GLP-1 Weight Loss Medications: Is the Hype Worth It?

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The GLP-1 agonists are a group of medications making waves in the treatment of Type 2 diabetes and obesity. These drugs work by mimicking a hormone called Glucagon-like peptide (GLP-1) which helps boost insulin production and curb appetite. This dual action gives them the ability to manage blood sugar while promoting weight loss in the process. However, there’s been a bit of a hiccup– worldwide shortages and possible adverse effects.

IS THE HYPE WORTH IT?

Well…. It depends on who you ask, and the purpose of this article is to present the facts and assess the benefit/risk ratio of these medications to decide if they are right for you. The GLP-1 medications work by mimicking a natural hormone in our bodies called GLP-1, which plays a crucial role in managing blood sugar and appetite. When you take GLP-1 agonists, they help your body release more insulin after meals, allowing better utilization of blood sugar by cells, effectively lowering your blood sugar. They also signal your liver to stop releasing extra sugar, while also slowing down the rate at which your stomach empties food, thus making you feel fuller, so you end up eating less. Unlike some other diabetes medications, GLP-1 agonists typically don’t cause dangerously low blood sugar levels on their own.

HOW EFFECTIVE ARE GLP-1 AGONISTS?

GLP-1 agonists appear to be highly effective medications for managing Type 2 diabetes and promoting weight loss. They have been shown to consistently lower HbA1c levels and fasting plasma glucose, making them superior to placebos in clinical trials. Long-acting versions like semaglutide and liraglutide are particularly effective, showing significant reductions in blood sugar levels and weight. They also offer benefits over other treatments like insulin, as they do not cause weight gain or significant hypoglycemia.

https://www.bmj.com/content/384/bmj-2023-076410?t&utm

https://www.ccjm.org/content/89/8/457?t&utm

WEIGHT MANAGEMENT

GLP-1’s play a significant role when it comes to managing weight. Studies have shown that GLP-1 receptor agonists are great at helping people lose weight by curbing their appetite and even changing how they perceive taste. Research indicates that GLP-1’s affect both peripheral and central nervous systems, impacting brain areas that regulate hunger and satiety. These mechanisms make GLP-1 receptor agonists effective for weight loss in individuals with obesity, even without diabetes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119845/?t&utm

https://www.ccjm.org/content/89/8/457?t&utm

https://diabetesjournals.org/diabetes/article/63/12/4186/40422/GLP-1-Receptor-Activation-Modulates-Appetite-and?t&utm

HOW SAFE ARE THEY?

Many people are not aware that these medications have been around since 2017 when semaglutide was first approved for use as a diabetes medication. There are some possible, immediate, short term side effects.

Common Short Term Side Effects Include:

• Nausea

• Vomiting

• Diarrhea

• Constipation

• Abdominal pain

With the recent surge of higher dosing in injectable form, it is important to be aware of some studies on these medications, as well as long-term safety considerations one should consider.

Long-term Safety Considerations:

While the medications have been highly effective in managing diabetes and weight, there have been concerns about the potential long-term risks of GLP-1 receptor agonists, such as pancreatitis Factors That Increase Pancreatitis Risk With GLP-1 Initiation, stomach paralysis Ozempic Stomach Paralysis

and thyroid cancer. Some studies indicate an increased risk of thyroid cancer, while others do not.

Glucagon-like peptide 1 receptor agonists and thyroid cancer: is it the time to be concerned? - PMC

Thyroid Cancer risk

COMPARISON TO OTHER TREATMENTS

While GLP-1 agonists as a whole have several advantages over traditional diabetes treatments, It’s important to weigh both their benefits and potential limitations. Let’s take a look at both sides.

Advantages Over Traditional Medications:

● Glycemic Control: GLP-1 receptor agonists provide effective glycemic control with a glucose-dependent mechanism, reducing the risk of hypoglycemia and lowering HbA1c significantly.

● Weight Loss: Unlike many diabetes medications, GLP-1 receptor agonists promote weight loss, benefiting patients with obesity.

● Cardiovascular and Renal Benefits: They reduce major adverse cardiovascular events and have protective effects on kidney function.

Potential Drawbacks or Limitations:

● Gastrointestinal Side Effects: Common side effects include nausea, vomiting, and diarrhea.

● Cost: GLP-1 receptor agonists can be expensive compared to traditional diabetes medications.

● Injection Requirement: Most GLP-1 receptor agonists are administered via injection, which may be less convenient for some patients.

● Risk of conditions such as stomach paralysis, pancreatitis and thyroid cancer.

● Increased risk of blindness Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide | Diabetic Retinopathy | JAMA Ophthalmology

Oral vs Injectable:

Both oral and injectable forms of semaglutide have been proven effective for weight loss and glycemic control. In some individuals, oral semaglutide, taken daily, has shown similar or even superior efficacy compared to weekly injections in some studies, particularly in reducing A1C levels. In some individuals however, it does not seem to affect appetite and is ineffective. https://www.healthline.com/health/weight-loss/semaglutide-oral-vs-injection?t&utm

Canada Pharmacy Online

Rybelsus (Semaglutide) - 3 mg starts at $325.99 for 30 tablets. (Oral)

https://www.canadapharmacyonline.com/DrugInfo.aspx?name=Rybelsus7645

ARE THERE NATURAL GLP-1 MEDICATIONS?

Many people aren’t aware of this, but our body has its own internal GLP-1 stimulating factory. Our beneficial gut microbes are able to produce a substance called Butyrate which has a direct effect on the GLP-1 receptors that the medications stimulate. Butyrate also affects the feedback pathways to the brain’s satiety center which also affect our appetite. When our beneficial gut bacteria are full, they make us feel full too. So what food do they like to eat to make butyrate? Fiber rich foods containing, inulin, pectin, and resistant starch can help to feed our gut bacteria what they like. These fibers are present in foods such as onions, garlic, asparagus, artichokes, chicory root (inulin) as well as apples with skins, oranges, and carrots (pectin). Foods containing resistant starch include green bananas, sweet potatoes, beans and lentils.

SHOULD YOU USE A GLP-1 FOR WEIGHT LOSS?

First, it’s important to always discuss the risks and benefits with your doctor since they know your medical history best. My personal advice on these medications is this; If you have a BMI in the obesity range (over 30) Calculate Your BMI and you have the presence of 1 or more chronic medical conditions that put you at risk of further health related problems, ie diabetes, high cholesterol, heart disease etc, then speak to your doctor about taking them as short term options (less than 6 months) while doing a lifestyle modification to include healthier food choices. We do not have long term data on these medications and while they can be effective, especially in individuals who are at risk of further medical problems that can affect lifespan, I personally tend to err on the cautious side. My book “The Gut Revolution” www.TheGutRevolutionbook.com will give you step by step guidance on how you can incorporate a healthy lifestyle whether using these medications as temporary aids or utilizing natural options to achieve long term success.

As always this article should not be construed as medical advice and is for information purposes only. Please consult with your doctor for further guidance.

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