Everything you need to know about GLP-1
What is GLP-1?
GLP-1 receptor agonist medications, including semaglutide, liraglutide, and dulaglutide, are synthetic versions of the body’s natural hormone. They are available as injections and a pill.
Tirzepatide, a dual receptor agonist, combines the synthetic version of GLP-1 with the synthetic version of the hormone GIP (glucose-dependent insulinotropic polypeptide).
Benefits of GLP-1
Expected weight loss depends on the drug and dosage. Research shows patients who took liraglutide for a year, along with an exercise program, lost an average of 15.7% of their starting body weight. In a study of semaglutide, people who took 2.4 mg of semaglutide every week for 68 weeks lost an average of 14.9% of their total weight. (Safe weight loss is one to two pounds per week.)
Because many GLP-1s are approved to treat diabetes, they can improve A1c. GLP-1s can also improve heart health by lowering blood sugar and helping people lose excess weight. Some GLP-1 medications can reduce the risk of major cardiovascular events such as heart attack, stroke, or death in adults with Type 2 diabetes and known heart disease, and in adults with obesity who do not have Type 2 diabetes.
Notably, some patients have reported reduced cravings and “food noise” while using GLP-1s for weight loss.
How does GLP-1 work?
When you eat, your food stimulates your gut to release the GLP-1 hormone. GLP-1 helps lower blood glucose (blood sugar) by prompting insulin release, which helps blood glucose enter your body’s cells for later energy use.
In some people, the gut doesn’t make enough natural GLP-1, or the brain isn’t sensitive to it.
Synthetic GLP-1 RAs (receptor agonists) work in the gut like natural GLP-1. Because GLP-1 slows digestion, it helps curb hunger and signal fullness to the brain. As a result, some people with obesity have lost weight while taking them.
Because GLP-1 drugs support a process the body isn’t doing well on its own, they may require long-term use.
It’s important to note that GLP-1 medications don’t work for everyone. There are many biological reasons why people struggle to lose weight. NWL’s clinicians, trained in obesity medicine, can help patients identify the root cause of their weight gain and personalize a prescription to target it. All prescriptions are up to a medical provider’s discretion.
More on personalized treatment with NWL
How to use it
Rybelsus®, a semaglutide pill, is typically taken once a day. Store it at room temperature.
Other brand-name GLP-1 medications are injections, typically taken once a week. Depending on the manufacturers’ instructions, patients inject the medicine under the skin in the upper arm, upper thigh, or stomach. Store injectable GLP-1s in a refrigerator.
Dosing
Dosing depends on your specific prescription and your care provider’s instructions. Please also read the pharmaceutical packaging.
Side Effects
Rapid or significant weight loss can lead to too much muscle loss. To protect your muscles, it’s important to start a strength training program and exercise regularly while taking tirzepatide.
Tell your health care provider if you have severe stomach problems that won’t go away, including abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting, including vomiting undigested food eaten a few hours earlier. These may be symptoms of gastroparesis (stomach paralysis).
Use effective birth control while taking this medication. If you are pregnant, breastfeeding, or planning to become pregnant, do not take tirzepatide.
Tirzepatide is not appropriate for those with insulin-dependent diabetes or diabetic ketoacidosis. So, if that’s you, tirzepatide isn’t the right fit.
Black Box Warning
Although rare, tirzepatide caused thyroid C-cell tumors in animal studies. Both brand names of tirzepatide have a “black box” warning of the risk of these tumors. If you have trouble swallowing, develop hoarseness, or feel swelling or a lump in your neck, contact your health care provider immediately.
The FDA also warns not to take Zepbound or Mounjaro if you have a personal or family history of multiple endocrine neoplasia syndrome Type 2 or medullary thyroid cancer.
Precautions
Rapid or significant weight loss can lead to too much muscle loss. To protect your muscles, it’s important to start a strength training program and exercise regularly while taking tirzepatide.
Tell your health care provider if you have severe stomach problems that won’t go away, including abdominal bloating or pain, acid reflux, a feeling of fullness after eating just a few bites of food, nausea, and vomiting, including vomiting undigested food eaten a few hours earlier. These may be symptoms of gastroparesis (stomach paralysis).
Use effective birth control while taking this medication. If you are pregnant, breastfeeding, or planning to become pregnant, do not take tirzepatide.
Tirzepatide is not appropriate for those with insulin-dependent diabetes or diabetic ketoacidosis. So, if that’s you, tirzepatide isn’t the right fit.
Interactions
Some drugs can also interact with tirzepatide, including:
- Insulin
- Sulfonylureas (when combined, these can cause blood sugar levels to drop dangerously low)
- Some birth control pills
- Other GLP-1 or GLP-1/GIP receptor agonist medications such as liraglutide, dulaglutide, or semaglutide
You should not drink alcohol while taking this drug because drinking can lower blood sugar. Combining alcohol with tirzepatide may cause blood sugar levels to fall too fast, leading to fainting and dizziness.
About NWL
NWL is an online weight loss program offering personalized care for every member. Some of the nation’s top obesity medicine specialists helped design our program. Our approach is based on science, and we’re committed to clinical excellence.
Members get access to: Clinicians trained in obesity medicine 1:1 health coaching Self-paced lifestyle change program designed by doctors, psychologists, and behavioral scientists Exclusive in-app community.
NWL’s comprehensive program is designed to work with your body—so you can achieve lasting results and enjoy better health.
