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Older adults taking GLP-1 medications like Ozempic may experience concerning side effects, according to a new study.
Researchers have warned that seniors have a greater risk of developing malnutrition, dehydration and other frailty-related conditions during significant weight loss.
The researchers clarified that they are not advising seniors against using GLP-1s, but are instead calling for caution among vulnerable individuals as the use of these medications expands.
GLP-1 medications like Ozempic, Zepbound and Mounjaro are increasingly used to treat obesity and Type 2 diabetes, helping patients lose weight, improve blood sugar control and lower the risk of cardiovascular disease.
According to the Centers for Disease Control and Prevention (CDC), obesity affects nearly 40 percent of U.S. adults age 60 and older, and use of these medications among seniors continues to grow.
While the benefits of GLP-1 medications remain substantial, researchers say physicians should be alert to signs of frailty as weight loss progresses in older patients.
“We undertook this new study because starting July 1, 2026, millions of Americans older than 65 years of age have become eligible to access weight-loss medicines such as Zepbound (tirzepatide) and Wegovy (semaglutide) through the new Medicare GLP-1 Bridge program,” study author Venky Soundararajan told Newsweek in an email.
“This makes the current study especially important and timely for understanding which patient subsets can achieve major weight loss while preserving strength, nutrition and physiologic reserve.”
The Findings
The observational study, conducted by healthcare artificial intelligence (AI) company nference, evaluated adults aged 65 and older taking tirzepatide.
The researchers examined the development of malnutrition, protein-energy malnutrition, appetite suppression, dehydration and sarcopenia, and they found that frailty-related conditions became more common as patients achieved greater weight loss.
Appetite suppression increased from 2.9 percent among those losing up to 5 percent of body weight to 10.2 percent among patients who lost between 30 and 40 percent.
Dehydration rose from 1.8 percent to 4.8 percent, while malnutrition increased from 0.8 percent to 3.1 percent and protein-energy malnutrition from 0.5 percent to 2.9 percent.
Poor Outcomes
Patients who developed frailty-related conditions after starting tirzepatide also experienced substantially higher rates of poor outcomes.
Compared with tirzepatide users who did not develop malnutrition, these patients had a 25-fold higher relative risk of mortality, a 20-fold higher risk of intensive care unit admission and an 11-fold higher risk of hospitalization.
Researchers also found that older age, more advanced diabetes, metabolic dysfunction-associated fatty liver disease or steatohepatitis, and cardiorenal disease were more common among patients who later developed frailty-related conditions.
Physician-reviewed causes of death among affected patients most frequently included respiratory failure, septic shock, advanced malignancy and multiorgan failure.
“The practical implication is that strength training, adequate protein and hydration should begin alongside major weight loss, rather than after weakness appears, particularly as tirzepatide-associated weight loss exceeds 10 percent to 15 percent of baseline light,” Soundararajan said.
“Routine care should track functional measures such as grip strength, chair-rise ability, walking speed, exercise tolerance and body composition so clinicians can recognize a trajectory toward frailty early and adjust nutrition, activity and treatment intensity.”
What’s Next
The researchers said doctors should work to identify older patients at higher risk of frailty during tirzepatide treatment and provide closer follow-up as weight loss progresses.
Monitoring nutrition, hydration and muscle health could become increasingly important as more older Americans gain access to GLP-1 medications through Medicare.
“Every adult over 65 should have an individualized discussion with their physician that carefully weighs the potential cardiometabolic benefits against the possibility of frailty-related complications based on their baseline muscle reserve, nutritional status, comorbidities and functional capacity,” Soundararajan said.
He added that a growing compendium of studies “reinforces the broader implication that GLP-1 medicines may affect multiple organ systems positively or negatively, making holistic-patient health monitoring particularly important in older adults.”
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