Gracie McGraw, Tim McGraw and Faith Hill's daughter, uses semaglutide to manage PCOS symptoms. Why Ozempic, Mounjaro aren't just for weight loss

Gracie McGraw isn't hiding how she manages her polycystic ovary syndrome (PCOS).

This week, the 26-year-old daughter of Tim McGraw and Faith Hill took to Instagram to share a black-and-white bikini photo of herself, joking in the caption, "It's a gorgeous day for narcissism!" A commenter replied, "And Ozempic," suggesting that McGraw was secretly on the FDA-approved diabetes drug that some are using to lose and manage their weight.

McGraw responded to the comment with, "I did use Ozempic last year, yes. I am now on a low dose of Mounjaro for my PCOS as well as working out. No need to accuse when I have been open about it."

What is PCOS and how is it treated?

Dr. Rekha Kumar, endocrinologist at Weill Cornell Medicine and NewYork-Presbyterian, tells Yahoo Life that PCOS is not a disease, but a syndrome. Women with PCOS have an imbalance of reproductive hormones, which affects how the ovaries work, as well as metabolism problems. Insulin resistance is also common in women with PCOS, which increases the risk of weight gain and developing type 2 diabetes.

"Not everyone will have all the symptoms, and PCOS can look different in different people," she explains. "To meet criteria for PCOS, women will have some of the following symptoms: irregular periods/lack of ovulation, acne, excess hair growth on the face and cysts on ovaries."

Rohini Bajekal, who is a nutritionist, board-certified lifestyle medicine professional and co-author of Living PCOS Free, tells Yahoo Life, "PCOS is a condition heavily influenced by our lifestyle — how we eat, sleep, move, stress, interact and so on. All national and international guidelines recommend lifestyle changes to be the first line of management for PCOS, even before medications."

Medications used to manage PCOS include birth control pills, the antidiabetic medication metformin, and medicines to lower testosterone, such as spironolactone. Glucagon-like peptide-1 (GLP-1) medications, a class of medications used to treat diabetes and, in some cases, obesity, are also used to treat PCOS.

Where do Ozempic, Wegovy and Mounjaro come in?

Ozempic and Wegovy are classified as semaglutide medications taken by injection, often used to treat type 2 diabetes. According to Kumar, semaglutide "works the same as our own version of this hormone called GLP-1."

"We naturally make GLP-1 in our intestines in response to a meal, and GLP-1 stabilizes blood sugar and tells our brain we are full," she explains. "Semaglutide is a long-acting analog of the hormone given as a medication."

Mounjaro is not a semaglutide, but a tirzepatide, per the Mayo Clinic. Like semaglutide, tirzepatide is a GLP-1 receptor agonist, which reduces appetite and slows the emptying of food in the stomach. It is approved for type 2 diabetes.

People tend to lose weight while on these medications because they are able to feel full despite consuming less food.

"Women with PCOS often have insulin resistance, which promotes weight gain and increases the risk of diabetes. Semaglutide treats insulin resistance, which is a part of the syndrome of PCOS," says Kumar.

Bajekal adds, "While a certain level of body fat is healthy and we need it for a number of body functions, including hormone production, excess fat known as visceral fat — fat you cannot see — is fat stored deep inside the abdomen, wrapped around the organs, including the liver and intestines. Visceral fat is associated with an increased risk of many chronic disease conditions," including cardiovascular disease, stroke, high blood pressure, Alzheimer's disease and certain cancers.

"On MRI scans, visceral fat has been shown to be higher in women with PCOS, and even in some women with lean PCOS. In fact, 20% of those with PCOS have 'lean PCOS' with a 'healthy' BMI, yet still struggle with the symptoms of PCOS," Bajekal says.

Kumar says that people with PCOS may be good candidates for semaglutide medications if they are overweight or obese, are not actively trying to become pregnant and have tried metformin and lifestyle interventions, such as a reduction in calories or carbohydrates and increased exercise, and were unsuccessful.

Why are these medications considered controversial?

Ozempic and Mounjaro are not technically approved for weight loss. Wegovy is approved for weight loss in people with obesity who also have weight-related medical problems. Earlier this year, however, stories began circulating that celebrities were using the medications not for a medical need, but to lose weight quickly.

For some celebrities, it's not just a rumor: Elon Musk, for example, said his slimmer figure was due to "fasting" — and Wegovy. Golnesa "GG" Gharachedaghi, of Shahs of Sunset, said on Thursday that she had lost too much weight while on her semaglutide journey and was now lowering her dose.

Some are concerned that these medications will be abused by people who aren't losing weight for health reasons, but to get ultrathin — bringing back a so-called body trend that many thought had been left behind in the early aughts. Now, if you check the Instagram comments of pretty much any celebrity who has slimmed down (McGraw included), you'll likely find a commenter accusing them of using one of these medications.

There's also the fact that these medications are often expensive, even with insurance, which has some saying that the rich and famous have yet another weight-loss tool the masses don't, leading to further unrealistic body standards.

However, others say that it's wrong to shame people for using these medications, which do serve an important function in the health landscape.

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