Our Thoughts on Weight-Loss Medications (GLP-1 Agonists)

Author: Jason Brodo, MS RDN LDN

Editor: Rachel Hershberger, MS CNS LDN

What are weight loss medications?

Weight loss medications are an extremely popular class of pharmaceuticals that help people lose weight with minimum effort. Typically, they are taken as an oral medication or an injection. These drugs help people consume less calories by reducing their appetite and curving food cravings. While these medications have profound weight-loss results, it is easy to overlook the consequences that come with taking them. Are weight loss medications as amazing as they seem, or are there some hidden dangers and side effects that people aren’t necessarily aware of? If you are considering taking weight-loss medications but are overwhelmed with information, this article is for you. We will cover both the positives and negatives of weight loss medications so you are informed to make the right choice for your body.

What are GLP-1 Receptor Agonists and how do they work?

There are many types of weight loss medications that work in a variety of ways. This article mainly focuses on the mechanisms of GLP-1 Agonists. Below, you will find a description of how GLP-1 Agonists work through their interaction with your body’s biochemistry:

  • Glucagon-Like Peptide-1 (GLP-1) is a natural molecule that helps signal to the brain that the body is full. Your body naturally releases GLP-1 after the consumption of a nutrient rich meal

  • Semuglutide (Wagovy, Ozempic, etc…) is an artificial medication that acts as a GLP-1 receptor agonist, meaning it helps GLP-1 bind to a spot in your body’s cell in order to carry out its function

  • By injecting external GLP-1 receptor agonist in the body, your brain is receiving a signal that you are full, even if you did not have a meal

  • GLP-1 receptor agonists also prolong gastric (or stomach) emptying which makes you feel fuller for longer

  • GLP-1 receptor agonists signal the pancreas to release insulin, which can enhance overall insulin sensitivity

Positives of GLP-1 Receptor Agonists

  • Significant Weight Loss:

    Due to its appetite suppressing effects, individuals who are taking GLP-1 receptor agonist lose between 10-15% of their weight on average

  • Improved Blood Sugar Control:
    These medications increase insulin release and reduce glucagon (a hungry hormone) secretion, leading to better regulation of blood sugar levels, especially in people with type 2 diabetes.

  • Reduced Risk of Cardiovascular Events:
    GLP-1 receptor agonists have been shown to reduce the risk of major cardiovascular events (heart attacks, strokes) in people with diabetes, making them heart-protective.

  • Slower Gastric Emptying:
    By slowing the rate at which food leaves the stomach, GLP-1 receptor agonists help control blood sugar spikes after meals and contribute to prolonged satiety.

  • Lower Risk of Hypoglycemia:
    Unlike some other diabetes medications, GLP-1 receptor agonists have a low risk of causing low blood sugar (hypoglycemia) because they only stimulate insulin release when blood sugar levels are elevated.

Negatives of GLP-1 Receptor Agonists

  • Side Effects:
    Common side effects of GLP-1 receptor agonists include nausea, vomiting, diarrhea, and constipation, especially when starting treatment. These symptoms often subside over time but can be bothersome for some individuals.

  • Risk of Gallbladder Problems:
    GLP-1 receptor agonists can increase the risk of gallbladder issues, such as gallstones or cholecystitis (inflammation of the gallbladder), particularly in those experiencing rapid weight loss.

  • Potential for Pancreatitis:
    Although rare, GLP-1 receptor agonists have been associated with an increased risk of pancreatitis (inflammation of the pancreas), a serious condition that requires immediate medical attention.

  • Injection Site Reactions:
    Since many GLP-1 receptor agonists are delivered via injection, some users may experience redness, swelling, or irritation at the injection site.

  • Cost:
    These medications, particularly newer ones like Wegovy and Ozempic, can be expensive, especially without insurance coverage, which may limit accessibility for some individuals. Some people may pay over $1000 per month for access to these drugs.

Natural GLP-1 Support:

Lets take a look at some natural lifestyle factors and supplements that help support your bodies natural GLP-1 production. As always, please talk to your doctor, or licensed dietitian-nutritionist before starting any supplement regimen.

  1. Diet

    • High fiber: oats, beans, lentils, flaxseeds, chia seeds, and vegetables like Brussels sprouts and broccoli

    • Healthy fats: avocados, olive oil, nuts, seeds, and fatty fish like wild-caught salmon, cod and mackerel

    • Fermented foods: yogurt (unsweetened), kefir, kimchi, sauerkraut, and miso

    • Quality proteins: pastured meats, wild-caught fish, pasture-raised eggs, tofu, tempeh, and beans

    • Foods Rich in Polyphenols: green tea, dark chocolate (>75% cacao), berries, red onions, and green leafy vegetables

    2. Supplements

  • Berberine - berberine has been found to improve gut health, reduce inflammation, and increase insulin sensitivity, all of which can help boost your natural GLP-1 activity. Editor’s note: Use high-quality and certified supplements only, and talk to a knowledgeable healthcare provider before beginning any supplement. Berberine should not be taken long-term and can have undesirable effects on liver health and your microbiome if not taken properly and under supervised care.

  • Probiotics - Gut health plays an imperative role in natural GLP-1 production and support. Your gut microbiome is responsible for short chain fatty acid (SCFA) production, anti-inflammatory effects, and gut-brain communication. Probiotics high in Bifidobacterium and Lactobacillus are found to be supportive of natural GLP-1 production.

  • Glucomannan - is a water-soluble polysaccharide that is considered a dietary fiber. Glucomannan may help to boost GLP-1 production due its effects on delayed gastric emptying, improved satiety and appetite regulation, SCFA production, and blood sugar control. Glucomannan is typically taken 1/2 hour before a meal with 8-10oz of water.

  • Curcumin - Curcumin, found in turmeric, is known for its tremendous anti-inflammatory benefits. Decreasing systemic inflammation promotes a healthier gut, which is favorable for GLP-1 production.

Conclusion: How a Dietitian or Nutritionist Can Help

Many people will start taking GLP-1 Receptor Agonists expecting it to be a miracle drug. Although it is extremely effective at short-term weight loss, we must look at a couple crucial factors that impact the efficacy of this drug in the long-term. First, many people who start taking this drug do not change the quality of their diet. This does not address the root cause of metabolic dysfunction that caused weight gain in the first place. Taking GLP-1 Receptor agonists without talking to a dietitian or nutritionist to improve your diet can lead to systemic inflammation, nutrient deficiencies, long-term insulin resistance, and other metabolic insufficiencies. Unless you want to be on these medications for the rest of your life, the result of these insufficiencies includes rapid weight gain once you stop taking the medication. It is absolutely essential that GLP-1 receptor agonists are taken in tandem with lifestyle modifications. When you are ready to wean off of any weight loss medication, a knowledgeable Dietitian-Nutritionist can help you craft a plan to increase natural GLP-1 support to help you maintain your weight loss. These drugs can be a catalyst for rapid weight loss, and partnering with a professional to support lifelong habits is imperative to keeping the weight off long term.

Resources:

https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists

https://www.wired.com/story/the-benefits-of-ozempic-are-multiplying/#:~:text=Known%20as%20GLP%2D1%20agonists,of%20certain%20obesity%2Drelated%20cancers.

https://news.bryant.edu/ozempic-weight-loss-miracle-drug-or-too-good-be-true#:~:text=Common%20side%20effects%20for%20both,kidneys%2C%20gallbladder%2C%20and%20thyroid.

https://www.goodrx.com/conditions/weight-loss/how-to-increase-glp-1-naturally

https://www.healthline.com/health/nutrition/glp-1-diet

Rachel Hershberger