Written by: Lauren Lund, APRN-CNP
Reviewed by: Laurianne Scott, DO
Meet the medication class revolutionizing medical weight loss...
A Brief History of GLP-1s
GLP-1 Agonists are a class of medications that were originally designed as an anti-diabetic medication. After studies revealed a host of other benefits for patients including weight loss, several have now gained FDA approval for weight management in non-diabetics when combined with diet and exercise. Other names for this medication class include:
- Glucagon-like peptide-1 agonists
- GLP-1 receptor agonists
- Incretin mimetics
- GLP-1 analogs
How do GLP-1s work?
GLP-1s work by balancing the hormones in the body that make you feel full or hungry. They help normalize insulin and glucose balance, and reduce the amount of glucose that's being produced by your liver when it's not needed. GLP-1s also reduce the rate at which the stomach digests food and empties, reducing appetite and make you feel fuller longer. In order for best weight loss results, patients taking GLP-1s should also make dietary changes and exercise.
Benefits of GLP-1s
- Promotes Weight Loss
- Increased Metabolism
- Regulates Glucose
- Increases Insulin Production
- Slows Gastric Emptying
- Decreases Hunger & Cravings
- Decreases Inflammation (2)
- Reduces risk of heart disease (1)
- May Improves lipid/cholesterol disorders
- May improve fatty liver disease (__)
- May reduce alcohol consumption (__)
- May protect the brain and decrease risk of Alzheimers (3)
How much weight can I expect to lose?
After 68 weeks, half of the participants using GLP-1 agonists lost 15% of their body weight, and nearly a third lost 20% (Wilding et al., 2021).
How do I take the medicine?
GLP-1 agonists may be oral or injectable depending on the medication prescribed by your provider. The injectable medication is injected at home by the patient. When patients are prescribed the medication, MOBO providers educate the patient how to self-inject the medication or how to have a friend inject the medication for you. The injectable medication is injected once per week. Choose your injection day of the week to coincide with times you typically over-eat (ie, right before weekends). The injections are subcutaneous and should be injected in the stomach, back of the arms, and top of the thighs. Dispose of needle in a sharps box after injection.
Side Effects
The most common side effects of GLP-1 agonists include: Loss of appetite, Nausea, Vomiting, Diarrhea, and Constipation.
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Tip to manage potential side effects:
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Other side effects can include: Dizziness, Mild tachycardia (increased heart rate), Headaches, Indigestion (upset stomach). You may also have temporary mild itchiness and/or redness on your skin at the site of the injections.
Severe (but rare) side effects can include: Pancreatitis, Medullary thyroid cancer, Acute kidney injury, Worsening diabetes-related retinopathy.
Who should NOT take GLP-1s?
You should not take any GLP-1s if you or your family have history of medullary thyroid cancer or if you have a personal history of pancreatitis. Avoid GLP-1s if you have a multiple endocrine neoplasia syndrome type 2 (MEN2). Avoid GLP-1 therapies if you are pregnant or trying to become pregnant. Stop using this medicine at least 2 months before you plan to get pregnant. Ask your healthcare provider if you're a candidate for GLP-1s.
Importance of Diet and Exercise while taking Weight Loss Medicine
GLP-1 drugs are supposed to be used with lifestyle changes such as a reduced-calorie diet and exercise.
- Exercise: In addition to the benefits of exercise — like better sleep, mental health, and sex drive — exercise also helps build lean muscle mass which is important for maintaining a healthy weight. Exercise improves insulin sensitivity, by increasing the amount of glucose your muscles use, and glycemic control is further enhanced when combined with GLP-1s. Find a workout that you enjoy! Depending on the type of exercise, your workout can help you burn fat, build lean muscle mass, or both. For example, pairing cardio with strength training can supercharge both weight loss and reduce your cardiovascular risk. Resistance training, may increase your resting metabolic rate. Remember: the more muscle you have, the more energy (and calories) your body will burn throughout the day (this is your basal metabolic rate). Recommendation: 2-3 days of mild to moderate strength training per week and walk 20 mins/day.
- Diet: It is important to emphasize that GLP-1s work only if the patient is on a calorie deficit - about 1600 calories per day. The behavior change is easier; however, because of the effects of the medication. Patients trying to lose weight while on a calorie deficit should focus on the nutrient density of what they eat as there isn't a lot of room for empty calories. Eat a lot of different vegetables and healthy proteins as the foundation of your diet. Vegetables and fruits, which are full of vitamins, minerals and fiber, are essential for a healthy weight-loss program. We recommend one to two daily servings of healthy fats such as avocados, nuts and seeds. It is recommended to avoid alcohol.
Interested in Medical Weight Loss?
People interested in medical weight loss should schedule a MOBO Med Spa Medical Weight Loss visit. There are options for in-person and telehealth visits. During your visit, a MOBO provider will assess your weight loss and wellness goals. Next, your MOBO provider will view lab work or place an order for lab work. If you are a candidate, MOBO providers will prescribe weight loss medication.
References
2. Mehdi, S. F., Pusapati, S., Anwar, M. S., Lohana, D., Kumar, P., Nandula, S. A., Nawaz, F. K., Tracey, K., Yang, H., LeRoith, D., Brownstein, M. J., & Roth, J. (2023). Glucagon-like peptide-1: a multi-faceted anti-inflammatory agent. Frontiers in immunology, 14, 1148209. https://doi.org/10.3389/fimmu.2023.1148209
3. https://aaic.alz.org/downloads2024/AAIC-2024-GLP-1-Ph2-trial.pdf
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