Team Metabolic Health
Though traditionally used to treat diabetes and lower blood sugar levels, a class of medications called glucagon-like peptide 1 (GLP-1) agonists can also decrease appetite and promote weight loss, making their use for shedding weight increasingly popular.
Some brands are prescribed off-label for weight management, while others are Food and Drug Administration (FDA) approved for weight loss for people with obesity or overweight.
Read on for everything you need to know about GLP-1 agonists including how they work, whether or not they’re effective and who might be a good candidate for these medications.
What Are GLP-1 Agonists for Weight Loss?
GLP-1 agonists are a class of medications used to treat type 2 diabetes and obesity. Only two types of GLP-1 agonists are approved for chronic weight management for people with overweight or obesity (without type 2 diabetes): Wegovy and Saxenda. Other GLP-1 agonists, such as Ozempic, are approved for the treatment of type 2 diabetes, but may also be prescribed off-label for weight loss in some cases. Ozempic is the same chemical compound as Wegovy, but packaged as Ozempic for the treatment of diabetes.
Keep in mind that all GLP-1 agonists should be used alongside diet and exercise to promote long-term weight loss, and like all weight loss medications, these drugs are intended for long-term use in order to be effective. Weight regain is likely after you discontinue use of the medication.
How Do GLP-1 Agonists Work for Weight Loss?
GLP-1 agonists work by mimicking the effects of a hormone called GLP-1, which is produced naturally in the body in response to food consumption. This hormone is involved in regulating insulin secretion, feelings related to hunger and the emptying of the stomach. GLP-1 agonists bind to GLP-1 receptors in the body, thereby resulting in the same effects.
“By activating receptors in the pancreas, [GLP-1 agonists are] able to regulate insulin and control blood sugar,” explains Spencer Nadolsky, D.O., an obesity specialist physician based in Portage, Michigan and medical director of Sequence, an online weight loss program. “But they also activate receptors in the brain to curb appetite and in the gut to slow stomach emptying.”
A GLP-1 agonist can impact satiety and cravings to support weight loss, he adds. “It helps you eat fewer calories by making you feel more satisfied with decreased cravings.”
How Effective Are GLP-1 Agonists for Weight Loss?
“Studies demonstrate that a GLP-1 agonist along with a diet and exercise program will result in up to 15% body weight loss,” says Jason Balette, M.D., a bariatric surgeon at Memorial Hermann in Houston, Texas. “The patients in these same studies with diet and exercise alone lost on average about 2.4% body weight.” (note that this study was funded by Novo Nordisk, a pharmaceutical company that produces GLP-1 agonists).
One study comparing the effects of the GLP-1 agonists semaglutide and liraglutide—both of which are approved specifically for weight loss—found that participants (all of which did not have diabetes but did have obesity) lost an average of 15.8% and 6.4% of their body weight, respectively, after 68 weeks[1]. Another study on the effectiveness of liraglutide found that 62% of participants lost at least 5% of their body weight after six months, while around 17% experienced at least 10% weight loss[2].
Who Is a Good Candidate for GLP-1 Agonists for Weight Loss?
“GLP-1 agonists are not intended for individuals looking to lose a few pounds,” says Dr. Nadolsky. He explains that you must meet specific FDA guidelines and criteria to qualify for a prescription, including having a body mass index (BMI) of at least 30 or a BMI of at least 27 with at least one weight-related condition, such as high cholesterol, type 2 diabetes or high blood pressure.
GLP-1 agonists are also not recommended for certain groups, including people who are pregnant, those with digestive conditions like inflammatory bowel disease (IBD) or gastroparesis and individuals with a family or personal history of pancreatitis or thyroid issues, such as multiple endocrine neoplasia or medullary thyroid cancer. A doctor can help determine if you might be a candidate for a GLP-1 agonist based on your medical history and weight loss goals.
Credit: Forbes