GLP-1 Medications

GLP-1 Medications: What You Need to Know About These Powerful Diabetes and Weight Loss Drugs

If you’ve been paying attention to diabetes or weight loss news lately, you’ve probably heard about GLP-1 medications. They are a class of drugs that are changing the way we manage type 2 diabetes and obesity.

Let’s break down what GLP-1 medications are. We will look at how they work and how they’re used. Here’s what you need to know before starting one.

What Are GLP-1 Receptor Agonists?

GLP-1 receptor agonists are a group of medications. They mimic the action of a natural hormone in the body. This hormone is called glucagon-like peptide-1 (GLP-1). This hormone is part of a group called incretins, which help regulate blood sugar after eating.

GLP-1s Work in Three Key Ways:

1. Stimulate insulin release when blood sugar is high
2. Suppress glucagon, a hormone that raises blood sugar
3. Slow stomach emptying, helping you feel full longer

They also reduce appetite, which often leads to weight loss.

📚 Reference: Drucker DJ. Cell Metab. 2018;27(4):740–756.
https://www.sciencedirect.com/science/article/pii/S1550413118301349

How Are GLP-1s Used?

GLP-1 receptor agonists were originally developed for type 2 diabetes. They’re now also approved for weight loss in people with or without diabetes.

✅ FDA-Approved GLP-1s for Type 2 Diabetes:

• Exenatide (Byetta®, Bydureon®)
• Liraglutide (Victoza®)
• Dulaglutide (Trulicity®)
• Semaglutide (Ozempic®)
• Tirzepatide (Mounjaro®)* – also works on GIP, another gut hormone

✅ GLP-1s Approved for Weight Loss:

• Liraglutide (Saxenda®)
• Semaglutide (Wegovy®)

📚 Reference: Wilding JPH, et al. N Engl J Med. 2021;384:989–1002.
https://www.nejm.org/doi/full/10.1056/NEJMoa2032183

️How Do GLP-1s Help in Type 2 Diabetes?

In type 2 diabetes, the body either doesn’t produce enough insulin or can’t use it effectively. GLP-1 medications help lower blood sugar in several ways:

• Enhance glucose-dependent insulin secretion
• Reduce glucagon secretion, especially after meals
• Delay gastric emptying, slowing the rise in blood sugar after eating
• Promote weight loss, which improves insulin sensitivity

These effects work only when blood sugar is elevated. This makes GLP-1s low risk for hypoglycemia (low blood sugar). This is especially true when used alone.

📚 Reference: Baggio LL, Drucker DJ. Gastroenterology. 2007;132(6):2131–2157.
https://www.gastrojournal.org/article/S0016-5085(07)00384-9/fulltext

Benefits Beyond Blood Sugar

GLP-1s have shown benefits beyond glucose control, including:

• Weight loss (often 10–20% of body weight with high-dose semaglutide or tirzepatide)
• Reduced risk of heart attack and stroke in people with type 2 diabetes and heart disease
• Improved blood pressure and cholesterol

📚 Reference: Marso SP et al. N Engl J Med. 2016;375:311–322.
https://www.nejm.org/doi/full/10.1056/NEJMoa1603827

A Functional Medicine Perspective on GLP-1s

In functional medicine, the goal is to address the root causes of disease. It also aims to promote long-term healing through personalized nutrition, movement, stress reduction, and environmental detoxification. From this perspective, GLP-1 medications can be valuable tools, but they’re not cures. Functional medicine practitioners may recommend GLP-1s as a short-term aid. They help reduce insulin resistance, inflammation, and appetite. This is especially in cases where lifestyle changes alone have not been enough. However, the focus remains on restoring metabolic health through sustainable changes in diet, physical activity, gut health, and mindset. GLP-1s can support the journey. True reversal of type 2 diabetes still depends on the foundational pillars of lifestyle and functional care. Long-term weight loss also relies on these fundamental lifestyle changes.

Functional medicine sees medications like GLP-1s as bridges — not destinations.

️Side Effects of GLP-1 Medications

While GLP-1s are generally safe, they can cause side effects — especially in the first few weeks.

Most Common Side Effects:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Loss of appetite

These symptoms usually improve over time. Starting with a low dose and gradually increasing helps reduce discomfort.

Less Common But Serious Side Effects:

• Pancreatitis (inflammation of the pancreas)
• Gallbladder disease (gallstones)
• Kidney problems, usually due to dehydration from vomiting
• Injection site reactions (with injectable forms)

📚 Reference: Nauck MA, et al. Diabetes Obes Metab. 2013;15(Suppl 1):26–33.
https://onlinelibrary.wiley.com/doi/full/10.1111/dom.12118

Who Should Avoid GLP-1s?

GLP-1 medications are not for everyone. Your doctor will review your history and medications to determine if they’re safe for you.

You may not be a good candidate if you:

• Have a personal or family history of medullary thyroid cancer
• Have multiple endocrine neoplasia syndrome type 2 (MEN2)
• Have had pancreatitis
• Have severe gastrointestinal disease (e.g., gastroparesis)

Precautions and Things to Know

• GLP-1s are usually given as injections, ranging from once daily to once weekly. Oral semaglutide (Rybelsus®) is also available.
• These medications can interact with other diabetes medications. They can especially interact with insulin or sulfonylureas. This may increase the risk of low blood sugar.
• Patients taking GLP-1s for weight loss should also receive nutrition and exercise counseling. This helps preserve muscle. It also ensures long-term success.

Bottom Line

GLP-1 receptor agonists are powerful tools for improving blood sugar, promoting weight loss, and even protecting your heart. But they’re not a magic fix.

These medications work best alongside a healthy lifestyle, including:

• A nutrient-dense, high-protein diet
• Regular physical activity
• Consistent follow-up with your healthcare provider

As always, speak with your doctor or pharmacist before starting any new medication. This is crucial, especially with a powerful one like a GLP-1.

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