Weight Management

A Deep Dive Into GLP-1s — What Are They and How Do They Aid Weight Loss?

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After a slew of media headlines and TikTok "before-and-afters," it’s impossible not to be at least a bit Ozempic-curious. Many are wondering if it's a miracle drug heralding a healthier era, or yet another pharmaceutical temporary fix. To get to the bottom of it all, let’s start with some simple science.

Can GLP-1s Help With Weight Loss?
You’ve probably heard by now that GLP-1s were originally created to treat diabetes, but then patients began reporting a desirable side-effect. While taking the medication, their hunger was virtually non-existent. Even more fascinating, some people discovered that their intrusive thoughts around eating seemed to quiet down, making it easier to make nutritious choices. 

One study have found that participants taking GLP-1s experienced a weight loss of about 10.5 to 15.8 pounds. Meanwhile, another study asked participants to pair their medication with healthy lifestyle changes. Researchers found that the participants logged an average loss of 33.7 pounds, while the group who used diet and exercise alone shed just 5.7 pounds. 

Currently, there are only two GLP-1s approved for weight loss—Wegovy and Saxenda. As for Ozempic, Dr Korner explains that both Wegovy and Ozempic use the same active ingredient, semaglutide, but they are given different brand names depending on whether they’re prescribed to treat diabetes (Ozempic) or weight loss (Wegovy).

This is the same for Saxenda (used for weight loss) and Victoza (used to treat diabetes), both of which use the GLP-1 agonist liraglutide. Zepbound, a brand that uses the active ingredient tirzepatide, was approved for weight loss in November 2023. This drug is technically a dual agonist and uses two types of incretin hormones—GLP-1 and GIP. Zepbound’s diabetes counterpart is called Mounjaro. 

Who Would Best Benefit From GLP-1s?
Dr. Korner always advises her patients to start with lifestyle improvements first. But often, she says, diet and physical exercise alone are not enough.

To deduce whether an individual is a good candidate for GLP-1 therapy, medical guidelines suggest using their Body Mass Index (BMI). Anyone with a BMI of 30 and above could benefit from using GLP-1s to manage their weight.   

"If someone has health conditions that are likely either caused or exacerbated by increased body fat, such as hypertension, sleep apnea, or diabetes, then we will use a BMI of 27 and above as the guideline," adds Dr. Korner. 

Are GLP-1s Safe and Who Should Not Take GLP-1s for Weight Loss?

For the most part, GLP-1s are not only safe for weight loss but ultra effective. Clinical trials have also shown some additional benefits to taking GLP-1s, including improvements in metabolic parameters like blood sugar control, blood pressure, and cholesterol levels.

However, Dr. Korner warns that those with medullary thyroid cancer (a rare form of thyroid cancer), multiple endocrine neoplasia (an overgrowth of tumors on the endocrine glands), pancreatitis, or gallbladder issues should not take the medication.

What Are the Potential Side Effects of GLP-1s for Weight Loss?

According to Dr. Korner, the most common side-effect of GLP-1s include gastrointestinal issues like nausea, vomiting, diarrhea, or constipation. Less common side-effects include fatigue, headaches, and gallstones (abdominal pain is an indicator you might have an issue).

Additionally, some preliminary research indicates that GLP-1s can potentially cause small bowel obstruction and has been reported in several observational studies. In fact, one study reports that in people with diabetes, an obstruction is 4.5 times more likely to happen with GLP-1s than with other glucose medications.

If you’re taking GLP-1s and experience any of the above, tell your provider. They may suggest altering your dosage or discontinuing the medication indefinitely. 

Bottom Line

There’s no denying that GLP-1s are incredibly effective at treating diabetes and contributing to weight loss. With more than 40 percent of the U.S. adult population classified as clinically obese and more than 11 percent diagnosed with type 2 diabetes, these drugs can be life changing for millions of people—especially when paired with sustainable lifestyle improvements.

“These medications always work better if used in conjunction with lifestyle changes and healthy diet,” says Dr. Korner. She also stressed the need to mitigate muscle loss during the weight loss process with regular strength training.

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