10 May 15-21, 2025 dallasobserver.com DALLAS OBSERVER Classified | MusiC | dish | Culture | unfair Park | Contents S hantaQuillette Carter-Williams was having one of her better days. The stroke and heart at- tack survivor had just wrapped up back-to-back pulmonology and cardiology appointments. Though she faced heart valve surgery, her doctors cleared her to resume daily life, just nine months af- ter a massive heart attack at 39. But the Inter- nal Revenue tax accountant began to feel dizzy at her desk. Her face began to droop, her arms weakened, and her speech slurred. She was suffering a second stroke. “It’s definitely something that you can’t prepare for,” Carter-Williams recalls of her 2019 stroke. The then-40-year-old spent two years in cognitive, physical, occupational and speech therapy. During recovery, her depression, overeating and inactivity led to a 75-pound weight gain. Alarming blood work results pointed to an impending Type 2 diabetes di- agnosis. She needed a miracle, fast, if her heart was going to survive. In December 2021, her doctors prescribed Saxenda, a $1,600-a-month medication in a class called glucagon-like peptide-1 agonist (GLP-1). After a diabetes diagnosis, Carter-Williams was able to get Ozempic, a form of GLP-1 that is a semaglutide injectable, for $25 a month, which she credits with saving her life. “I started it, and it completely did a 180,” she says. The era of GLP-1s ascended with light- ning speed into mainstream media in 2024. Hollywood stars have shrunk in the blink of an eye. In Dallas, patients have ditched sur- gical weight loss and medical supervision in favor of once-weekly injections that seem- ingly melt off weight. Approved by the Food and Drug Ad- ministration in 2005, GLP-1s are injected into the fatty layer underneath the skin. Common types include semaglutide, lira- glutide, tirzepatide, dulaglutide and ex- enatide. Ozempic has become a household name for the drug category, though We- govy, Mounjaro and Zepbound have also skyrocketed in demand for their weight- loss effects. Between February and April 2022, Carter- Williams lost 30 lbs and has since lost more than 100 lbs. Her transformation, documented in real time, earned her 1.3 million followers on TikTok and 1.1 million on Instagram. “I went viral because I showed up in the middle of a mess,” she says. “... People saw me at 300 pounds, and now they’re seeing me at 150 pounds. They saw me sad, now they see me happy.” As HeyShantaQ, Carter-Williams uses comedy and candid storytelling to advocate for health equity. She also authored an e- book, Grow & Glow with GLP-1. “These medicines are a tool. They’re a very powerful tool,” says Dr. Ian Justl El- lis, founder of Voafit, a medical concierge service overseeing GLP-1 use for hundreds of North Texans. The membership-based program offers a GLP-1 prescription, diet and exercise counseling, weekly check- ins, dose management, on-demand access to a physician and more. GLP-1s’ promising weight loss effects have created shortages, affecting diabetes patients like Carter-Williams, who went three months without the drug. She gained only 5 pounds in that time. In addi- tion to scarcity, GLP-1s have dethroned surgical weight loss. The Fall “G LP-1s are a great drug. It’s a great wonder, but without supervision, it could be a killer,” says Dallas plastic surgeon Dr. Carlos Raul Barceló. Barceló has practiced medicine for more than 35 years and has expertise in cosmetic surgery. He has won international praise for breast lifts, body contouring, butt lifts and li- posuction. He says he’s seen a notable de- cline in educated post-bariatric patients and a rise in malnourished ones who lost weight solely with GLP-1s. “Nationally, a lot of people claimed that they were down about 40% in bariatric sur- gery volume because of the GLP-1s. I would like to say that we probably decreased a good 50 to 60% during that time,” says Crys- tal Sadler, owner of Total Wellness and Bar- iatrics. Total Wellness and Bariatrics offers sur- gical and medical weight loss options. With 12 years of experience in bariatric surgery, Sadler says that while the Dallas-Fort Worth market remains competitive, GLP-1s are un- deniably reshaping bariatrics. Increasingly, bariatric surgeons are leaving the specializa- tion to pursue concierge medicine, a mem- bership- or retainer-based medical model that provides greater access to primary care physicians or general practitioners. Others are shuttering clinics. “My goal is to be one of the last ones standing,” she says. A Dallas Bariatric Center spokesperson confirmed a 50% drop in bariatric surgeries. The center has added GLP-1s to its services. Dr. Nirmal Jayaseelan, the center’s surgeon, was unavailable for comment. In December 2024, Medpage Today re- ported that Norman Regional Health Sys- tem’s “Journey Clinic” in Oklahoma closed after seeing a nearly 50% drop in bariatric procedures and noted an increase in bariat- ric surgery cancellations nationwide. Ignorance Is Bliss B arceló says 2024 marked a shift. He observed a steep decline in patient education, mainly driven by pa- tients relying on social media rather than physicians for information. “Having a shot with no surveillance or knowledge is more dangerous than surgery,” he says. He cites rare conditions like multi- ple endocrine neoplasia Type 2 (MEN2), a genetic disorder that causes susceptibility to glandular cancers. The overlap of MEN2 and GLP-1 use could be deadly, Barceló says. Sage Plastic Surgery, Barceló’s practice, has seen an increase in GLP-1 patients seek- ing cosmetic procedures. Many arrive emancipated, malnourished and without medical oversight. He’s turned many of them away due to safety concerns and a lack of basic medical clearance. “Patients should be our priority number one, and if patients don’t have true knowl- edge of what could happen with GLP-1s, that’s a big gap in the responsibility of who is selling these medications to the public and trying to keep them away from the medical decision,” he says. For many, TikTok, Instagram and Face- book have become the new-age medical ex- perts. Anonymous posts in neighborhood Facebook groups ask, “Any rec’s on a medspa that does semaglutide?” Facebook users sound off in the comments. Others GLP-1 seekers turn to longstanding weight-loss programs like WW (formerly known as Weight Watchers), which began offering a “no clinic visit required” compounded semaglutide program in 2024, or Kathy Tran TIPPING the Scales Demand for bariatric surgery falls as the craze for a new of class weight-loss drugs like Ozempic soars online, often cutting out medical supervision and raising risks. BY DESIREE GUTIERREZ ▼ Culture >> p12 ShantaQuillette Carter- Williams survived a heart attack, followed by diabetes. She credits GLP-1s for saving her life.
