Debunking myths about GLP-1s: Separating fact from fiction

GLP-1 medications—such as those branded Ozempic® or Wegovy® —are getting a lot of attention lately, especially for their role in weight loss. Between articles about “Ozempic face” and cautionary tales about people regaining weight after stopping GLP-1 medications, it’s no wonder many are hesitant to try them or curious about them. But here’s the thing: there’s a lot of misinformation and stigma out there right now. GLP-1 medications aren’t quick fixes, and they don’t come without side effects—no medications do. 

Excess weight is not simply a matter of laziness, either. Science has shown us that obesity is a disease, not a decision. Some people with obesity and type 2 diabetes may also have insufficient GLP-1 response, which GLP-1 medication can help. GLP-1 medications mimic the natural GLP-1 peptide hormone your body already makes. GLP-1s aren’t much different than using bioidentical hormones—artificial hormones which mimic hormones the body produces naturally—to treat conditions like menopause or some cancers. Bioidentical hormone therapy was once considered controversial too, but it is now widely accepted. 

GLP-1 medications are meant to be taken long-term alongside lifestyle changes, under a healthcare provider’s supervision, and only for those who meet specific criteria. For example, liraglutide, under the brand name Saxenda®, is approved by the Food and Drug Administration (FDA) for chronic weight management in patients aged 12 years and older who are obese or weigh at least 132 pounds or for adults with a body mass index (BMI) of 30 or higher or a BMI of 27 with at least one weight-related condition. (Under the brand name Victoza®, liraglutide is FDA-approved to manage type 2 diabetes). Semaglutide (Ozempic for diabetes and Wegovy for obesity) is also FDA-approved for chronic weight management. 

Now let’s dive into what you’re really here for—how GLP-1 medications work in your body. 

An overview of glucagon-like peptide 1 hormone

First, let’s talk about the natural glucagon-like peptide 1 hormone you make in your gut. GLP-1 hormone—GLP-1 for short—is made in your intestinal L-cells. When you eat, the nutrients from your food (glucose, fatty acids, and dietary fiber) stimulate the release of GLP-1 hormone in your gut. GLP-1 is a type of incretin hormone that helps lower blood glucose levels by stimulating the release of insulin. And insulin helps blood glucose enter your body’s cells for later energy use. Specifically, the GLP-1 hormone lowers blood glucose levels by prompting the expansion of insulin-secreting β-cell mass, a type of cell that makes and secretes insulin, in your pancreas. 

Glucagon-like peptide 1 hormone also: 

• Slows down gastric emptying (digestion), so the nutrients from your food are absorbed more slowly—this helps prevent blood sugar spikes after meals. 
• Inhibits the release of glucagon, another hormone that helps control blood glucose levels
• Tells your brain when you’ve had enough to eat, which can keep your appetite in check and often leads to weight loss. 

GLP-1 medications explained

Glucagon-like peptide-1 receptor agonists (or GLP-1 RAs) are a class of drugs used to treat type 2 diabetes and obesity. They’re meant to be taken alongside lifestyle changes—like increased physical activity and healthier eating—that also contribute to weight loss.

GLP-1 RAs* mimic everything your GLP-1 peptide hormone does: It ups the release of insulin, decreases the release of glucagon, delays gastric emptying, and increases satiety. They do this by binding to cells that have GLP-1 receptors throughout your body, just like your natural GLP-1 would. In doing so, GLP-1 medications can restore your insulin secretory functions. In other words, they improve glycemic control and can help reduce body weight in people with diabetes. 

It’s not 100 percent clear how GLP-1 medication causes weight loss, but it was a common side effect  observed initially in clinical trials. However, it’s known they increase satiety, in other words: reduce hunger. Since they slow down the movement of food from your stomach to your small intestine, you may feel fuller faster. That satiated feeling lasts longer, so you eat less.

One notable difference between your natural GLP-1 hormone and GLP-1 RAs is that the former can be quickly broken down by an enzyme called dipeptidyl peptidase 4 (DDP-4). But GLP-1 RA medications are resistant to DDP-4, so they’re more powerful and last longer in your body (which is what you want). Another benefit is that these medications have a low risk of causing hypoglycemia, a condition in which blood sugar levels dip too low. 

You can think of it like this: When we have an ache or pain, we don’t think twice about reaching for a Tylenol. But our body doesn’t make acetaminophen naturally. So in taking a GLP-1 medication, we’re just giving our body the extra support it needs by stimulating insulin secretion. 

Why do some people with obesity need a GLP-1 receptor agonist medication? 

Some people with prediabetes, type 2 diabetes, or obesity may release less GLP-1 peptide hormone than they need. Others may not be sensitive enough to incretin hormones like GLP-1 and GIP (gastric inhibitory polypeptide, another incretin hormone). Research shows that in some people with obesity, the actions or effects of their GLP-1 hormone may be impaired, even in those with normal blood sugar regulation. The good news is that people with obesity who have GLP-1 impairment—and have tried all the diets and weight loss programs without success—may finally see results from taking GLP-1 RA medication. And people with type 2 diabetes benefit from taking GLP-1 medications since they act to lower blood sugar in the bloodstream. 

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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