Are the new GLP-1 weight loss drugs safe?

For decades, the fight against obesity has been a complex one. Diet and exercise remain the cornerstones of weight management, but for many, these efforts haven’t been enough. Enter glucagon-like peptide-1 (GLP-1) receptor agonists – a new class of medications generating significant attention for their potential to revolutionize weight loss.

What are GLP-1 drugs and how do they work?

GLP-1 is a naturally occurring hormone produced in the gut. When we eat, GLP-1 is released, which

  1. sends signals to the brain that we’re full, and
  2. promotes insulin secretion to regulate blood sugar.

GLP-1 agonists mimic the effects of GLP-1, essentially tricking the body into feeling satisfied for longer, and regulating blood sugar levels.

The National Institutes of Health (NIH) explains that GLP-1 agonists work in several ways:

  • Slowing gastric emptying: This means food spends more time in the stomach, leading to feelings of fullness and reduced appetite.
  • Increasing insulin secretion: This helps the body utilize glucose (sugar) more effectively, promoting healthy blood sugar levels.
  • Decreasing glucagon secretion: Glucagon is a hormone that raises blood sugar levels. By suppressing glucagon, GLP-1 agonists contribute to blood sugar regulation.

Why are GLP-1 drugs gaining popularity?

Clinical trials have shown promising results for GLP-1 agonists in weight management. A study published in the esteemed journal Diabetes Care found that individuals taking liraglutide, a GLP-1 agonist, lost an average of 5.4% more body weight than those on a placebo over a year.

5% may not sound like much, but if someone weighs 300 pounds, 5% is a 15-pound weight loss.

A recent study published in the Journal of the American Medical Association (JAMA) investigated the use of a higher-dose GLP-1 agonist called semaglutide for weight loss. Results showed an average weight loss of 14.8% in patients taking semaglutide, compared to 2.4% in the placebo group. This significant difference highlights the potential of GLP-1 drugs to achieve substantial weight loss.

GLP-1 agonists were initially developed for diabetes treatment, and their weight loss benefits emerged as a welcome side effect. This dual action makes them particularly attractive for individuals struggling with both weight and blood sugar control.

It’s been forecasted that 7% of Americans (or 24 million people) will be taking GLP-1 medications by 2035.

Weight loss leads to other health benefits

The advantages of GLP-1 drugs extend beyond weight management and diabetes control. Research suggests potential benefits for:

  • Reducing cardiovascular disease risk: Obesity is a major risk factor for heart disease. Weight loss achieved through GLP-1 agonists may lead to lower blood pressure, improved cholesterol levels, and a reduced risk of cardiovascular events.
  • Improving sleep apnea: Excess weight can contribute to sleep apnea, a condition where breathing repeatedly stops and starts during sleep. Studies suggest GLP-1 agonists can improve sleep apnea symptoms by promoting weight loss and potentially influencing airway function.
  • Nonalcoholic fatty liver disease (NAFLD): This condition is characterized by excess fat buildup in the liver. GLP-1 agonists have shown promise in reducing liver fat and improving liver health in individuals with NAFLD.

Are GLP-1 drugs a magic bullet?

While GLP-1 drugs hold significant promise, they are not a magic solution for weight loss. Here are some things to consider:

  • Injections: Unlike some weight loss medications taken orally, GLP-1 drugs are administered via injection. This may be a drawback for some patients who dislike needles.
  • Side effects: Common side effects include nausea, vomiting, diarrhea, and constipation. These typically improve as the body adjusts to the medication.
  • Cost: GLP-1 drugs can be expensive, and insurance coverage varies.

 Less common but more serious side effects of GLP-1 agonists include:

  • Pancreatitis (inflammation of the pancreas)
  • Gastroparesis, in which movement of food out of the stomach is slowed or stopped.
  • Bowel obstruction

Who will benefit most from these weight loss drugs?

Current guidelines suggest that GLP-1 drugs may be suitable for adults with:

  • A body mass index (BMI) of 30 or higher (considered obese)
  • A BMI of 27 or higher (considered overweight) with at least one weight-related health condition, such as type 2 diabetes, high blood pressure, or sleep apnea.

It’s important to note that these are general guidelines, and individual considerations are vital. GLP-1 drugs are not a one-size-fits-all solution. If you’re considering these medications, it’s crucial to consult with your doctor. They can assess your individual needs, medical history, and weight loss goals to determine if GLP-1 agonists are right for you.

It’s important to remember that GLP-1 drugs are most effective when combined with a healthy diet and exercise routine. These medications can provide a powerful tool to support weight loss efforts, but lasting success — as always — hinges on lifestyle changes.

Exercise and healthy nutrition are still extremely important

Everyone knows the value of physical activity, healthy eating, and lifestyle improvements. We’ve been preaching this for decades, while telling clients there is no magic bullet for weight loss. Now along come these medications that enable many people to achieve significant weight-loss without struggling with the hunger part of eating less. So this part is good news! And these drugs DO work for suppressing appetite. As stated by Greg Degnan, MD, associate clinical professor at the University of Virginia, “These are effective drugs for weight loss, no question.”

But keep this in mind:

Just because you’ve lost some fat by taking weight loss drugs, that does NOT necessarily mean that you are in good shape or that you are healthy!

A solid workout regimen has a ton of health benefits:

Strength training is the foundation of exercise. A solid strength training regimen will

  • Tone and strengthen your muscles
  • Increase your metabolism
  • Improve your posture
  • Reduce aches and pains
  • Improve bone density
  • Increase immunity and health
  • Help regulate hormones and sleep
  • Increase energy
  • Reduce depression and anxiety
  • Improve diabetes

Twice-a-week muscular training is already included in the Physical Activity Guidelines for all adults, and being on weight loss meds doesn’t change that. The strength training is so important! With the GLP-1 drugs, there is a concern that people may be losing more lean mass when dropping weight as a result of taking these drugs than they would if they achieved the weight loss through diet and exercise. If a person achieves weight loss without performing physical activity, particularly strength training workouts, they are going to lose more muscle weight — and that holds true whether the weight is lost with GLP-1 medications or with dieting.

True fitness is all about getting in good shape and better health. It’s a measure of your physical conditioning and ability to do physical work. It’s about getting down to a healthier weight. Cardiovascular conditioning, endurance, balance, and agility are all things that will improve.

We’ll work on improving your abilities, whether you’re brand new to exercise or an experienced athlete. As you get in better shape, you’ll be able to do more — and it will feel great! 💪🏼

Mobility and flexibility are other important components of fitness. Your personal trainer will teach you proper posture, correct movement mechanics, and how to stretch effectively so you can stay limber and injury-free!

Nutrition considerations with GLP-1 drugs

Nutrition is a primary consideration to keep in mind for people taking GLP-1 drugs, because it can be challenging for them to meet their nutritional goals (including eating enough protein to maintain muscle) and to eat a balanced diet while consuming so few calories. People are simply not hungry when taking these drugs, so eating enough can be a challenge.

Additionally, clinical trials have found that consuming more protein than the recommended dietary allowance not only reduces body weight, but also enhances body composition by decreasing fat mass while preserving muscle in both low-calorie and standard-calorie diets. This may be a consideration for clients taking these drugs, as they have such dramatically decreased appetites.

Your nutrition coach can help you maximize the nutrients you get from a smaller amount of food. And eating a clean, well-balanced diet is vital to your health, regardless of whether or not you’re using weight loss drugs!

Another consideration of these medications is that they do not attend to any of the emotional aspects of stress eating, sugar addiction, or other emotional relationship issues with food.

Just because you’re less hungry does not mean that you have conquered emotional eating! We just happen to have the guy who wrote Beating Sugar Addiction For Dummies who you can talk to 😲

Never lose sight of the complex interplay between nutrition and exercise, especially considering the effects and side effects of these drugs. A suboptimal diet can have a profound impact on your energy levels, while feeling full often means people drink less water and struggle to stay hydrated. So, don’t underestimate the challenges people using weight loss drugs face in maintaining healthy and balanced nutritional habits.

The Bottom Line: A Promising Tool, But Not a Total Fix

GLP-1 drugs represent a significant breakthrough in weight management, offering a powerful tool for individuals struggling to lose weight and manage weight-related health issues. However, it’s important to maintain realistic expectations.

These medications are most effective when combined with a healthy diet and exercise routine. They can provide a significant boost, but lasting weight loss success requires a commitment to lifestyle changes.

These medications may help reduce some of that “food noise” and free up time to focus on physical activity as it connects to happiness, quality of life, stress management, sleep quality, etc. When weight loss is no longer the primary goal of exercise (as it has long been for many people), the other benefits of working out become more apparent and accessible, which, in turn, may lead to a more well-rounded attitude of health and wellness.

Final Thoughts on Diet and Exercise

It’s important to recognize that those who are taking GLP-1 medications may have had a rocky history with physical activity and nutrition, characterized by years of yo-yo dieting or extreme tactics to lose weight. They probably need supportive behavior-change coaching that makes it possible for them to develop healthy lifestyle habits that address their overall health and well-being—not just their weight! That’s what quality personal training and health coaching can do for you 😁

For many people, these drugs can release them from an appetite/fullness system that has not been working for them. People report things like, “For the first time, I am not thinking about food and being hungry all day long.” With this added pharmacological support, we can help you identify additional goals, such as better health and mobility, that may have been de-prioritized because people were so focused for so long on hunger and weight.

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About the Author

Personal training in NashvilleDan DeFigio is a well-known personal trainer and nutrition expert who has been featured on CNN’s Fit Nation, The Dr. Phil Show, SELF Magazine, Readers Digest, MyFitnessPal, Shape Magazine, and a host of other media outlets. Dan is the author of multiple books, including Beating Sugar Addiction For Dummies, and is the founder of