GLP-1 Medications

You may not have heard of GLP-1 medications, but you’ve probably heard of some of the brand names of these, such as Ozempic or Wegovy. You may have friends or relatives who have used one of these medications, or read about celebrities including Oprah Winfrey, Rebel Wilson, and even elite athletes like Serena Williams sharing their experiences publicly.

GLP-1 stands for “glucagon-like peptide 1.” It’s a hormone produced in the gastrointestinal tract that affects digestion and helps you feel full. Many people also report that it quiets “food chatter” or helps them worry less about what or when they will eat next. These medications are powerful tools to aid people trying to lose weight, when used appropriately and under the care of an experienced medical provider.

Adults:
GLP-1 medications are generally recommended for adults with a body mass index (BMI) of 30 or more, or adults with a BMI of 27.5 or more and at least one weight-related medical condition, such as high blood pressure, high cholesterol, or type 2 diabetes.
Some GLP-1 medications may also be prescribed for reasons other than weight loss, such as to treat sleep apnea, fatty liver disease (metabolic dysfunction associated steatohepatitis, or MASH), or to reduce the risk of cardiovascular events like heart attack and stroke in patients at high risk.

Pediatrics:
In pediatrics we use different cut-offs to determine when a child or adolescent’s weight meets criteria for obesity or may be affecting their health. Your doctor can help you determine if your child may benefit from weight loss medication.

When used in combination with a healthy, low-calorie eating plan and regular physical activity, many people achieve excellent results with GLP-1 medications.

In clinical studies for Wegovy (semaglutide), patients lost an average of 15% of their body weight and maintained that weight loss over a 2-year period – about 35 lbs for the average patient in the clinical studies.

In clinical studies for Zepbound (tirzepatide), patients lost an average of 21% of their body weight after 72 weeks – about 50lbs for the average patient in these studies.

In these studies, most patients were able to maintain weight loss with continued treatment. However, when the medications were stopped, most people regained the weight they had lost. This highlights the need for long-term treatment.

Both medications also helped to improve other complications of obesity such as high cholesterol, elevated blood sugar (in patients with type 2 diabetes), and high blood pressure.

The most common side effects are gastrointestinal. These include nausea, vomiting, constipation, bloating, and heartburn. These side effects are generally manageable. Your doctor can guide you in how best to manage or minimize the side effects.

About half of all people who try a GLP-1 medication stop it within 1 year, often due to side effects that could have been managed. Working closely with a physician to help you manage these side effects can maximize your chances of success. Side effects of these medications are often temporary; support and guidance during the initial period while your body gets used to the medication can allow you to continue long term.

Serious side effects are rare but could include: gallstones that require surgery, pancreatitis, changes in vision, severe dehydration, and others. Your doctor will go over what to look out for if you choose to start a GLP-1 medication.