What Are GLP-1 Medications & Who Should Use Them?

Due to its rise in popularity over the last few years, you’ve probably heard the buzz around medications like Ozempic. GLP-1 agonist medications have gained significant attention, especially for their role in weight management and type 2 diabetes treatment. 

While these medications have been around for nearly 20 years for diabetes, they only recently became popularized as a tool for managing appetite and promoting weight loss. Let’s explore exactly what GLP-1 medications are, their potential benefits, risks and who should (or shouldn’t) consider taking them.

What Are GLP-1 Medications?

GLP-1 agonists are a class of medications that mimic the action of the hormone GLP-1 (glucagon-like peptide-1), which is involved in insulin production and appetite regulation. 

“GLP-1 stands for glucagon-like peptide-1. It is a hormone that is made by our intestines when we eat food. GLP-1 helps our pancreas make more insulin which can help with blood sugar regulation and it is involved with appetite regulation. Our own natural GLP-1 is broken down within 1 to 2 minutes. GLP-1 medicines are engineered to not be broken down easily. This means the GLP-1 levels from the medicine get much higher, which translates to better blood sugar and appetite control,” explains Dr. Spencer Nadolsky, DO, an obesity and lipid specialist physician.

Many people describe the benefits of the medication as feeling less hungry, feeling full faster and experiencing less “food noise” or thoughts about food throughout the day.

Different Types of GLP-1 Medications

There are several types of GLP-1 medications available, each with varying dosing schedules and forms of administration. Some of the most well-known GLP-1 agonists include Ozempic, Wegovy and Trulicity. Zepbound is the newest GLP-1 medication on the block. 

While all of these medications share a similar mechanism of action, they may differ in their specific uses, such as whether they’re more commonly prescribed for diabetes management or weight loss. Here is a list of commonly prescribed GLP-1 medications: 

• Saxenda
• Byetta
• Trulicity
• Victoza
• Mounjaro
• Ozempic 
• Wegovy
• Zepbound

Potential Benefits of GLP-1 Agonists

GLP-1 medications offer a range of potential health benefits, specifically for those with type 2 diabetes or those looking to lose weight. The prescriber recommendations for weight loss include “those with a BMI of 30 or above or a BMI of at least 27 and a coexisting condition such as diabetes, heart disease or sleep apnea may be considered for these medications,” shares Melissa Mitri, M.S., RD, nutrition writer and owner of Melissa Mitri Nutrition.

They also can be helpful for someone who has tried multiple attempts to lose weight with a traditional diet or exercise with continued weight regain. This is because GLP-1 agonists can help counteract the physiological causes of weight regain, which can help reduce yo-yo weight cycling over time, Mitri adds. However, it is important to note that GLP-1 medications are meant to supplement a balanced diet and healthy lifestyle, not replace it. 

These medications help regulate blood sugar and appetite levels by increasing insulin production and decreasing glucose production in the liver. Plus, they slow down the digestive process, which can help you feel fuller for longer periods of time, ultimately reducing appetite and food intake which can help support weight loss. This combination of blood sugar stabilization and healthy weight management can be particularly useful for those with chronic conditions like diabetes, heart disease and obesity. 

Potential Risks of GLP-1 Agonists

Although GLP-1 medications can be highly effective, they are not without some risks. Due to slowed gastric emptying, common side effects may include nausea, vomiting, diarrhea and constipation. “Other side effects are possible, such as headaches or injection site reactions, since most GLP-1 agonists are taken as an injection,” comments Mitri. 

Still, more serious risks may include pancreatitis, gallbladder issues, kidney failure and an increased risk of thyroid tumors, though these risks are relatively rare and seen in folks with a personal or family history of these conditions prior to starting the medication.

“There is a slight increase in the risk of gallstones, which can lead to a gallbladder attack. This may be due to the rapid weight loss that occurs with the medicine,” offers Dr. Nadolsky.

However, if prescribed appropriately, these symptoms are usually mild and tend to improve over time as the body adjusts to the medication. It’s essential to work closely with your healthcare providers to monitor any potential risks or side effects and ensure that the medication is a good fit for your personal lifestyle and health history.

Who Should Take GLP-1 Agonist Medications?

GLP-1 medications are typically prescribed for individuals with type 2 diabetes who are struggling to manage their blood sugar levels, especially if other treatments have not been effective. 

These medications can also be beneficial for people with obesity or those who need help managing their weight due to other health conditions. Since GLP-1 agonists are effective in reducing appetite and promoting weight loss, they have become an increasingly common prescription for individuals who meet certain weight or health criteria, even if they do not have diabetes. These are individuals who could be a fit for a GLP-1 medication: 

• Individuals with type 2 diabetes who struggle to manage blood sugar levels with other treatments.
• People with obesity or those who have difficulty managing weight despite lifestyle changes.
• Patients with weight-related health conditions such as hypertension, sleep apnea, fatty liver disease and lipidemia who may benefit from weight loss support.
• Those who have not achieved success with other medications or treatments for blood sugar or weight management.
• Patients with binge eating behavior may benefit from these medications. However, you should make this decision with an eating disorder specialist who understands your unique position as there are also risks for folks with binge eating to take an appetite, suppressing medication.

Consult with a healthcare provider to determine if GLP-1 agonist medications are the right fit for your specific health situation.

Who Should Avoid GLP-1 Medications

Not everyone is a good candidate for GLP-1 medications. These medications should generally be avoided by individuals with a history of certain medical conditions, like pancreatitis or thyroid cancer. Those whoe are pregnant or breastfeeding may also want to avoid GLP-1 agonists, as the safety of these medications during pregnancy has not been well-established. Always talk to your healthcare team to figure out what’s best for you. Those who may want to avoid GLP-1 medications include: 

• Individuals with a history of pancreatitis or other pancreatic conditions.
• Those with a personal or family history of thyroid cancer or thyroid tumors.
• Those who are pregnant or breastfeeding, as the safety of these medications in pregnancy has not been established.
• People with severe gastrointestinal disorders, such as gastroparesis, where slowed digestion could worsen symptoms.
• People who are underweight or malnourished. This may include folks who are elderly who could have serious side effects from drastic weight loss and reduced muscle mass and those with known nutrient deficiencies.

Jessie Carpenter, M.A., MD, RD, LD, owner of Nutrition Prescription, reminds us that the injections have to be taken long term because of the high rate of reversed benefits when stopped. Plus, you should consider the potential financial burden of the medication and the likelihood of possible shortages which means you might be going without it for periods of time. “I highly recommend implementing diet, exercise and lifestyle changes with or without the medications,” Carpenter comments. 

It’s important to discuss your complete medical history with a healthcare provider before starting any new medication, including GLP-1 agonists.

The Bottom Line

GLP-1 medications are trendy, but they offer significant benefits for individuals managing type 2 diabetes and for those looking to lose weight. Due to their delayed stomach emptying and reduced appetite signaling side effects, most people experience weight loss without strong hunger cues or “food noise”. 

While they can be highly effective, it’s important to weigh the potential risks and work closely with a healthcare provider to determine if these medications are the right choice for you. Whether you’re considering them for blood sugar management or weight loss, GLP-1 agonists can be a powerful tool for some when used appropriately.