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With so much talk about GLP-1s, it can be hard to separate fact from fiction. Even after doing your research, you might have more questions than answers.
GLP-1 medications are a group of drugs mainly prescribed for type 2 diabetes and obesity. Here are some straightforward answers to common questions about GLP-1 treatment.
Sometimes called GLP-1s for short, GLP-1 receptor agonists (or GLP-1RAs) are medications that mimic a natural hormone in the body. This hormone is glucagon-like peptide 1, or GLP-1.
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GLP-1 helps regulate blood sugar levels, appetite, and digestion. It stimulates the release of another hormone, insulin. Insulin lowers blood sugar levels.
GLP-1 also slows digestion and increases feelings of fullness. GLP-1s can reduce appetite and help you feel full sooner. For people taking them for weight management, these are intended effects that can help with weight loss.
Some GLP-1 medicines act on two hormone pathways. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist. Tirzepatide targets these two pathways at the same time to lower blood sugar and suppress appetite.
Medications like tirzepatide are often grouped in the same general category as other GLP-1s.
Several GLP-1 medications are approved to treat type 2 diabetes, which they were originally developed to treat. Some of these medications are also prescribed at higher doses to treat obesity.
GLP-1 medications used to treat type 2 diabetes include:
Many injectable GLP-1 medications come in prefilled pens that can be used at home. Some GLP-1 medications, including oral semaglutide and orforglipron, are taken as tablets instead.
Some GLP-1 medications approved for obesity are sold under different brand names than those used to treat type 2 diabetes. Current options include:
These medicines are meant to be part of a broader obesity and weight-management plan. They’re meant to support, not replace, healthy eating and physical activity.
There’s some overlap between GLP-1s for diabetes and obesity. But you can’t switch medications without a doctor’s approval.
For weight management, these medications are generally prescribed to adults with obesity, defined as a body mass index (BMI) of 30 or higher. Adults with a BMI of 27 or higher may also qualify if they have at least one weight-related health problem, such as high blood pressure or type 2 diabetes.
There’s no one-size-fits-all treatment for weight management. Two people can have the same weight but have different risks and needs. Beyond GLP-1s, providers may suggest other weight-management tools, depending on the person’s medical history and other factors.
There’s no specific weight loss guarantee with GLP-1s or any other treatment. Your results may be different from someone else’s. Weight loss varies by medication and by person.
In studies of newer GLP-1-based weight-management drugs, many participants lost at least 10 percent of their starting weight, and some lost much more.
GLP-1s may also provide health benefits beyond the number on the scale. Losing even 5 percent to 10 percent of starting body weight can improve measures such as blood sugar, blood pressure, and triglycerides for some people.
Your healthcare provider may adjust your treatment over time, depending on your results and any side effects. Weight loss often continues for longer than six months with newer GLP-1-based medications. People may keep losing weight for a year or longer before their weight begins to level off.
Adjustments may include trying a different dose or medication.
GLP-1s are considered a long-term treatment. These medications work while you’re taking them, and their effects may decrease after you stop.
Some people successfully lower their dose after reaching their goal weight. Others gain weight when they stop or decrease their dose, even if they maintain healthy eating and exercise habits.
Continue taking your medication as prescribed by your healthcare provider. Have regular follow-up visits where you can discuss making changes to your plan if needed.
Gastrointestinal side effects are among the most common. These can include:
Smaller meals and limiting foods that worsen symptoms may help. Your healthcare provider may also recommend different ways to manage side effects. For example, increasing fiber and water intake or using stool softeners may help with constipation.
If you have severe symptoms or discomfort, don’t wait to get help. Some side effects of GLP-1s can be serious and need medical attention.
Some people taking GLP-1 medications have reported vision problems and nails separating from the nail bed. Researchers are still studying these reports and whether the medications cause all of these problems.
All medications come with possible risks, including GLP-1s. Your healthcare provider should review your risks when making treatment decisions.
Several GLP-1-based medications shouldn’t be used by people with a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia syndrome type 2. This warning depends on the specific medication, so your healthcare provider should review the FDA labeling for the drug you are considering.
Healthcare professionals also need to consider a history or risk of pancreatitis, gallbladder disease, severe gastrointestinal problems, or gastroparesis. Gastroparesis means the stomach empties food more slowly than normal even though there’s no physical blockage. GLP-1 medications can also slow stomach emptying, so people with severe gastroparesis may need to avoid some of these drugs.
If you’re planning to have surgery, tell your surgeon and anesthesia team if you’re taking a GLP-1 medication. These drugs can slow stomach emptying, which may increase the risk of stomach contents entering the lungs during anesthesia. Most people can continue taking GLP-1 medications before surgery, but your care team may recommend changes based on your individual risks.
Tirzepatide may also reduce the effectiveness of birth control pills. If you take birth control pills, you should switch to a nonoral method or add a barrier method for four weeks after starting tirzepatide and for four weeks after each dose increase.
GLP-1-based medications are not recommended during pregnancy. Breastfeeding guidance depends on the specific drug because the amount of information available differs from one medication to another. Talk with your healthcare provider about the risks and benefits before using one of these drugs while breastfeeding.
Talk to your healthcare provider if you become pregnant during treatment or plan to become pregnant. Some GLP-1 medications need to be stopped well before pregnancy. For example, semaglutide should be stopped at least two months before a planned pregnancy.
Along with brand-name GLP-1 products, several products are sold through compounding pharmacies. Compounded medications may contain the same active ingredients as FDA-approved drugs, but they aren’t FDA-approved and don’t undergo the same review for safety, effectiveness, and quality.
The FDA says compounded versions may be appropriate in limited situations when an FDA-approved drug can’t meet someone’s medical needs. These medications should be prescribed by a licensed healthcare provider and obtained from a state-licensed pharmacy.
The FDA has received reports of fraudulent compounded semaglutide and tirzepatide products, as well as counterfeit Ozempic. These products may be mislabeled or contain incorrect or harmful ingredients.
Compounded GLP-1 medications may come in vials containing multiple doses rather than prefilled pens. As a result, people may make dangerous mistakes when measuring their doses manually.
Be careful with websites that sell GLP-1 medications without a prescription or offer unusually large discounts. When in doubt, ask your primary care provider if the product you’re considering is safe.
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