Can anyone take a GLP-1 RA for weight loss? The answer is no–but here’s who can

We know you’ve seen countless celebrities and TikTok influencers raving about GLP-1s and how they’ve helped them lose body weight—and fast. We also know it’s too easy to compare your progress to the social media hype around GLP-1s (short for GLP-1 receptor agonist or  GLP-1 RA).  The truth is that many celebrities and influencers alike use GLP-1s to drop a few pounds without doing the lifestyle changes necessary for long-term weight management. However, GLP-1s weren’t made for losing just a few pounds for that big event. 

For people with obesity or excess weight, those taking GLP-1 receptor agonists can reach a body weight loss of 15% or more. For example, a double-blind trial on semaglutide, a GLP-1 approved by the US Food and Drug Administration (FDA), studied the efficacy of a 2.4 mg dose of the drug for chronic weight management. (That’s the same dose of semaglutide as in the anti-obesity medication Wegovy®.) Researchers learned that semaglutide led to significant weight loss among the 1,212 patients when paired with lifestyle changes.

• 86.4% (1047 participants) lost 5% or more of their body weight
• 69.1% (838 participants) lost 10% or more of their body weight 
• 50.5% (612 participants) lost 15% or more of their body weight
• 32.0% (388 participants) lost 20% or more of their body weight  

Another study on liraglutide in people with obesity without diabetes showed that 14.4% of participants lost 15% of their body weight or more compared to 63.2% of participants who lost 5% or more of their weight. (Participants in this study also received counseling for lifestyle changes). It’s important to note that the weight-loss results were reported at a little over a year in the semaglutide and liraglutide studies.

With other weight-loss medications—non-GLP-1s—losing more than 15 percent of body weight is rare. Research has shown that people with obesity (without diabetes) taking metformin, another medication FDA-approved to treat type 2 diabetes, lose 5.6% of their body weight at six months on average. (That said, 5%-10% of body weight loss is enough to improve most comorbidities associated with obesity.) 

What are GLP-1s?

Before we get deeper into who benefits most from GLP-1s, it’s important to address the role of these medications and what they do in your body. GLP-1, or glucagon-like peptide-1, is a peptide hormone naturally made in your body. It helps regulate blood sugar levels by stimulating insulin secretion after you eat. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medications that mimic the actions of your natural GLP-1. 

Specifically, GLP-1 RAs may increase your body’s insulin secretion, delay gastric emptying (digestion), and reduce appetite. Since GLP-1 RAs can help with appetite control, when you take them, you may eat less—and lose weight. But the exact mechanisms for how they help people lose weight aren’t clear. However, researchers are working on better understanding how they work and we do know that in clinical trials, weight loss was originally observed as a common side effect. 

There are several GLP-1 receptor agonists FDA-approved to treat type 2 diabetes and two GLP-1 RAs are FDA-approved for treating obesity. 

• Liraglutide once daily FDA-approved for chronic weight management under the brand name Saxenda® alongside diet and exercise in patients 12 and older with obesity and who weigh at least 132 pounds; or for adults with a body mass index (BMI) of 30 or higher or a BMI of 27 or higher with at least one weight-related medical condition.
• Semaglutide once weekly FDA-approved to treat obesity under the brand name Wegovy®. (Semaglutide is also approved for type 2 diabetes under the brand names Ozempic® and Rybelsus® which you may recognize.) 

Who’s a candidate for GLP-1s?

GLP-1 RAs were originally developed for glycemic control (helping control blood sugar) in people with type 2 diabetes but they have been found to be helpful for other conditions as well. According to Rekha Kumar, MD, Found’s Chief Medical Officer and former medical director of the American Board of Obesity Medicine, people with obesity or excess weight can also benefit from GLP-1s. “People who benefit from taking GLP-1 RAs for weight management are thought to have insulin resistance as the driving factor in their weight gain,” she notes. Insulin resistance can develop when there’s too much sugar in your body, causing your pancreas to pump out more insulin. Your cells can build up a tolerance, or resistance, to the excess insulin.

Research suggests that there may be GLP-1 impairment in some people with obesity. It’s possible that their body either doesn’t respond to its natural GLP-1 or doesn’t make enough of it. For people who aren’t eligible for GLP-1s, there are other medications that can also help with weight loss. 

How do you know you're responding well to a GLP-1 medication?

What’s considered a “good” response to a GLP-1 RAs varies person to person based on age, biological sex, hormone status, previous weight loss, and other factors, says Dr. Kumar. “Although one pound per week is an average amount of weight loss while taking a GLP-1 medication, some people will lose less, while others lose more,“ she explains. “And for some people, success might look like the end of weight gain or feeling more in control of their appetite, so they can make good nutritional choices.” 

For the treatment of type 2 diabetes, the initial approach many providers take (depending on the patient's medical history) is to start by prescribing metformin alongside lifestyle changes like exercise and a healthy diet. But if the patient doesn’t respond to metformin—that is, there’s no improvement in their A1C (average blood sugar levels over two to three months)—that’s when a GLP-1 RA might be introduced. 

Bottom line: These medications are meant to be taken alongside lifestyle changes, under a healthcare provider’s supervision, and taken long-term for those who qualify. 

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.

About Found

Found is among the largest medically-supported weight care clinics in the country, serving more than 200,000 members to date. To start your journey with Found, take our quiz.