Written by: Alyssa Costantino, MS, RDN, LDN
What are GLP-1s?
Glucagon-like peptide 1 receptor agonist drugs are a class of medications that were originally developed to manage type 2 diabetes, recently gaining popularity for their remarkable effects on weight loss. Semaglutide (Wegovy®) and Tirzepatide (Zepbound®) are two GLP-1 receptor agonists that have been FDA approved consumer use to aid in weight management. Ozempic® and Monjaro® are two corresponding sister drugs for the above medications that are FDA approved primarily for diabetes treatment, but also leading to weight loss effects. GLP-1s are only recommended for patients with a BMI>30 or BMI>27 with concurrent health conditions, when a healthy eating plan and regular physical activity has not been successful towards significant weight loss.
So, How Does it Work?
These medications have a 90% homology to native GLP-1, meaning they mimic the effect of a naturally occurring hormone found throughout the body.
How GLP-1 Functions:
- In the Pancreas: GLP-1 acts on pancreatic beta cells to increase insulin secretion.
- In the Brain: GLP-1 acts on the hypothalamus to increase leptin levels which increases feelings of satiety directly after a meal along with hours after eating.
- In the GI tract: GLP-1 delays gastric emptying and slows gut motility, keeping our stomachs full longer.
Effectiveness:
GLP-1s are effective towards increasing insulin release to reduce blood sugar levels, interacting with hormones in the brain and GI tract to regulate appetite, and slowing gastric emptying while reduce food cravings leading to weight loss. Beyond weight loss, GLP-1s have also shown cardio-protective benefits including improvements in blood pressure, reducing inflammatory markers, improving lipid profiles, and preventing neurodegeneration.
Risks & Considerations:
While these medications may be effective for weight loss and diabetes management, they do come with potential side effects including: nausea, vomiting, abdominal pain, diarrhea, constipation, fatigue, dizziness, hypoglycemia, GERD or acid reflux, hyponatremia, inadequate intake & nutrient deficiencies, return to baseline weight and laboratory health values after discontinuation!
Consult your dietitian to review your unique nutrition needs and strategically incorporate our key considerations for optimizing your health while taking a GLP-1.
Sustainability:
One critical consideration with taking a GLP-1 is the sustainability of weight loss after discontinuation. Whether you are considering use for weight loss or blood sugar management, GLP-1s are meant to be taken long term. Clinical trials have shown that after 20 weeks of Semaglutide use, participants randomly selected to switch to a placebo regained the weight they had lost in comparison to the control group.
Weight isn’t the only health marker that increased with discontinuation!
Participants also saw levels regress to their baseline values for…
- Blood pressure
- Inflammatory proteins
- VLDL cholesterol
- Triglycerides
- HbA1c
Key Considerations for use:
- Always consult your healthcare provider! GLP-1s can only be prescribed by licensed healthcare professionals such as doctors, nurse practitioners, and physician assistants. Work closely with your healthcare provider to determine what risk factors you should be aware of, and if this treatment plan is right for you.
- Plan your meals and make sure you are eating enough! As GLP-1 use is associated with a significant reduction in food consumption, it is essential to be aware of your intake and make sure you are still getting in all of the nutrients you need from your diet. Optimizing your nutrition will not only improve your health and minimize side effects, but also aid in the maintenance of weight loss and improvements in laboratory health values after discontinuation.
- Closely monitor your side effects. Working with a Registered Dietitian while taking a GLP-1 can help to optimize your nutrition for your health and tailor your intake to minimize any negative side effects. If symptoms persist or become severe in nature patients need to contact their healthcare provider*
If symptoms persist or become severe in nature patients need to contact their healthcare provider*
Photo credit: Jennifer Burk, Unsplash.