Want to know more about GLP-1 weight loss after watching Oprah Winfrey's "Shame, Blame and the Weight Loss Revolution" special? Get details from an obesity medicine specialist.
Fact: Obesity is a disease. Experts at the National Institutes of Health recognized it as such in 1998—with the American Medical Association finally classifying it as a chronic disease, rather than a personal choice, almost ten years ago.
And while the medical world has come a long way in understanding the science about overweight and obesity as a disease, the old idea that obesity is a lack of willpower still lingers. We’ve all been targeted online with fad diets that promise if you just try this one [insert paleo, keto or a million others here], in addition to exercise, the weight will fall off.
Successful and sustainable weight loss indeed includes lifestyle changes. However, research also shows that your environment and biology play a huge role in your ability to lose weight and keep it off. And because primary care providers often aren’t well versed in treating obesity, you may have only heard about weight loss options like bariatric surgery. (A viable but often expensive surgical option in the United States, depending on your healthcare coverage.) Another option you may have heard less about is prescription weight loss medication.
A specific group of prescription medications called glucagon-like peptide 1 receptor agonists (or GLP-1s*) has been approved by the Food and Drug Administration (FDA) for managing type 2 diabetes. One of them, semaglutide, is manufactured by Novo Nordisk under the brand name Ozempic (for diabetes) and is FDA-approved to treat overweight and obesity under the brand name Wegovy.
But even though Wegovy is perhaps the most buzzed-about GLP-1 for weight loss, there’s not just one GLP-1 medication. Indeed, there are many of them, which means there’s a lot to learn about how they can help us. So, let’s pop the hood and talk about the ins and outs of GLP-1 weight loss.
Simply put, GLP-1s are a class of medications used in the treatment of type 2 diabetes and obesity. And while metformin has been the first-line therapy in treating type 2 diabetes, the FDA announced in 2019 that Rybelsus (semaglutide), a GLP-1, can also be offered as a first-line treatment. Now, a GLP-1 can replace metformin (with, for some, fewer side effects) or be taken together with metformin not only for the treatment of type 2 diabetes but also off-label for weight management.
Does GLP-1 help you lose weight? Yes. Here’s why: GLP-1s mimic the action of glucagon-like peptide 1. This hormone plays a role in digestion and appetite regulation, causing you to feel fuller faster and aiding in weight management by making you eat less. It also helps with blood sugar levels—when levels start to rise after we eat— GLP-1s stimulate the body to produce more insulin, helping to lower blood glucose levels.
Which GLP-1 medications are FDA-approved for weight loss? Two GLP-1s are FDA-approved for long-term weight management: the once-weekly Wegovy and the daily-dose Saxenda (liraglutide).
The first approved GLP-1 for weight loss, Saxenda, was approved for weight loss in 2014. It’s for chronic weight management in patients with a body mass index (BMI) of 27 or greater who have at least one weight-related condition or in patients with a BMI of 30 or greater. In fact, in a 2017 review of five studies published in the journal Obesity Science & Practice, researchers determined that patients taking liraglutide lost at least 5 to 10 percent of their body weight as compared with those taking the placebo.
The second, Wegovy, was approved for weight loss in June 2021 under the same BMI guidelines as Saxenda. Additionally, the semaglutide has undergone rigorous trials before becoming FDA-approved, including one published in 2021 in The New England Journal of Medicine. The double-blind clinical trial of 1961 adults with overweight or obesity without diabetes found that the average weight loss after 68 weeks was about 15 percent of body weight for those given semaglutide versus only about 2.5 percent for those taking the placebo. In other words, significant weight loss happened with semaglutide.
Along the same lines, it’s important to mention that although Wegovy is an FDA-approved medication for weight loss, medications like Ozempic and Rybelsus are FDA-approved for treating type 2 diabetes. However, since their active ingredient is also semaglutide, they may be prescribed off-label for weight management.
So far, we’ve put the spotlight on Wegovy and Saxenda, but other GLP-1s are FDA-approved for type 2 diabetes but are also used off-label for the treatment of overweight and obesity. Here are a few others for GLP-1s to take note of:
It’s another GLP-1 medication that’s FDA-approved for type 2 diabetes and goes under the generic name of dulaglutide. Significantly, a study published in 2021 in Diabetes, Obesity and Metabolism saw promising results for weight loss with the drug. In participants given the highest dose (4.5 mg) of the once-weekly dulaglutide, the mean weight loss was about ten pounds at 36 weeks, with continued weight loss at the 52-week mark.
We mentioned liraglutide earlier when we talked about Saxenda as a GLP-1 for weight loss, and the amazing results in studies. Victoza also has liraglutide as its active ingredient. The key difference between the medications Victoza and Saxenda is that Victoza is not an FDA-approved GLP-1 weight loss medication while Saxenda is.
These are often prescribed under their generic name, tirzepatide. Mounjaro is approved to treat type 2 diabetes and Zepbound is approved for weight loss. They differ from GLP-1s in that they target not only the GLP-1 hormone but also the GIP (glucose-dependent insulinotropic polypeptide) hormone, which helps to lower A1C, or blood glucose levels. Even more promising for weight loss, a 40-week study of 475 participants with diabetes published in 2022 in the Journal of the American Medical Association (JAMA) found that those on a 15 mg dose of tirzepatide lost an average of 19 pounds as compared to the placebo group who actually gained almost four pounds during the trial.
There isn’t one correct answer regarding which is best for you because we’re all unique. Your health care provider will always approach the treatment of overweight and obesity on a case-by-case basis to determine if GLP-1s or another weight loss medication fits you before prescribing one.
And as you embark on your weight loss journey with Found, keep in mind that the most meaningful and sustained weight loss journey is achieved with medication as well as a reduced calorie diet, increased physical activity, and behavior changes like getting enough sleep and taking care of your mental health.
The most common GLP-1 side effects are headaches, nausea, and gastrointestinal issues. Clinical trials have shown that these subside with time. It’s important to let your health care provider know if you experience any adverse effects of the medication so they can assess if you should stay on the drug or switch to another.
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GLP-1*
GLP-1 prescriptions, filled through your local pharmacy, are now available as part of Found's weight-loss toolkit. While GLP-1s are effective for weight loss, they are not clinically appropriate for everyone. Eligibility for a GLP-1 is based on a thorough evaluation of your medical history, eating behavior, lab work, and insurance coverage. If a GLP-1 is not appropriate for you, our providers will work with you to determine an effective medication for your health profile.
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Found providers are not your typical health care provider. They’re specifically trained in obesity medicine and consider your unique biology.
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