The TCM does load the engine very high at lower RPM's at highway speeds.
I have not played with the Tow Mode much, but it probably delays upshifts and may even keep the torque converter from locking up as well as it may not shift into 10th gear?? Another small side effect is I believe it keeps the Active Grille Shutters open, this provides more cooling air but impacts aerodynamics a bit.
I think mainly you will suffer a drop in fuel economy, I would be a bit concerned about watching the transmission temperature, I do not think it will be a big issue, but if the torque converter does not lock up, the transmission temperatures will probably be a bit higher. I typically see around 145-150F on the highway, sometimes I will see 155-160F if I have to slow down and crawl after cruising for a while.