There are a few mainstays of a safe, effective, and sustainable weight-loss plan. Eating a nutritious diet. Exercising regularly. Getting enough sleep.

But even if you do everything “right”, sometimes the scale won’t budge. That’s especially true as we age and losing body fat gets harder. For some people, weight-loss medications can provide a jumpstart to long-term weight changes. But what are the best GLP-1s for seniors? And are they safe as we age?

Keep reading for everything you need to know about these popular weight-loss medications in older adults.

Understanding weight loss in seniors

Losing weight is often challenging, no matter your age. For seniors, it can take real dedication, as some biological factors work against you as you get older.

That said, maintaining a healthy weight as you age is important. It can help you stay independent, mobile, and engaged in the activities you enjoy.

Common weight-related challenges for seniors

There are a handful of reasons weight loss gets harder with age that are out of your control. These affect everyone, no matter your exercise routines or diet.

Slower metabolism

First, your metabolism slows down. Metabolism is the rate at which your body burns calories, or the energy your body needs every day. This stays pretty stable in adulthood until around age 60. After age 60, your metabolism starts to slow down, so you burn fewer calories and may gain more weight, especially around your stomach.

Muscle loss

At the same time, you’re also naturally losing muscle mass. As we get older, we lose about 8 percent of our lean muscle mass per decade, starting around our 30s or 40s. This muscle loss can get even faster around age 65.

Muscle cells burn more calories than fat cells, even when you’re not active. That means losing muscle also hurts your metabolism, potentially leading to weight gain.

Menopause

Lastly, after menopause, women tend to gain additional weight due to the decline in estrogen.

All of these factors can make it harder to lose weight or even just maintain your current weight as you get older.

What are GLP-1s?

To fully understand GLP-1s and aging, it helps to know a little more about what these medications actually are.

GLP-1s stand for glucagon-like peptide-1 agonists or glucagon-like peptide-1 receptor agonists. These medications were first developed to help treat type 2 diabetes. They can also help people with obesity lose weight and manage sleep apnea symptoms.

That’s because of how they affect the body’s own signals of hunger and fullness. Glucagon-like peptide-1 is a hormone you make naturally. When you eat, your digestive system releases GLP-1, which eventually signals to your brain that you’re full.

GLP-1 medications mimic this process, telling your brain that you’re already full, so you eat less and lose weight over time. They also slow down digestion, so you feel full for longer.

While this can lead to substantial and rapid weight loss, it can also spark nausea, constipation, diarrhea, and muscle loss.

Age considerations with GLP-1 medications

One of the risks of GLP-1 medications can be muscle loss, especially if someone loses a lot of weight very quickly. In fact, 25 to 30 percent of weight lost on GLP-1s can come from losing muscle rather than fat.

Muscle loss is concerning at any age, because maintaining muscle mass keeps us functioning at our best. But it’s particularly concerning as we get older. That's because it can worsen the natural muscle loss that occurs with age, called sarcopenia. Speeding up sarcopenia can limit your strength, worsen your balance, and increase your risk of a dangerous fall.

That’s why it’s important to eat plenty of protein and do strength training workouts regularly while taking GLP-1s.

These actions will help you stay active and independent in your 60s and beyond, while watching the number on the scale change.

GLP-1 age limit

Most GLP-1s are approved for adults 18 and older. There is currently no upper age limit on GLP-1 use.

Are GLP-1s safe for seniors?

Generally, yes.

It’s important to note that very few people 65 and older have been included in any of the studies of GLP-1s. In fact, people 75 and older make up less than 1 percent of GLP-1 study participants.

Older adults can safely lose weight, manage diabetes, and control sleep apnea with GLP-1s. But seniors also have higher risks of some of the side effects of these medications, such as nausea, diarrhea, and constipation. "Older adults are at a higher risk for increased muscle loss, especially those who are not physically active,” says Bold Care nurse practitioner Christa Steffensmeier.

Losing or maintaining a healthy weight as you get older can help manage your risk of heart disease, high blood pressure, stroke, and diabetes. A healthcare provider, including a Bold Care provider, can help determine if a GLP-1 is a safe option for you to explore in your 60s and beyond.

Online weight-loss medications

Various online providers can prescribe weight-loss medications without an in-person visit, including Bold. Our weight-management programs for older adults combine GLP-1s for eligible members with lifestyle changes for weight loss that lasts. You’ll receive personalized guidance on meals, movement, and sleep, as well as recipes, reminders, and healthy habits created just for you. Your provider stays in the loop and adjusts the plan as you go so you can make sure your approach is working. 

There are two forms: pills that you take orally and injections that you give yourself at home.

Oral weight-loss medications

Pills for weight loss include:

• Orforglipron (Foundayo), a pill taken once a day, approved for adults with obesity, that reduces hunger, makes you feel full, and slows digestion
• Orlistat (Xenical), a pill taken three times a day, approved in anyone 12 and older, that reduces the amount of fat your body absorbs from food
• Phentermine-topiramate (Qsymia), a pill taken once a day, approved in anyone 12 and older, that reduces appetite and makes you feel full 
• Naltrexone-bupropion (Contrave), a pill taken one to two times a day, approved in adults, that may reduce appetite and make you feel full
• Oral semaglutide (Rybelsus, Wegovy), a pill taken once a day on an empty stomach, approved for adults with obesity, that slows digestion and makes you feel full

Injectable weight-loss medications

Injectable GLP-1s approved for adults include: 

• Semaglutide (Ozempic, Wegovy), injected weekly
• Tirzepatide (Mounjaro, Zepbound), injected weekly
• Liraglutide (Saxenda), injected daily

Best GLP-1 medications for seniors

The challenges above are among some of the reasons older adults might turn to medications for assistance in losing weight.

There is no one “best” GLP-1 medication for older adults. In fact, there’s very little research on the effects of these medications in people 65 and older.

In one of the largest reviews of this limited data, researchers found older adults were more likely to have gastrointestinal side effects from GLP-1s than younger adults. They were also more likely than younger adults to stop taking the medication.

Some healthcare providers consider GLP-1s a last resort for older adults. They'll only prescribe them after other weight-loss strategies haven’t worked.

That means determining the best GLP-1 for you will involve a conversation with your doctor about your lifestyle and goals. You might consider your personal preference for a pill over an injection, your insurance coverage and costs, and potential side effects, for example.

Weight-loss programs for seniors

Weight-loss programs for seniors often involve lifestyle changes, support from a care provider, and some time and dedication. Here’s what you can expect. 

Understanding healthy weight ranges

The number on the scale won’t tell you much about your overall health. So, it’s important to talk with a healthcare provider about a healthy weight range for you. They’ll consider factors like your age, sex, height, physical activity levels, and body composition.

Some healthcare providers use body mass index (BMI) to estimate body composition. BMI compares your weight to your height to estimate how much body fat you have. Higher body fat is associated with a number of health risks. This might be a more helpful indicator of health than your weight alone. But BMI doesn’t take into consideration how much muscle mass you have. Very muscular people can end up being miscategorized as having obesity.

You can find your BMI using an online calculator. The results will fall in one of four categories:

• Underweight: less than 18.5
• Healthy weight: 18.5 to 24.9
• Overweight: 25 to 29.9
• Obesity: 30 and above

This calculation can be a starting point for a conversation with your healthcare team or Bold Care provider about a healthy weight for you. 

In Bold Care visits, you’ll set some concrete goals for specific, measurable, and achievable results over a set period of time. You’ll also talk about processes for keeping track of your progress, such as:

• Noticing how your clothes fit differently
• Seeing how your energy and sleep improve
• Writing down the increases in weight you can carry or distances you can walk
• Weighing yourself weekly

Lifestyle changes

You can tweak the following factors to help support your weight-loss journey.

Diet

When it comes to the actual weight loss, there are some straightforward diet changes to consider. Get plenty of protein and choose complex carbohydrates that are rich in filling fiber. Swap animal-based saturated fats found in dairy and red meat for unsaturated fats found in nuts, seeds, avocado, and fish. Make sure you’re thoughtful about your portion sizes. Ultimately, you need to burn more calories than you take in to lose weight. Drink plain water, unsweetened tea and coffee, and seltzer to avoid excess calories from sugary beverages.

Exercise

Exercise can help you burn additional calories along your weight-loss journey. According to the CDC, adults should aim for:

• At least 30 minutes of aerobic activity, at least five days a week
• At least two muscle-strengthening workouts a week
• Two hours of stretching and balance exercises over the course of the week

Talk to a healthcare provider before starting any new exercise routine, including one for weight loss for older adults. They can help you identify safe and effective types of exercise you might enjoy.

It might take some trial and error to find a form of exercise you like and that feels good for your body. Start by taking a look at Bold’s exercise platform. We have seated, standing, and floor workouts for all skill levels, with or without added equipment, that anyone can follow along with. And if you’re already working with a Bold Care weight-loss care provider, you’ll have one-on-one support to find movement that works for you.

Sleep

Successfully losing weight also takes getting enough sleep. Adults ages 61 to 64 need seven to nine hours of sleep a night. Adults 65 and up need seven to eight hours. And managing stress can also help. It can be harder to stick with an exercise routine or a nutritious diet when you’re under a lot of pressure.

Combining medication with lifestyle changes

For older adults who need additional assistance losing weight, FDA-approved GLP-1 medications can be a helpful addition to the lifestyle changes above. Bold’s Care Plan couples medication with personalized exercise and nutrition programming, no calorie tracking or meal logging required. Under the Medicare Bridge program Part D, eligible patients can receive FDA-approved GLP-1 medications for a $50 monthly copay.

Weight-loss medications, including GLP-1s, are most effective when used alongside lifestyle changes. In fact, you might see language about adopting a reduced-calorie diet or getting more exercise in the prescribing information. 

A year after stopping GLP-1s, research suggests people have typically gained back 60 percent of the weight they lost. But if you’ve already adopted supportive diet and exercise habits, you may be less likely to gain back the weight after you stop taking medication.

You also don’t have to stop taking GLP-1s; you can adjust your dose and use it to maintain, Steffensmeier says. “This dose looks different for everyone, but regardless of medication use, consistent activity, quality sleep, stress management, substance avoidance, and healthy eating habits are pillars of weight management,” she says.

Strength training and eating enough protein can help ward off muscle loss from using weight-loss medications.

Bold for weight management

Bold’s doctor-supervised weight-management program is uniquely designed to help older adults looking to lose weight. And 78% of Bold users pay nothing out of pocket for their appointment.

Our providers can prescribe weight-loss medication online. But they also offer personalized exercise and nutrition programming and dedicated, consistent support to help you stay accountable, including monitoring you for any side effects. 

We believe your weight-loss success isn’t just about the number on the scale. Bold can help you maintain your independence and continue doing the things you love at 65 and beyond.

So talk to a Bold Care provider today. They'll help you understand the ins and outs of GLP-1s for weight loss for seniors and how to stay strong and healthy while taking them.