making plans to lose weight. Millions more will likely start GLP-1s this year.
What are GLP-1s?
Glucagon-like peptide-1 is a naturally occurring hormone within the body that regulates insulin uptake. The drug is injected and increases the amount of this hormone in the body.
First approved in 2005, the drug was primarily used for diabetes patients to increase and help regulate insulin in the body.
“It’s immensely helpful for a lot of people,” said Providence dietician Caitlin Snider. “There seems to be kind of continually new discoveries in research around these medications about benefits, not just for diabetes and weight, but also for things like heart health, like heart disease risk reduction and kidney health.”
Because the amount of GLP-1 determines how much insulin is released into the body, it was first used for diabetes patients. But the drug also slows the emptying of the stomach, which gives people a sense of fullness earlier in a meal than they would otherwise.
The drug does not cause weight loss itself. Patients lose weight because the shot changes their eating habits by making them feel fuller. The drugs are sold under brand names like Ozempic, Wegovy or Zepbound.
Patients asking for GLP-1 make up about half of the requests on any given day at Spokane’s MultiCare Rockwood Weight Loss Center, said nurse practitioner Megan Vulcan.
“GLP-1s produce approximately 10% to 20% body weight loss, and that is just much more than traditional oral medicines,” Vulcan said.
The so-called “diet pill” popularized in the last half century only produced a 5% to 7% body weight loss, which often was not enough to have significant health benefits.
The weight loss from GLP-1s occur over a long period to minimize negative side effects. Dosing starts low and is increased slowly.
Risks and
side effects?
Use of these drugs has skyrocketed in recent years, partly because they have few known long-term side effects.
“There really aren’t any very concerning long-term effects that we’re seeing,” Snider said. “Side effects are fairly common, but they typically will lessen over time.”
The most common side effect is nausea, which often dissipates after several weeks. Having severe and persistent nausea is often a sign the patient should stop the medication. Other digestive side effects include constipation, diarrhea, bloating, gas and acid reflux.
Many of these symptoms are caused by the medication’s slowing of movement within the digestive tract, which can often cause issues when the body adjusts to its new rhythm. If someone does not sufficiently change their diet after starting the medication, their body may have difficulty digesting the larger food portions they previously ate without issue.
When the drug is used for weight loss, the patient should have at least a body mass index of 27. The National Institutes of Health lists a BMI of 25 as overweight and a BMI of 30 as obese.
A lot of people currently using the drug should not be, Vulcan said.
“There is a lot of buzz on the internet. But a lot of the people taking the medication aren’t candidates for it. They don’t weigh enough to meet the criteria,” she said.
GLP-1s are not a medication that should be used to lose those last 5 pounds, she added. It is a serious commitment that most patients will remain on for the rest of their life.
“More and more of those in the health field are seeing excess body weight as a chronic condition, and it’s being treated as one,” Snider said. “For other chronic conditions like diabetes or high blood pressure, we generally expect people to take a medication to manage that condition for the rest of their lifetime. We should think of these drugs the same way.”
That is not how most patients view the drug. Approximately half of GLP-1 users stop taking the drug within a year of starting it, according to a 2025 study from the European Association for the Study of Diabetes.
Many start the drug to lose weight but plan to stop once they reach their goal. In most cases, the weight will rapidly return after stopping the drug. A review of dozens of studies found GLP-1 users gained approximately 2 pounds a week after stopping the drug. Within two years, the patient returned to their original weight or higher and regained similar levels of heart disease and diabetes within that time frame.
Vulcan likened having a metabolic problem with weight to that of having blue eyes – just as much of a genetic issue as that of lifestyle choices.
“There are times where you might take a hiatus for specific reason, but most of the time when we’re treating a chronic illness, people will be on treatment long term,” Vulcan said.
Another side effect frequently associated with GLP-1s is the loss of muscle mass. More the consequence of any rapid weight loss than a side effect of this specific medication, muscle loss is still a risk for GLP-1 users.
At MultiCare’s Rockwood Weight Loss Center, a body scanner is used every 90 days to check for muscle loss.
“We need to make sure we’re not being too aggressive so that we’re not causing harm,” she said.
Losing weight too fast
Andrea Snelling started Zepbound at the end of last summer, and in less than six months she lost nearly 60 pounds.
Her weight loss was not steady throughout that time. Snelling did not see any progress on the starter dose of 2.5 milligrams a week, and her primary care physician increased her dose to 10 milligrams a week within a few months. Once at that higher dose, Snelling lost the majority of those 60 pounds within several months.
Having struggled with her size for many years, Snelling had never lost that much weight in such a short time. She thought losing weight so quickly showed her body was getting healthier.
“I was happy. My goal was to lose 70 pounds, so I was almost there already,” she said.
But suddenly on Christmas Eve last year, she had “excruciating” abdominal pain that put her in the emergency room. Her rapid weight loss had made it more difficult for her gallbladder to process bile, which had hardened in the organ to form gallstones. A few weeks ago, she had surgery to remove the organ.
After her experience with GLP-1s, Snelling is scared to continue using the drug. But she is also scared of regaining the weight.
“I’m so scared, ’cause I worked so hard to lose weight and literally lost my gallbladder because of it. I don’t want all of that to mean nothing,” she said.
She does not regret taking Zepbound. She regrets allowing herself to lose so much weight so quickly.
“I wish I had done it slower, and I wish someone would have told me that rapid weight loss is not healthy,” she said.
Vulcan stressed the importance of going in person to a physician to get these medications from a physician and not purchasing them online.
“Appropriate dosing is really important, and seeing how a patient is reacting to the medication is especially,” she said. “A lot of the negative attention is around people who advance the dosing too quickly and too high, and they’re not making lifestyle changes that are sustainable.”
How much
do they cost?
A large barrier to the drug is its cost. While GLP-1s are frequently covered by insurance when used to treat diabetes, coverage for weight loss is much less common.
In the United States, drug manufacturers set a list price someone would pay out of pocket for medication. GLP-1 manufacturers like Lilly or Novo Nordisk have set the list price for the drug at more than $1,000 a month. But “no one really pays” the list price, said University of Utah health economics professor Joey Mattingly.
These prices are often discounted when sold wholesale through insurance, and even out -of -pocket costs are often lowered by rebates and discounts. Even these discounted rates can be untenable for most patients.
Zepbound can be purchased directly from Lilly for $500 a month. That is the price MultiCare patient April Wright pays for her GLP-1 medication.
At her heaviest, Wright weighed 456 pounds and lost nearly half of that weight after bariatric surgery in 2017.
But in the years since that surgery, Wright struggled to fully get down to the weight she wanted. After starting Zepbound last year, she now weighs 180 pounds.
She initially hoped the drug would be covered by her insurance, but she was no longer diabetic following her weight loss surgery. Without insurance, she struggles to pay the $6,000 a year price tag, but she says the GLP-1 medication is worth the cost.
“This is something I plan to maintain the rest of my life. Hopefully it gets a little cheaper, so it doesn’t have to be this rough. But this is a priority in my life. My medicine comes out with my rent,” she said.
Insurance has historically viewed weight loss medication as “merely cosmetic,” but that might change in the near future, Mattingly said.
For Timmer, losing weight was not merely cosmetic, it was recognition she had a problem and needed to do better. Seeing her daughter’s struggle with drug addiction made her realize she had an addiction too.
“What happened to our family made me look at myself. I have this addiction, and I came to terms with that. My drug of choice is just food,” she said.
Whenever the world became too difficult to bear, Timmer would eat. While GLP-1s helped her do it, it was only through changing her relationship to food that Timmer lost weight and got healthier.
“I feel a lot better now and I think that’s just as important as the weight I lost,” she said.
