By DR. SHEILA NAZARIAN
Weight loss medications have been embraced by millions as a ‘miracle drug.’
So it’s difficult for some people to hear that this modern medical marvel is not for them.
Real Housewives of Beverly Hills and cancer survivor Teddi Mellencamp‘s recently complained that her physician refused to prescribe her GLP-1 medications for her treatment–related weight gain.
‘I gained weight from the steroids,’ Mellencamp, 44, said on her podcast last week. ‘Because I’m getting bigger from the steroids, I asked my doctor if I could please have GLP-1s. And he was like, ‘No!’
As a board-certified plastic surgeon and physician who routinely prescribes GLP-1s, I understand Mellencamp’s frustration.
Weight gain after cancer therapy is not only common, it is often biologically driven. Chemotherapy, hormonal treatments, steroids and the emotional toll of cancer can disrupt metabolism, increase fat storage and reduce lean muscle mass. Patients frequently feel like they are fighting their own bodies, doing everything right with diet and exercise yet they see the scale move in the wrong direction.
So why would a doctor say ‘no’ to a class of drugs that has been widely celebrated for its effectiveness?
GLP-1s have transformed obesity medicine and importantly, weight loss itself is not just about aesthetics.
Reality star and cancer survivor Teddi Mellencamp’s recently complained that her physician refused to prescribe her GLP-1 medications for her treatment–related weight gain
‘I gained weight from the steroids,’ Mellencamp, 44, said on her podcast last week, with co-host Tamra Judge. ‘Because I’m getting bigger from the steroids, I asked my doctor if I could please have GLP-1s. And he was like, ‘No’
Excess body fat is a known driver of chronic inflammation, insulin resistance, and hormonal imbalance, all of which can contribute to cancer development and recurrence. Weight loss is strongly associated with improved metabolic health and a reduced risk of several cancers, including breast, colorectal and endometrial cancers.
I prescribe GLP-1 medications in my own practice to carefully selected patients who want to look and feel better, even if they are not morbidly obese. The goal is not vanity. It is optimizing health, reducing long-term risk and helping patients regain a sense of control over their bodies.
But medicine is rarely one size fits all, especially in cancer survivors.
Mellencamp was diagnosed with Stage 2 skin cancer in 2022, leading to 11 surgeries in a single year. In April 2025, she revealed the cancer had spread to her brain and lungs. As of April this year, Mellencamp said that she is still undergoing immunotherapy and dealing with its complications, including hair loss, skin scarring and weight gain from steroids, but she was cancer free.
That, of course, is fabulous news. Mellencamp has overcome incredible hurdles, but that doesn’t mean she should rush into another treatment.
Here are some of the most pressing post-cancer concerns when considering GLP-1s.
First, the type of cancer matters. While GLP-1 medications are generally considered safe, long-term data in patients with a history of certain cancers is still evolving.
Some early studies raised concerns about a potential association with thyroid C cell tumors in rodent models. While this has not been definitively demonstrated in humans, physicians remain appropriately cautious, particularly in patients with a personal or family history of medullary thyroid carcinoma or MEN2 syndrome.
In hormone sensitive cancers such as certain breast cancers, weight gain is often linked to endocrine therapies.
These medications alter estrogen pathways and the metabolic consequences are complex. Introducing a GLP-1 drug into that already intricate hormonal environment is not necessarily inappropriate, but it does require careful coordination and individualized risk assessment.
As of April this year, Mellencamp said that she is still undergoing immunotherapy and dealing with its complications, including hair loss, skin scarring and weight gain from steroids
Dr. Sheila Nazarian is the founder of Nazarian Plastic Surgery and NazarianSkin
Second, timing is critical. Immediately after cancer treatment, the body is in a state of recovery. Nutritional status, immune function, and muscle mass are all priorities.
Rapid weight loss, especially if it includes lean tissue, can be counterproductive. Many physicians prefer to stabilize a patient’s overall health before introducing medications that significantly suppress appetite.
And finally, there is the question of clinical judgment. While GLP-1 medications can play a role in helping patients look and feel their best, they are still powerful metabolic therapies that should not be prescribed without thoughtful assessment of the patient’s overall health, treatment history and goals – not as a reflexive response to post-treatment weight gain alone.
So, did Teddi Mellencamp’s doctor make the right call?
Based on what we know, it is very possible they did.
That said, this does not mean GLP-1s are off the table forever. Many cancer survivors can safely use these medications once they are further out from treatment, metabolically stable and appropriately evaluated.
The key is individualized care, something that is increasingly rare in a world driven by trends and quick fixes.
For patients in Teddi’s position, the path forward should involve a comprehensive approach, resistance training to rebuild muscle, nutritional strategies to support metabolic health and, when appropriate, medical therapies introduced at the right time.
Weight gain after cancer is real. It is frustrating. And it deserves to be taken seriously. But so does the complexity of the human body, especially after it has endured something as profound as cancer.
Sometimes, the best care is not the fastest solution. It is the most thoughtful and bespoke one.
