Weight loss injections (GLP-1 receptor agonists like semaglutide or liraglutide) are increasingly used in seniors, but several important considerations apply. Clinical trials (e.g., LEADER, SUSTAIN) included older adults but rarely as a primary analysis group; evidence for efficacy and safety in frail elderly is limited. Key risks include accelerated muscle loss (sarcopenia), dehydration, electrolyte imbalances, drug interactions (especially with diuretics and antihypertensives), and potential worsening of renal function. Gastrointestinal side effects (nausea, vomiting) can lead to malnutrition in older patients. Additionally, many seniors have a normal or low BMI and do not require weight loss. The decision must be individualized based on overall health, frailty, and medication profile. Current guidelines recommend caution in patients over 75. Evidence: human-moderate (subgroup analyses, no dedicated RCTs in frail seniors). Caveat: Do not self-prescribe; medical supervision is mandatory.
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