One of the most discussed weight loss treatments in today’s health care are GLP-1 medications. Some of the names you might have heard are Wegovy, Ozempic, Saxenda, Mounjaro or Zepbound. Some have been made especially for the handling of weight loss, and some are taken as drugs for diabetes, but can be mentioned as a way to help lose weight. Let’s help patients understand how these medications can and cannot help as there is a lot of information available online.
What is GLP-1 Medications?
GLP-1, or glucagon-like peptide-1, is a hormone naturally secreted by the body that helps to regulate blood sugar, appetite and digestion. GLP-1 receptor agonist medications work by imitating the hormone. They may make the patient feel fuller more quickly, suppress appetite, slow the stomach emptying rate and help control blood sugar levels.
Some newer medications, such as tirzepatide, work on both GLP-1 and GIP hormone pathways. This may be one of the reasons tirzepatide has demonstrated successful outcomes for weight-loss in clinical trials.
It is important to understand that these medicines are NOT “quick fixes”. They are medical therapies that should be used in addition to healthcare support, physical exercise, and healthier nutrition. According to the NIDDK, prescription weight loss medications, combined with lifestyle changes, cause some adults to lose between 3% and 12% of their original body weight after 1 year, which is more than lifestyle changes alone.
How Much Weight Can Patients Lose?
Results from clinical trials have been great. An analysis of a major 68-week trial, published in New England Journal of Medicine, found that adults who took Semaglutide 2.4 mg once weekly lost an average of 14.9% body weight while those who took the placebo lost 2.4%.
Tirzepatide has similarly shown very good results. The SURMOUNT-1 trial, which was published in The New England Journal of Medicine, showed that taking Tirzepatide once a week leads to impressive and long-term weight loss in adults with obesity. On average, the participants taking the higher dose lost more weight than those participants that received the placebo.
Who is Eligible?
GLP-1 pharmaceuticals that aid in weight-loss are typically reserved for overweight adults or adults with obesity who have obesity-related health risks or conditions, such as type 2 diabetes, hypertension, high cholesterol, sleep apnea, or cardiovascular risk. Medication, patient history, BMI, pre-existing medical conditions, and clinical judgment may be used to determine eligibility.
Always get your complete health record checked before receiving a prescription. These include current medications, pregnancy plans, history of pancreatitis, gallbladder disease, kidney disease, thyroid cancer risk, digestive problems, and family history of thyroid and other endocrine tumors.
Common Side Effects
Most side effects tend to be digestive. Patients can have gastrointestinal side effects such as nausea, vomiting, diarrhea, constipation, stomach discomfort, bloating, loss of appetite, and heartburn. These effects are often more intense during the initiation and/or escalation of a treatment.
GLP-1 drugs are initialized at a low dose and slowly increased. It is a step-by-step process which allows the body to adjust. This approach minimizes side effects. If symptoms are severe, or if the patient has dehydration, severe abdominal pain, yellow skin or is not able to keep fluids down, however, they should contact his/her health care provider.
High-Risk Conditions That Patients Need to Know
While these drugs are generally accepted without a problem, they are not without danger. Due to the reports of thyroid C-cell tumor in animal models, some GLP-1 drugs carry warnings for possible C-cell thyroid tumors. Such drugs generally are not used in patients with a personal or family history of medullary thyroid carcinoma or MEN2. There also may be the risk of gallbladder disease, low blood sugar when used with certain drugs for diabetes, gastrointestinal symptoms, and kidney problems due to dehydration.
The FDA also looked at reports of suicidal thoughts or suicidal actions by GLP-1 receptor agonist users. The FDA said its review did not reveal any higher risk of suicidal thoughts or behavior with GLP-1 receptor agonist drugs, but also argued for monitoring and labeling decisions.
What Happens If You Stop?
Following treatment, many people tend to put on weight, particularly if the changes in their lifestyle are not adhered to. This does not mean the medication “failed.” Obesity is a chronic medical condition, influenced by a number of factors such as hormones, metabolism, genes, environment, sleep, stress and behavior. Weight-loss drugs might involve long-term planning as with any blood pressure or diabetes medicines.
A comprehensive treatment program typically yields optimal outcomes, which includes dietary recommendations, an exercise program, sleep hygiene, laboratory assessment, reasonable expectations, and regular follow-up.
Final Thoughts
GLP-1 drugs are effective weight management tools but are not quick fixes, cosmetic treatments or a fit-for-all solution. The reality is that they can be a vital tool in helping many patients achieve meaningful weight loss, but are a tool that needs screening, safe prescribing, monitoring, and lifestyle support.
For weight-management consultations, medication guidance, or help deciding whether GLP-1 treatment may be appropriate for you, email appointment@familydiagnosticclinic.com and our team will get you scheduled.
