Wenger is also a family medicine and sports medicine physician in Lawrenceville, New Jersey, who regularly works with people on GLP-1s. If you’re taking one or considering it, though, it’s important to remember that using the drugs to suppress appetite doesn’t just contribute to fat loss. To learn more about how we are advocating for everyone affected by diabetes, visit us on X (@AmDiabetesAssn). Attendees will receive exclusive access to thousands of original research presentations and take part in provocative and engaging exchanges with leading diabetes experts. Therefore, the research and development of the relevant drugs and the replacement therapy of double GIP-GLP-1R agonists (e.g., tirzepatide) and triple GIP-GCG-GLP-1R (e.g., peptide 20) agonist are key research fields. These agonists are developed to maximize metabolic benefits and reduce side effects (126). Glucagon (GCG) is a 29 amino acid peptide secreted by pancreatic α cells when blood glucose levels are low. PEX-168 is a China-domestic long-acting GLP-1R agonist approved by the China's FDA for marketing and used for blood glucose control of adult patients with T2DM. Certain health conditions can make weight loss more difficult, even with medication support. Continued weight loss generally requires mindful nutrition choices and regular movement, even when medications are being used as part of the plan. In some cases, the reason weight loss is slower – or not happening at all – may have less to do with the medication itself and more to do with how the body is responding to it. By leveraging its proprietary technology platform, 50-state medical group, and nationwide mail-order pharmacy network, LifeMD is increasing access to amazing healthcare that is affordable to everyone. Medical treatment from licensed providers is provided by the “LifeMD Affiliated P.C.s,” an affiliated network of medical Professional Corporations and Associations. Iron levels are low — I recommend adding iron-rich foods or supplements. Stacey’s guiding principle in healthcare is that every patient deserves top-quality care, dignity, respect, and — most importantly — to be heard. Multiple glucagon-like peptide-1 (GLP-1) agonist medications, created for the treatment of type 2 diabetes mellitus, are now labeled for the treatment of obesity. One study he cites in the book showed that 40% of the weight loss in patients on once-a-week injections of semaglutide came from lean body mass. Paloma Health can support you in achieving your weight loss goals by offering personalized treatment plans that integrate GLP-1s and other weight loss drugs and strategies designed to meet your unique health needs. The main concern with microdosing GLP-1 medications is that microdosing therapy may not be effective at helping you achieve significant weight loss and complete blood sugar control. Additionally, weight loss from GLP-1 drugs typically levels off after about 68 to 72 weeks, likely due to the body’s natural resistance to further weight loss. By working closely with your healthcare provider, you can find the medication that best fits your needs and helps you achieve your health goals. Selecting the right GLP-1 agonist involves considering your health needs, potential side effects, frequency of administration, cost, and personal lifestyle. These medications can be expensive, and not all insurance plans cover every option. They also help balance blood sugars after eating by stimulating insulin secretion and inhibiting glucagon secretion.A 2023 study published in the “Journal of Hepatology” reported on a Phase IIa trial aimed at evaluating the efficacy and safety of efinopegdutide in patients with NAFLD, comparing it to semaglutide.144 Efinopegdutide is a dual agonist for GLP-1R and GIPR.144 The study used a randomized, open-label design and employed magnetic resonance imaging technology (MRI-PDFF) to measure liver fat content (LFC) after 24 weeks of treatment.For example, a patient with a BMI of 17.96 kg/m2 found that BN did not make him lose weight but increased it.Following a healthy lifestyle program such as the Mayo Clinic Diet is a great way to support your weight-loss journey when taking GLP-1 medications.Currently, some GLP-1RAs require daily injections, which can be inconvenient for patients.GLP-1 agonists have already made a big difference in the treatment of diabetes and weight loss.GLP-1 agonists offer a range of benefits beyond blood sugar control."If you have a thyroid issue, if you have diabetes, you may not get as strong an effect," Dr. Meghan reveals. “It can be hard to see you need to put some thought into this, when the medication is doing all of the work,” Ward said. “If your appetite is low, a protein shake or small snack with protein and carbs, such as Greek yogurt with fruit or chocolate milk, can be more manageable than a full meal,” Wenger said. After your workout, refuel within 30 to 60 minutes, which is when your muscles will be ready to take in nutrients. But if you don’t plan your meals around your workouts, that can contribute to even more muscle loss.” Researchers first compared the expression of GLP-1R in human pancreatic cancer tissues with adjacent non-tumorous pancreatic tissues, finding generally lower or absent expression of GLP-1R in pancreatic cancer tissues.520 Subsequently, the study observed that treatment with liraglutide, both in vitro (cell culture models) and in vivo (mouse models), inhibited the tumor formation and metastatic capabilities of pancreatic cancer cells by activating GLP-1R.520 The anti-tumor effect of liraglutide is related to its inhibition of the PI3K/Akt signaling pathway, as the activation of Akt is crucial for promoting cell survival and proliferation, and liraglutide can inhibit this process in a dose-dependent manner.520,526 In the context of T2DM, liraglutide, by regulating the PI3K/Akt pathway and activating GLP-1R, effectively inhibits the growth and spread of pancreatic cancer cells.520 Results showed that efinopegdutide was more effective in reducing LFC compared to semaglutide. In terms of apoptosis inhibition, GLP-1 activates the PI3K/Akt signaling pathway, enhances the expression of the anti-apoptotic protein Bcl-2, and inhibits the activation of caspase family proteins, reducing cell apoptosis.206 This helps prevent the progression of NASH to liver fibrosis and cirrhosis. If SGLT2 inhibitors and GLP-1RAs are effective in patients with heart failure (regardless of whether the ejection fraction is reduced or preserved), the commonalities between the two types of heart failure may be greater than is often thought. Higher scores indicate fewer symptoms and physical limitations and weight change from baseline. "I don't think the companies have leveled with the American public on how these drugs work," says Kessler. At their worst, side effects such as vomiting and nausea or hypoglycemia can land you in the emergency room. In the book, Kessler acknowledges that you can't really separate those unpleasant feelings from the effective mechanism of the drugs themselves. GLP-1 drugs are powerful appetite suppressants, Kessler says. The great thing about these drugs, says Kessler, is that they allow you to relearn how to eat. The two primary endpoints were the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS, which ranges from 0 to 100) and the Kansas City Cardiomyopathy Questionnaire Clinical Summary Score (KCCQ-CSS). Moreover, GLP-1R has not yet been identified on human myocardial cells, negating any direct effects of GLP-1RAs on myocardial cells.470 Heart failure with preserved ejection fraction (HFpEF) accounts for approximately half of all heart failure cases, with patients bearing a high symptomatic burden and physical limitations that impact their daily lives. The symptoms in patients are severe and often accompanied by functional impairments, especially in the obese population. First, GLP-1RAs have been shown to inhibit the expression and release of proinflammatory cytokines, such as IL-6 and TNF-α, thereby inhibiting the overall inflammatory response.461 GLP-1RAs can suppress the activation of nuclear factor-kappa B (NF-κB), a key transcription factor involved in the regulation of inflammatory processes.462 Inhibition of the NF-κB signaling pathway leads to the decreased production of inflammatory mediators, including adhesion molecules and chemokines, which are crucial for the recruitment of immune cells to sites of inflammation.463 In addition, liraglutide can delay the formation of AS by inducing cell cycle arrest in vascular smooth muscle cells through the AMPK pathway.5 This weight loss is not just about looking better; it’s also about improving health.Related article A study linking popular weight loss drug to suicide risk again raises long-standing safety questionsKnowing what to expect and how to manage these effects can make your experience with these medications smoother and less stressful.In over half of the studies identified, the proportion of LBM reduction ranged between 20% and 50% of total weight lost, which is consistent with diet-induced weight loss and bariatric surgery.Your best defense against regain is a gradual taper off of GLP-1s combined with a structured maintenance plan focusing on protein, fiber, and consistent physical activity.What’s unique about GLP-1 agonists is that we already have a lot of experience with them in patients with diabetes.These medications are highly effective, often leading to significant health improvements with minimal side effects.One of the main ways GLP-1 agonists aid in weight loss is by helping to control appetite.Weight loss can also cause hair loss, and may be responsible for other rarely reported side effects, such as tiredness.The researchers’ model suggested that even though the alternative weight-maintenance programs might be slightly less effective than long-term, full-dosage GLP-1RA use, the clinical benefits would only decrease slightly, while lifetime healthcare spending would decrease substantially. Counting calories is a common practice on a weight-loss diet, but it looks a little different for someone who is taking a GLP-1 medication. GLP-1 nutrition plans will vary from person to person, based on their individual weight loss goals, current nutritional intake, and personal preferences. Taking GLP-1s can also lead to muscle loss and make it more difficult to maintain muscle mass, which keeps your body functioning properly. A separate study reported 3.5 kg weight loss after 16 weeks of treatment in individuals with overweight/obesity and T2DM and reported that 11.4% of weight loss comprised of LBM . We searched for published studies reporting data on the effects of GLP-1RAs and SGLT2is on body composition using the online database, PubMed, from inception to August 2019, using search terms related to GLP-1RAs, SGLT2is, weight loss and body composition. Both classes of therapy also elicit clinically relevant weight loss , with liraglutide gaining an independent license (at a higher dose of 3 mg) for use in obesity management. It’s also important to stay hydrated and eat enough protein while on a GLP-1 to maintain muscle mass. Remember, weight loss isn’t the only perk you’ll get from regular exercise. “Seeking approval of any new exercise program from your primary care doctor is always important, but especially if you have chronic health conditions including obesity,” says Stevens. By reducing glucagon levels, GLP-1 agonists help keep blood sugar from getting too high between meals. Glucagon has the opposite effect of insulin; it raises blood sugar levels by signaling the liver to release stored sugar into the bloodstream. The pancreas is a crucial organ in the management of blood sugar because it produces insulin, a hormone that lowers blood sugar levels. GLP-1 agonists are medications that mimic the action of the natural GLP-1 hormone. In addition to their benefits for heart and kidney health, GLP-1 agonists are also effective in promoting weight loss. By protecting the heart, these medications can improve the overall life expectancy and quality of life for people with diabetes. These medications are known for their ability to help control blood sugar levels effectively. By slowing down digestion, GLP-1 agonists allow your body more time to absorb sugar from the food you eat, which helps prevent sharp increases in blood sugar levels. Because of this effect on the brain, GLP-1 agonists are helpful not just for controlling blood sugar, but also for supporting weight loss. This is something I need to do the rest of my life so I can continue remaining healthy for me and my family, and not gain back what I lost.” “Regular exercise is worth it for the happiness it brings, but I hope to retain as much muscle mass as possible, too.” But many users, including Sally, say they’ve had success prioritizing plants, fiber, and protein, as Glickman suggests. No exercise or eating plan is one-size-fits-all, including for people on GLP-1s. For those struggling with an altered sense of identity, Rickel recommends engaging with the parts of you that have nothing to do with your body size or appearance. Foods To Choose When on a GLP-1 This comprehensive change reflects how alterations in the expression of individual key proteins can impact the entire metabolic and inflammatory pathways, thereby improving disease conditions and enhancing therapeutic efficacy.376 In the muscle atrophy mouse model, Ex-4 also increased muscle mass and muscle fiber size and improved muscle function. Obesity disrupts bone metabolism and leads to increased bone resorption, but GLP-1RAs can inhibit this damage and improve bone health by increasing the OPG/RANKL ratio, reducing osteoclast activity, and promoting bone formation The confirmatory secondary endpoints included the change in the 6-min walking distance, a hierarchical composite of death and heart failure events; the difference between the change in the KCCQ-CSS and the change in the 6-min walking distance; and the change in the C-reactive protein (CRP) level.470 In this trial, semaglutide benefited patients with heart failure and preserved ejection fraction by intervening with upstream metabolic drivers. Additionally, GLP-1RAs facilitate the maintenance of endothelial barrier integrity, thus playing a crucial role in preventing vascular leakage.452 Endothelial cells exhibit enhanced NO production and concurrent suppression of endothelin formation, resulting in vascular smooth muscle relaxation and vasodilation mediated by the endothelium (e.g., GLP-1, exenatide, and liraglutide).453 Indeed, GLP-1RAs, including exenatide, liraglutide, and semaglutide, have been linked to the diminished expression of matrix metalloproteinases (MMPs).454,455,456 MMPs are a class of enzymes that play a crucial role in the breakdown of extracellular matrix components. GLP-1RAs have diverse effects, including alleviating neuroinflammation and pain in OA, reducing food intake and improving body weight, protecting peripheral nerves, maintaining astrocyte function and metabolic homeostasis, and showing potential therapeutic benefits in AD and PD. Interestingly, a clinical study published in “Nature Metabolism” in 2023 investigated the restorative effects of liraglutide on impaired associative learning in individuals with obesity. In addition to its effects on metabolic regulation, GLP-1, when synthesized within the brain, exhibits neuroprotective properties.397,427,431 A clinical trial titled “Liraglutide in Early Parkinson’s Disease” was published in the New England Journal of Medicine, exploring the effects of liraglutide on patients with early-stage PD diagnosed within the last three years.432 The research was a 14-month Phase II double-blind randomized controlled trial. When this happens, hunger levels may gradually return to what they were before treatment started, making it harder to maintain the same rate of progress. Even so, it’s still possible for some to experience limited weight loss while using Zepbound®, and understanding why this happens is an important part of finding the right approach. It’s also important to note that some medications, such as Zepbound®, work slightly differently. These treatments mimic a hormone called glucagon-like peptide-1, which plays an important role in regulating appetite, slowing down stomach emptying, and improving insulin sensitivity. If you have been using a GLP-1 medication and have not seen the results you hoped for, it does not necessarily mean the treatment is failing – or that you are doing something wrong. Glucagon-like peptide-1 receptor: mechanisms and advances in therapy The weight loss of the low dose (0.03 mg/kg) group, medium dose (0.1 mg/kg) group, and high dose (0.33 mg/kg) group were about 2g, 4g, and 1g (8 weeks). Guo (120) et al. found that PEX-168 significantly reduced the body weight of simple obese mice. Hirsch et al. (117) found that after 24 weeks of drug treatment of once-weekly EX-LAR or dapagliflozin or co-administered, nondiabetic women with a BMI (≥30 kg/m2 and ≤ 45 kg/m2) and polycystic ovary syndrome all lost weight. These medications offer broader health benefits, particularly for the heart and blood sugar levels. GLP-1 receptor agonists like semaglutide and tirzepatide offer a promising solution for individuals struggling with obesity or weight-related health conditions. This might include adjusting the dosage or combining the medication with other treatments, depending on the patient’s overall health, weight loss goals, and any coexisting conditions. In addition to weight loss, these medications offer additional health benefits. These medications differ from other weight loss treatments like orlistat or phentermine. In addition to the medication, Julie has begun seeing a therapist experienced in treating eating disorders, whom she hopes will help her heal her tumultuous relationship with food. It goes on and on and on,” says Katie Rickel, PhD, a clinical psychologist and chief executive officer at Structure House in Durham, North Carolina. “Everyone’s body is different; your mileage and participation may vary,” she says. We always want patients to know that long term, it’s hard to say where they will fall on that spectrum.” Some patients are super responders and see results above that average,” he says. They also help balance blood sugars after eating by stimulating insulin secretion and inhibiting glucagon secretion. But what are they, how do they work and are there things current cancer patients should be aware of if they’re considering these drugs? Most people know that losing weight has numerous benefits, but making major lifestyle changes can be extremely difficult. A substantial proportion of LBM loss may be comprised of skeletal muscle, which may be clinically relevant, particularly in the populations to which these therapies are prescribed. Collectively, the available evidence suggests that the initiation of GLP-1RA or SGLT2i therapy results in weight loss that is primarily derived of FM. The frequency of injection varies depending on the specific medication, ranging from once daily to once weekly. Some patients may also experience headaches, dizziness, or an increased heart rate. As research continues, we can expect to see further developments in this field, offering new options and even more effective treatments. Looking to the future, the field of GLP-1 agonists is continually evolving. It is essential to have a conversation with a healthcare provider to determine the best option based on individual circumstances. It is also important to state that the absolute mass of skeletal muscle is not the only factor to consider, and improving muscular function (strength, endurance, flexibility etc.) remains critical to improve physical function and performance in tasks of daily living; to impact positively on an individual's quality of life. In turn, strategies to preserve or increase skeletal muscle and physical function in these individuals (e.g., through structured exercise training), are of importance. TBW, as provided by BIA, does not allow distinction between water contained in, and thus lost from, different body compartments (i.e., FM or FFM/LBM). In one it was twice as great , whilst another reported a loss of skeletal muscle despite an increase in FFM . In seven of these studies, the loss of skeletal muscle comprised between 55% and 100% of the LBM/FFM lost. In this article, we’ll discuss some common reasons why people don’t lose weight on GLP-1 medications and explain what steps to take if you find yourself in that situation. Even with highly effective medications, weight loss can sometimes be less than expected, and it is important to understand why that might happen. Maybe we will learn that some weight loss can be maintained if habits change significantly or if there are options for maintenance with other medications.” In the research conducted by Daniel J. Drucker’s team, the mechanism of anti-inflammatory action of GLP-1RAs was explored, revealing a key role for the CNS in regulating this anti-inflammatory effect.423 The study began by inducing inflammation in mice through the injection of various Toll-like receptor (TLR) agonists and then assessed the inflammation by measuring plasma tumor necrosis factor-alpha (TNF-α) levels.423 It was observed that the GLP-1RA, exendin-4, significantly reduced the TNF-α levels caused by various TLR agonists, indicating that exendin-4 can lower the TNF-α levels induced by multiple TLR agonists.423 The research further demonstrated that this anti-inflammatory effect was not mediated by GLP-1R in the blood or endothelial cells but required the GLP-1R in the CNS. However, this inhibitory effect is significantly weakened in patients with T2DM, indicating that its potential application in diabetes treatment requires further investigation.241 Through this series of complex molecular and cellular mechanisms, GLP-1 plays a vital role in the physiological and pathological processes of metabolic diseases like T2DM.232,233,241,259 (Fig. 2). This may be due to altered α-cell function in diabetic patients, which impairs the efficacy of GLP-1(9–36).241 In vivo experiments have shown that high concentrations of exogenous GLP-1(9–36) can lower circulating glucagon levels during insulin-induced hypoglycemia. GLP-1 can stimulate pancreatic β-cells to release insulin.236,237 Insulin not only directly lowers blood glucose levels but also further inhibits glucagon secretion from α-cells through a feedback mechanism.238 The high concentration of insulin in the local pancreatic environment creates a negative feedback effect, reducing the amount of glucagon secreted by α-cells.234 Additionally, GLP-1 can reduce blood glucose production by delaying gastric emptying and decreasing appetite, which also contributes to overall blood glucose control.239,240 In summary, GLP-1 lowers blood glucose levels and inhibits glucagon secretion through direct action on α-cells, promotion of insulin secretion, and regulation of gastrointestinal activity.241 On December 18, 2023, Structure Therapeutics published the latest clinical data for GSBR-1290 on its official website.175 Currently, GSBR-1290 is undergoing a 12-week Phase 2a randomized, double-blind, placebo-controlled clinical trial to assess its effectiveness in treating patients with T2DM and obesity. Dulaglutide works by stimulating insulin secretion in response to meals and slowing gastric emptying. Liraglutide has also been found to have cardiovascular benefits, making it a preferred choice for patients with a high risk of heart disease. Victoza is used to treat type 2 diabetes and is taken once a day. Focus on (and celebrate) non-scale victories like better bloodwork, increased strength, improved sleep, and other benefits. That doesn’t mean you need to be lifting weights every day, though. Strength training is a well-known way to build up muscle mass — one that both Callins and Stevens recommend as part of your exercise routine. The drugs are expensive, and experts say the recent spike in popularity has already led to shortages and increased hesitancy among insurance providers to cover these drugs. Rethinking long-term weight management strategies to overcome cost barriers They highlighted the need to consider potential tradeoffs between efficacy and side effects, finding that higher doses can have stronger efficacy but also induce more severe side effects. Another key consideration is side effects, which can vary significantly from patient to patient. A striking study on liraglutide showed 80% of prediabetic patients avoided developing full diabetes while continuing the medication. A doctor will review your health history, perform a thorough evaluation, provide guidance on how to reduce unwanted side effects, and help determine whether this treatment is appropriate for you. Women who are planning to become pregnant should discuss alternative weight loss methods with their healthcare provider. The effects of these medications on fetal development and breastfeeding infants have not been well studied, and animal studies have suggested potential risks. Patients taking GLP-1 agonists should continue to follow a healthy diet and engage in regular physical activity to maximize the benefits of the medication. They may also be recommended for weight loss in people who are overweight or obese, especially if they have difficulty losing weight with diet and exercise alone. This hormone is naturally produced in the intestines and plays a key role in regulating blood sugar levels, insulin secretion, and appetite. The second study, using BIA, reported 2.9 kg weight loss after 52 weeks of treatment with luseogliflozin-plus-liraglutide, in individuals with T2DM, of which 14% comprised of LBM . In the final study identified, 24 weeks of treatment with ipragliflozin resulted in a loss of FM that was greater than the total weight loss in individuals with T2DM and NAFLD, inferring a small gain (0.2 kg) in FFM . In contrast, a 12-week RCT reported that almost all (94%) of the 3.1 kg weight loss elicited with dapagliflozin was LBM , whilst a small cohort study in 11 individuals with T2DM and nonalcoholic steatohepatitis, reported a 1.2 kg increase in LBM after 24 weeks of treatment, despite 3.8 kg weight loss . In clinical studies, LIXI has shown the benefits of weight loss, which is well tolerated by patients and can meet the needs of overweight patients for weight control. A clinical study involving 78 non-diabetic overweight/obese patients found that BN may be a more effective treatment option for overweight/obese Chinese than metformin (43). We anticipate that this review will generate data that will help biomedical researchers or clinical workers develop obesity treatments based on GLP-1R agonists. Among them, anti-obesity drugs have high compliance rates and cause noticeable short-term effects in reducing obese levels. GLP-1 medications are effective weight-loss drugs that have become well-known and accessible recently (3). What’s also interesting about these drugs is that GLP-1 is a neuropeptide. There have also been some recent reports that they might be linked to gastroparesis in some patients. That makes these drugs comparable to surgical options, like gastric sleeve surgeries. Others inhibited fat absorption, but were hard to tolerate for many patients because they caused gastrointestinal issues. Your best defense against regain is a gradual taper off of GLP-1s combined with a structured maintenance plan focusing on protein, fiber, and consistent physical activity. After all, studies show up to two-thirds of lost weight returns within a year of stopping, especially with abrupt discontinuation. QuickMD offers affordable options starting at $149 monthly, significantly less than traditional prescriptions, with convenient telehealth visits on your schedule. Connect with weight management specialists from anywhere, your couch, car, or even hiding in the pantry for a moment of quiet. QuickMD makes it easier with convenient telehealth support through every step. Related article A study linking popular weight loss drug to suicide risk again raises long-standing safety questions Lynn-Pullman has not only lost 60 lb and maintained that weight loss for over a year, but "my cholesterol is now normal and my A1C dropped, as well," she says. Nausea and vomiting were the main side effects that Pickford and Lynn-Pullman experienced in the early days of treatment. "I was barely hitting 800 calories, which isn't enough calories for a child! My protein intake was not sufficient to meet the needs of the weight training I was doing," she says. When the registered dietitian and certified diabetes care and education specialist Jennifer Lynn-Pullman, CDCES, RD, reached 200 lb, she knew that her weight and family history of type 2 diabetes was setting her up for a diabetes diagnosis. Who Qualifies for GLP-1 Weight Loss Drugs? GLP-1 agonists are typically prescribed for individuals with type 2 diabetes who need help managing their blood sugar levels. GLP-1 agonists work by binding to the GLP-1 receptors in the pancreas, increasing insulin production when blood sugar levels are high. For anyone dealing with diabetes or struggling with weight, GLP-1 agonists are an essential tool that should be considered in their overall health management plan. They provide multiple health benefits, including better blood sugar control, weight loss, and improved cardiovascular health. In conclusion, GLP-1 agonists represent a significant advancement in the treatment of diabetes and obesity. This could be particularly helpful for people who have trouble remembering to take their medication or who don’t like needles. This would be much simpler and less painful, making it easier for people to stick to their treatment plans. To solve this problem, researchers are exploring new delivery methods that might make it easier to take these medications. Some new drugs might be combined with other types of medication to improve their effectiveness. Researchers and scientists are continuously working on new ways to make these medications even better. Commonly prescribed GLP-1 receptor agonists include semaglutide (sold under brand names like Wegovy and Ozempic) and tirzepatide (marketed as Mounjaro). These medications can increase fertility — but the risk of taking them while pregnant isn’t well known Protein also keeps your body from losing muscle instead of fat. But your body still needs a variety of nutrients to be healthy. GLP-1 agonists affect the way your body signals hunger and digests food. “The general philosophy is to treat obesity as a chronic disease with indefinite use of GLP-1 medications. Davisson agrees that using GLP-1 medications is best as a long-term treatment, but also acknowledges that this field of research continues to evolve. “This is because the human body defends against weight loss. Some people may have successful weight loss before reaching the highest dose, while others may not see results until reaching the highest dose. “We take many factors into consideration when choosing a medication dose, including rate of weight loss. Weight-Related Health Conditions By improving your habits from the start, you’ll learn how to eat well, move more, and refocus your mindset, which will help to ensure a lifetime of health and well-being. This applies even if you haven’t lost weight through lifestyle changes alone. The answer is “yes.” As with any weight-loss program, lifestyle changes are necessary for long-term weight management. Seek Advice From Your Medical Team if Side Effects Impact Your Exercise Remember, the drugs slow down the emptying of the stomach into the small intestine, and that can lead to things getting backed up further down the line, Kessler says. "If you are increasing the protein, you're decreasing the rapidly absorbable carbohydrates, you're decreasing fat, excess calories, and sugar," says Kessler. With good medical care, he says, many people can still take pleasure in food at those smaller portion sizes. Working with an obesity medicine specialist, he says, is ideal, though he acknowledges finding one may be a challenge. The side effects are one reason it's important to work with a physician who can monitor your progress and help you find the right drug at the right dose. “But that doesn’t mean you need to eat huge amounts or drink protein shakes with 40 grams of protein per bottle,” says Escobar. Losing weight has long been a hard-earned, difficult process. Weight loss is a matter of energy balance — so your food intake and activity levels will always remain important, even on a GLP-1. Research shows GLP-1 agonist drugs are effective but come with complex concerns. To date, the trial has enrolled 94 participants, with 54 in the T2DM group and 40 in the obesity group. GSBR-1290 is an oral small molecule GLP-1RA developed by Structure Therapeutics, aimed at treating T2DM and obesity. The study involved 411 adult patients with T2DM and was designed as a randomized, double-blind, placebo-controlled trial where patients received varying doses of danuglipron or a placebo. Current dual agonists under investigation also include efinopegdutide and cotadutide.144,145,146,147 Once per week, users attach a needle to their pen, prick themselves in the torso or another fleshy area, and press a button on the pen to administer their medication. The drugs also boast other long-term benefits, such as protection against cardiovascular disease. Food and Drug Administration (FDA) and may carry greater risks than FDA-approved treatments. Each patient's journey is unique, and understanding these lesser-known aspects of GLP-1 treatment can help you set realistic expectations and achieve better results. As Dr. Meghan explains, "If they're taking an injectable GLP-1 Wegovy, they may want to try something like Zepbound or Saxenda, or they may want to try an oral medication." The comprehensive exploration of their benefits underscores their transformative potential in medicine, positioning them as a promising approach for addressing a wide array of health issues and paving the way for new research and clinical applications. For example, in the treatment of Alzheimer’s diseases (AD) and Parkinson’s diseases (PD), GLP-1RAs have shown potential in slowing disease progression, while their anti-inflammatory properties offer new hope for conditions such as osteoarthritis (OA), rheumatoid arthritis (RA) and cardiovascular diseases.13,14,15 By integrating the latest clinical trial data, we explore the efficacy of GLP-1RAs in treating diseases of the nervous, cardiovascular, endocrine, and digestive systems. This receptor specifically interacts with GLP-1, a key hormone that plays an integral role in regulating blood glucose levels, lipid metabolism, and several other crucial biological functions. The glucagon-like peptide-1 (GLP-1) receptor, known as GLP-1R, is a vital component of the G protein-coupled receptor (GPCR) family and is found primarily on the surfaces of various cell types within the human body. This is because your body needs nutrients both to fuel your workouts and, afterward, to replenish your energy stores and repair muscle tissue. Along with her new medication regimen, she’s exercising more and making healthier food choices, changes she says have benefited her mental and physical health. Lindsay has also had to grapple with the notion that taking GLP-1s is akin to “cheating” her way to weight loss. My weight has fluctuated my entire life, and I could never understand why people around me could do the same activities and eat the same foods and never struggle with the issues I struggled with,” Lindsay says. “Those for whom excess weight has been a lifelong struggle may find that a significant part of their identity is tied up in ‘I am a person who needs to lose weight,’” Rickel says. Maybe this really was a health issue because my doctor gave me medicine, and it’s getting better,” says the IT systems engineer in Croton-on-Hudson, New York. Mireya, a 32-year-old from Austin, Texas, has experienced some typical side effects, such as nausea and constipation, since she began taking a GLP-1 in March 2024. “We want patients to eat as much fiber as possible, as many whole foods as possible, while minimizing highly processed food,” he says. “Taking this medication has given me a chance to not focus on food, aka food noise, and really start seeing my past more clearly,” she says. BMI isn’t a perfect measure, but it gives clinicians a standardized tool to assess your baseline health risk and decide whether medical intervention is appropriate. This hormone is released after you eat and helps regulate blood sugar, slow down digestion, and signal to your brain that you're full. Perhaps you’re noticing higher blood pressure at your last checkup or feeling fatigued. You’ve tried everything—cutting carbs, counting calories, following intense workout plans—only to see minimal results or gain the weight back. Know that some exercise is better than none These medications are designed to treat obesity. Popular brands of the GLP-1 receptor agonist semaglutide — including Ozempic and Rybelsus —are approved by the Food and Drug Administration (FDA) for treating diabetes, while Wegovy is FDA-approved for obesity management. There's a healthier way to lose weight with weight-loss medication. Affordable and personalized virtual care for opioid addiction, hormone therapy, weight loss, and urgent health needs. These results suggest that GLP-1 may improve exercise endurance in mice by enhancing skeletal muscle glycogen synthesis and glucose uptake.And muscle is gold dust, it boosts your metabolism, shapes your body, and keeps you strong for the long haul.This is important because LBM (predominantly comprised of skeletal muscle) has several important functions.The analysis from Dandelion Health, a health care analytics firm, is based on the electronic health records of nearly 17,000 people who were prescribed a GLP-1 from 2019 through 2023.GLP-1R agonists improve glucose homeostasis in patients with T2DM, cause weight loss, and benefit cardiovascular health over time. You've seen the headlines about dramatic weight loss results with GLP-1 medications. If restarting, patients usually return to a lower dose to avoid side effects and ensure a gradual reacclimation, allowing the medication to reach therapeutic levels safely once again. GLP-1 dosing protocols are developed by a combination of researchers, clinical experts, and regulatory bodies to ensure the medications are both safe and effective for patients. If you are struggling to lose weight on your current plan – or if you are wondering whether GLP-1 medications or other treatments could be right for you – LifeMD is here to help. Improved energy levels, better blood sugar control, reduced blood pressure, and an overall healthier body are all significant wins. Unlike some other diabetes medications that only focus on lowering blood sugar, GLP-1 agonists also help with weight loss, which is a crucial part of managing type 2 diabetes. These medications are not only helpful in managing blood sugar levels but also play a significant role in helping people achieve weight loss. “Some other treatments for Type 2 diabetes can actually cause weight gain, whereas GLP-1RA drugs effectively control blood glucose levels while also reducing body weight,” Yuan said. GLP-1 receptor agonists (GLP-1s) are a class of medications originally developed for type 2 diabetes but have gained widespread use for weight loss due to their effects on appetite and metabolism. Future research on GLP-1-based and other therapies designed for weight loss should focus on more accurate and meaningful assessments of muscle mass, composition, as well as function, mobility or strength, to better define their impact on muscle health for the substantial number of patients who will likely be taking these medications well into the future. It would be rare for someone to continue the medicine if they are experiencing enough vomiting and diarrhea to lose excessive amounts of weight,” says Davisson. In my experience, patients who continue to have such symptoms beyond a couple of weeks will not stay on the medicine. “Once someone is at the highest dose in six months, they typically continue to lose weight for the rest of the year and maybe beyond that, but there are always exceptions to the rule.” It takes at least six months for someone to get to the maximum dose of Zepbound, for example, and longer for those who have more side effects. There has also been plenty of media buzz about anecdotal side effects with names like “Ozempic face” and “Ozempic butt.” Gastrointestinal issues are usually strongest in first-time users, or when people step up to a larger dosage, but they usually dissipate over time. Additionally, a minority of users will find it necessary to discontinue the drug because they cannot tolerate the side effects. Wegovy and Saxenda are also approved for the treatment of children aged 12 and older; the precise BMI cutoffs for children differ by age. Doctors start their patients on lower “starter” doses and work their way up — it can take months to work up to a full-strength dosage. When these medications bind to receptors in the brain, they send signals that slow down the emptying of your stomach. When GLP-1 agonists bind to receptors in the pancreas, they stimulate the pancreas to produce more insulin. These medications are designed to attach to the same receptors that natural GLP-1 would bind to. The word “agonist” means that the medication acts like GLP-1 in your body. Wenger and other experts share tips on how to safely build muscle strength while using a GLP-1. But lost muscle mass isn’t good for anyone, no matter your age. “If those people lose even 10% to 15% of lean mass, it’s still significant because they have low mass to begin with.” Sarcopenia is the age-related loss of muscle mass, strength and function. Exercise and strength training to stave off too much muscle loss are especially critical if you’re 65 or older. Consulting with a healthcare provider is critical before starting any GLP-1 treatment. Anyone with a known allergy to the medication should avoid GLP-1 treatments. GLP-1 medications are not recommended for pregnant women or those who are breastfeeding. Modified DPP-4 can not only mask the enzymatic hydrolysis site of DPP-4 but also bind closely with albumin to reduce renal excretion and prolong the half-life.35,104,116 On August 22, 2022, Novo Nordisk announced the primary results of the Phase II clinical trial for the dual-action compound CagriSema, which demonstrated effective blood sugar reduction and weight loss. GLP-1 helps regulate blood sugar levels by stimulating the release of insulin, suppressing glucagon secretion (which raises blood sugar levels), and slowing the rate at which the stomach empties, leading to a feeling of fullness and reduced appetite.69 In addition to its use in diabetes management, GLP-1RA has also shown potential in other areas of research. Dr. John found that exenatide is an analog of human GLP-1RA, with 53% homology to human GLP-1RA; exenatide can stimulate human insulin secretion and regulate blood glucose levels in the body. In December 2014, they published a paper in Nature Medicine, showing that the triple agonist’s weight loss effects in mice exceeded those of the dual agonists.28 (Fig. 1). One study found that two-thirds of the weight loss was regained after one year off GLP-1 (4). How does exercise influence weight loss outcomes in those who are on GLP-1? Being in a caloric deficit alone can result in 10-30%, even 40% in some cases, of the weight lost from muscle mass. Pi-Sunyer (92) et al. enrolled 3731 patients without T2DM (BMI ≥ 27 kg/m2 or 30 kg/m2) and gave LIR 3mg daily subcutaneous injection. The United States Food and Drug Administration (FDA) approved it to treat obesity. Clinically, it is mainly used to treat T2DM and causes weight reduction when used in large doses (3mg/day) (83). However, iGlarLixi patients had more gastrointestinal-related adverse, primarily nausea (16.9% vs. 0.8%) in this 26-week, randomized, open-label study (70). This needs to be monitored as we do not want excessive weight loss, which can create excessive muscle loss” and other possible problems. Furthermore, one-third of the study’s participants who took the weekly semaglutide lost at least 20 percent (an average of 46 pounds) of their body weight by the end of 15 months. “The medicines slow down food movement through the GI tract, which makes people feel full longer as an additional method of helping with weight loss,” Davisson says. For me, the goal is sustainable, healthy weight loss,” says Caissa Troutman, MD, founder of Midlife reMDy in Camp Hill, Pennsylvania. Join a judgment-free community of people who are also on a GLP-1 through WW’s social platform, Connect. Meet with a dietitian 1x1, join virtual Experiences and Workshops, and follow on-demand strength-training videos tailored to all fitness levels.† Log your weight and activity to get a clearer picture of your journey. Enter your meals to keep you on track with the nutrients that matter most for the GLP-1 journey, including protein and fiber. In this section, we’ll explore how GLP-1 agonists work in diabetes management, compare them to other diabetes medications, and explain how they help in reducing HbA1c levels. GLP-1 agonists are a type of medication that has become very important in treating diabetes and helping people lose weight. For many people, these medications offer an effective way to achieve and maintain a healthy weight, which can lead to better overall health and well-being. While the review has so far found no conclusive evidence of association, reports circulating without the proper contextual information may fuel disinformation and discourage patients who would benefit from GLP-1 RA therapy. The caring team at Genesis Lifestyle Medicine is here to help you uncover the most effective, medically sound solution for your body and goals. Your medical history is thoroughly reviewed by the clinicians at Genesis Lifestyle Medicine to ensure your treatment is safe and effective. Can weight loss injections decrease your cancer risk? "I was barely hitting 800 calories, which isn't enough calories for a child! My protein intake was not sufficient to meet the needs of the weight training I was doing," she says.Cost can often be a prohibitive factor for these medications – a month’s supply of GLP-1 medications can often cost about $1,000 – but the analysis included only people who had insurance plans that covered weight-loss medication prescriptions.Some studies have shown that GLP-1 agonists might reduce the risk of heart disease, which is a common problem for people with diabetes.If you believe you may be a good candidate for GLP-1 weight loss treatment, it is essential to consult with a healthcare provider to discuss your options."I can still enjoy myself and I don't have to just live off of bland food to lose weight."However, these medications offer many other benefits that go beyond just managing glucose.A huge benefit (backed by science) of GLP-1s is their positive impact on your heart health.GLP-1RAs have been shown to reduce the levels of systemic inflammatory markers.457,458 Importantly, the effective management of inflammation is widely acknowledged to play a crucial role in the prevention of cardiovascular diseases.459,460 The anti-inflammatory effects of GLP-1RAs contribute to the attenuation of atherosclerotic plaque lesion development through various mechanisms. If you are not losing weight, there are a few steps to consider. Until the full effective dose is reached, the impact on appetite and weight may be limited. In addition to targeting the GLP-1 receptor, Zepbound® also activates another receptor called GIP (glucose-dependent insulinotropic polypeptides), which can influence metabolism in a different way. She has a passion for healthful living as well as helping moms live a more fulfilled motherhood with her coaching program and forthcoming book “The Mom-Life Reset.” Some people will stop using them for various reasons, and that will give us an opportunity to study what happens. What’s unique about GLP-1 agonists compared to other weight loss drugs is that we already have a lot of experience with them in patients with diabetes. Many people take GLP-1 agonists or other weight loss medication, they lose weight, they go off the drugs and then they gain the weight back. In three months, Holz said, he’s shed just over 10% of his body weight, and he is enthusiastic about GLP-1 drugs not just for weight loss but for their protective effects on the heart and other potential health benefits. Of the studies identified in this review, 12 reported changes in either LBM or FFM, along with changes in skeletal muscle. There are no clear patterns within the data collected in this review, including treatment type, dose or duration and the technique used. Within 53 groups of individuals prescribed GLP-1RA, SGLT2i or combined therapy, only five groups saw a loss of LBM, FFM, or skeletal muscle mass (depending on reporting) that was greater than FM lost. Each utilised BIA to assess body composition, but only one study reported changes in both total BW and FFM. These patients reduced their initial weight by ≥5% through a low-calorie diet during the 4-12 weeks pre-trial induction period. Researchers believe that nausea/vomiting is related to greater weight loss (90). The relevant study also found that the 1-year average weight loss of participants (LIR 3.0 mg) was 9.2 kg reporting nausea/vomiting episodes, while that of participants without nausea/vomiting was 6.3 kg. A prospective clinical study from Spain found that besides controlling blood glucose (fasting blood glucose and glycosylated hemoglobin), LIXI can also improve blood lipids, especially total cholesterol and triglyceride (68). By preserving kidney function, GLP-1 agonists may reduce the need for dialysis or kidney transplants in the future.Originally approved to treat obesity and type 2 diabetes, these medications, commonly known as GLP-1 agonists, are increasingly being used to aid in general weight loss.GLP-1 agonists are medications that mimic the action of the natural GLP-1 hormone.The dosing schedule for tirzepatide involves a gradual increase in dose to help the body adjust and minimize side effects.Given the potential benefits of GLP-1 receptor agonists in managing metabolic disorders, it is crucial to explore how microdosing might influence metabolic pathways and patient outcomes.This can lead to significant weight loss over time, which in turn can improve overall health and make it easier to control diabetes.Eli Lilly and Company is currently researching a dual agonist called tirzepatide, which has outperformed semaglutide in phase 3 clinical trials.Eli Lilly will test just that, according to recently posted study plans on a federal database of clinical trials. Weight loss induced by glucagon-like peptide-1 receptor agonists (GLP-1RAs) and dual glucagon-like peptide-1 receptor (GLP-1R)/glucose-dependent insulinotropic polypeptide receptor agonists is coming closer to the magnitudes achieved with surgery. For example, triple-target agonists like retatrutide are leading multi-target GLP-1 drugs. While the therapeutic benefits of GLP-1RAs in diabetes management are well-established, their emerging role in other diseases suggests novel treatment strategies. GLP-1 and its receptor agonists show some potential in the treatment of gastrointestinal cancers, although this remains an emerging area of research.518,519,520,521 Learn more about our diabetes solutions. After signing up, let us know if you’re living with type 1 or type 2 diabetes and we'll take your needs into account. "I’m happier, I’m more energetic, and there's no question I'm healthier." "I can still enjoy myself and I don't have to just live off of bland food to lose weight." Medical History and Current Health Status This pathway facilitates the generation of NO, thereby contributing to the preservation of vascular health and endothelial function. One study suggested that GLP-1RAs exert direct endothelial protective effects by activating the GLP-1R-dependent AMPK/Akt/eNOS pathway. GLP-1RAs have been shown to exert beneficial effects on the maintenance of endothelial integrity. Semaglutide, a diabetes drug, can also reduce alcohol consumption by modulating the brain’s reward and punishment systems AD is a progressive and irreversible neurodegenerative disorder characterized by an unclear etiology and pathogenesis.424 In AD, GLP-1(7-36) amide inhibits IL-1β transcription and prevents cognitive dysfunction, amyloid precursor protein synthesis, and cell death. This weight loss is not just about looking better; it’s also about improving health. For example, one popular GLP-1 agonist was shown to help people lose about 5-10% of their body weight over several months. Studies have shown that GLP-1 agonists are effective in promoting weight loss. Additionally, because GLP-1 agonists help keep blood sugar levels in check, they reduce the likelihood of experiencing hunger due to rapid drops in blood sugar. Since losing weight requires taking in fewer calories than your body uses, this effect of GLP-1 agonists can be very helpful. Protein powders are essential for GLP-1 users to prevent muscle loss during rapid weight loss. That said, protein targets may be different since they are individualized based on what you weigh at the beginning of the program (1g of protein per 1 kg starting body weight). Log injections—including the medication, dose, and site—as well as side effects so you can better understand your body and what helps you feel your best. These tests can be repeated intermittently to see progress in a patients health metrics as they lose weight and get healthier. Millions have already seen some incredible results with GLP-1 medications like Ozempic, Wegovy, and Mounjaro. A professional evaluation will ensure the treatment is safe and appropriate for your specific health needs. Individuals with a history of failed weight loss attempts and those committed to long-term lifestyle changes are the best candidates for this therapy. Regular check-ups allow healthcare providers to track progress, make any necessary adjustments, and address potential side effects early on. These medications are especially beneficial for people who struggle with obesity or have not achieved their blood sugar goals with other treatments. GLP-1 agonists are a class of medications that play a key role in treating type 2 diabetes and helping with weight loss. GLP-1 weight loss drugs are a class of medications that mimic a naturally occurring hormone in your body called glucagon-like peptide-1 (GLP-1). These medications are part of a medical weight loss strategy tailored to your body and health profile. They all belong to a class of drugs known as glucagon-like peptide-1 receptor agonists (GLP-1RAs), which mimic a hormone (GLP-1) in the body that helps control insulin and blood glucose levels and promotes feelings of satiety. But even medications within the same category as dosed differently. “If a patient experiences side effects, their doctor may suggest they stay on the same dose for longer to give their body more time to adjust,” Dr. Wyllie says. That way, Dr. Wyllie says, the body can adjust to either the semaglutide or tirzepatide injection. In the nonalcoholic steatohepatitis (NASH) model, BN can reduce liver weight and steatosis and improve insulin sensitivity. Results showed that BN could reduce glucose levels, improve insulin secretion in glucose tolerance tests in a dose-dependent manner, and inhibit food intake and gastric emptying. The study found that the average weight decreased by 10.05 kg after 3 months of treatment (40). In clinical studies, Wang (41) et al. included 36 patients (T2DM) with BMI ≥ 24 kg/m2. However, the mechanism of GLP-1R in treating obesity is still uncertain, and more clinical evidence is needed for its long-term safety and efficacy. We understand that choosing the right medication can be overwhelming, especially with so many options available. Throughout this article, we will break down the science behind GLP-1 agonists in simple terms. The purpose of this article is to provide a comprehensive guide to GLP-1 agonists. Those with a history of weight cycling, losing and regaining significant amounts repeatedly, often benefit from continued medication support. While GLP-1s have side effects worth monitoring, many patients find the benefits outweigh the risks. For example, studies suggest that GLP-1 medications might slightly elevate the risk of gallbladder issues, including inflammation or gallstone attacks. "The companies and the FDA, no one's identified an endgame with these drugs," Kessler says. Once he went off the drug though, Kessler says he was flying blind when it came to maintaining his weight. When Kessler reached his personal weight-loss target, he was developing some slight abdominal pains, so he decided to stop. In summary, the recommended clinical treatment for diabetes is 0.75 mg or 1.5 mg.As the first original research drug in the field of diabetes in China, it has been recommended for meal injection and approved for the hypoglycemic intervention of T2DM (40), especially for patients with poor blood glucose control by metformin alone.Although Tanzeum is effective, it is less commonly prescribed compared to other GLP-1 agonists.GLP-1 receptor agonists work by imitating the body’s natural GLP-1 hormone, which is involved in several key functions related to blood sugar control and appetite regulation.GLP-1 receptor agonists (GLP-1s) are a class of medications originally developed for type 2 diabetes but have gained widespread use for weight loss due to their effects on appetite and metabolism.This is where specialized telehealth services can make all the difference.These side effects are often mild and tend to improve over time.72,73,74 Rare but serious side effects may include pancreatitis and allergic reactions.75Achieve your weight-loss goals with GLP-1 treatments like Wegovy® and Zepbound®, guided by licensed providers every step of the way.Researchers have discovered that semaglutide has the ability to reduce both recurrent alcohol consumption and overall alcohol intake in rats by more than 50%.433 Specifically, alcohol-dependent rats were administered semaglutide, which resulted in a significant reduction in their alcohol consumption.433 Further investigation into the mechanism underlying the alcohol-reducing effects of semaglutide suggested that this effect may involve the modulation of alcohol-induced rewards and punishments within the brain. Long-term weight loss effects of semaglutide in obesity without diabetes in the SELECT trial. Here, 10 real people share their GLP-1 weight loss experiences, including the medications’ benefits and drawbacks, and what it’s like adjusting to a new body. Still, GLP-1 medications may have benefits far beyond weight loss – for heart and liver health, for example – which may extend even to people who don’t lose as many pounds as they might have expected, experts say. An analysis of health insurance claims released Tuesday found that most people using GLP-1 medications – about 58% – were on their treatment plan for less than 12 weeks, falling short of a key benchmark in the weight-loss treatment timeline. For most individuals, GLP-1 treatments are recommended after other weight loss methods have failed. Conditions such as type 2 diabetes, hypertension, sleep apnea, and cardiovascular disease can make someone a better candidate for these medications. Individuals with weight-related health conditions are prime candidates for GLP-1 treatments. GLP-1 treatments are generally prescribed to individuals in the obese category or those in the overweight category with additional health risks. People who met with their providers less frequently – and those living in underserved regions with broader health inequities – were more likely to discontinue GLP-1 treatment sooner. Findings from the Blue Cross Blue Shield data emphasize the important role that providers can play in helping patients stick with their treatment with GLP-1s. Physicians and patients have to just look at all the data and make a decision about treatment together,” she said. Side effects – such as nausea, diarrhea, vomiting and constipation that are common early on – may also drive people away. We also consider side effects, body composition including lean body mass, adequacy of nutritional intake, and lab results,” says Davisson. The study notes that all participants made healthy lifestyle changes in addition to taking the semaglutide. That said, the pace of weight loss varies quite a bit from one person to the next. The second place where the medications work is in the gastrointestinal (GI) tract — also known as the gut. While a faster route to weight loss may be welcome news, that effect could come with a key disadvantage. That being said, we do not have many years of using these medications for obesity treatment. Troutman suggests thinking of weight loss treatment similarly to other chronic issues, such as high blood pressure. Beyond understanding what healthy weight loss on a GLP-1 looks like, here’s what else you should know as you dive into your treatment regimen. If you’re on a GLP-1 weight-loss program, it’s important to formulate a weekly exercise routine that includes strength training to protect your health and your physical independence. More than 15 million Americans are now losing weight with GLP-1 drugs. With your support, the American Diabetes Association® can continue our lifesaving work to make breakthroughs in research and provide people with the resources they need to fight diabetes. Using a DNA-based bioreceptor (called an aptamer), the sensor was designed to detect phenylalanine, and a key biomarker released during muscle breakdown or after eating protein. A new study, presented as a late-breaking poster, demonstrates proof of concept for a continuous protein sensor as a tool to prevent muscle loss during GLP-1 therapy. That transition from active weight loss to maintenance can feel overwhelming. Remember, the improvements from continued treatment often outweigh potential side effects. People managing obesity-related conditions can see profound benefits beyond weight. Your body fights to return to its highest weight, and GLP-1s help counter this biological resistance. Currently, except for LIR and SMG, the numbers of related clinical studies of other GLP-1R agonists are few, especially in obese or overweight people without diabetes.Myths about drugs like Mounjaro and Ozempic abound — some outlandish, but some quite believable.In the last couple of years, a new class of weight-loss injection drugs called GLP-1 agonists like semaglutide, tirzepatide, liraglutide and dulaglutide has made headlines for their promise to help people lose weight.When dietary nutrients are ingested, endogenous incretins (GIP and GLP-1) activate K and L cells in the gut, which then secrete GIP and GLP-1.488,489,490 In the pancreas, this stimulates the secretion of insulin and inhibits the secretion of glucagon.491 In the brain, it reduces appetite and improves satiety.130,133 In the gastrointestinal tract, it lowers the synthesis and secretion of triglycerides.491 By regulating appetite, insulin secretion, and lipid metabolism, GLP-1RAs have potential benefits in the treatment of NAFLD, NASH, and T2DM.130,492,493It is important to talk with your doctor about these potential side effects and what to do if they arise during the treatment.Our NAD+ pairs well with GLP-1s for cellular health.“We want patients to eat as much fiber as possible, as many whole foods as possible, while minimizing highly processed food,” he says. Therefore, during DUL treatment, we should pay close attention to the related signs of pancreatitis, and if pancreatitis occurs, we need to stop the drug immediately (113). AWARD-6 is a randomized, open, parallel-grouped, multicenter, phase 3, non-inferiority study comparing the safety and efficacy of weekly DUL and daily LIR in patients with uncontrolled T2DM treated with metformin. It is approved for treating hyperglycemia in patients with T2DM in many countries (105, 106). DUL is a long-acting GLP-1R agonist which can promote insulin secretion, inhibit gastric emptying, and reduce appetite. In addition to protein, she says it’s important to consume key nutrients like dietary fat, fiber, micronutrients, and carbohydrates for performance. Then, multiply your goal weight by 1 to determine the upper end of your target range. To determine the optimal amount of protein for a GLP-1 nutrition plan, Masi recommends calculating a daily range to aim for. When you may be less in tune with your body’s hunger and fullness cues, remembering to eat throughout the day and meeting your body’s macronutrient and micronutrient needs can be challenging. But they have struggled with weight regain and feel like they need something that helps them more efficiently and effectively sustain weight loss long term.” “Often, they’re patients who have been struggling with obesity for many years,” says Suzannah Luft, MD, a gastroenterologist at Cheshire Medical Center in Keene, New Hampshire. In the past few years, thousands of people have turned to GLP-1s to shed pounds and improve their health. At 5'1" with a 34-inch waist circumference, she discovered her measurements indicated insulin resistance and potential pre-diabetes. At 53, she's not only lost over 50 pounds but has successfully maintained her weight loss for over a year. Two studies report changes in body composition with dapagliflozin therapy using DXA, providing similar findings to those for canagliflozin. A single study of dulaglutide reported data from a case series of five individuals assessed before and after 12 weeks of treatment, using BIA . One further study reported a small increase (0.3 kg) in LBM after 52 weeks of treatment in individuals with T2DM . As the first original research drug in the field of diabetes in China, it has been recommended for meal injection and approved for the hypoglycemic intervention of T2DM (40), especially for patients with poor blood glucose control by metformin alone. The possible mechanisms of weight loss caused by GLP-1R agonists is shown in Figure 1. D’Alessio et al. (18) demonstrated that circulating peptides mediate insulinotropic activity with either bariatric surgery or treatment with long-acting GLP-1R agonists. Many clinical trials have proven GLP-1R agonists’ effectiveness and safety in treating or preventing obesity (14). As for clinical outcomes, in the T2DM group, there was a significant reduction in HbA1c (decreased by 1.01% to 1.02%, placebo-adjusted) and a clinically meaningful decrease in body weight of 3.26% to 3.51% after 12 weeks of treatment. The results showed that during the 16-week treatment period, patients who received the highest dosage (120 mg twice daily) of danuglipron experienced an average reduction in HbA1c of 1.16 percentage points and a weight loss of 4.17 kilograms. Beinaglutide was the first original drug approved for the treatment of obesity in China and the third GLP-1 class reduction drug approved worldwide, and it represents a new treatment option for overweight and obese patients.67,118,119 Beinaglutide, a recombinant human GLP-1 (rhGLP-1) polypeptide, exhibits a remarkable resemblance to human GLP-1(7-36), with nearly 100% homology.120 This innovative compound demonstrates dose-dependent efficacy in regulating glycemic control, suppressing appetite, delaying gastric emptying, and facilitating weight reduction.121 Consequently, beinaglutide holds significant promise for advancing research in the areas of overweight/obesity and nonalcoholic steatohepatitis (NASH).67,122 Beinaglutide is a natural human GLP-1(7-36)-NH2 expressed in Escherichia coli. GLP-1RAs are being developed to be more similar to the natural GLP-1 hormone found in the human body. This hormone is not readily degraded by DPP-4 to GLP-1 in the human body and can act for 12 h or longer.25 It predominantly localizes to the cellular membrane of diverse cell types throughout the human body.37 Indeed, GLP-1R is present beyond the confines of the pancreas and extends to a multitude of organs and tissues throughout the body. This figure illustrates the number of published articles over time, from 1978 to 2022, related to GLP-1 and GLP-1RAs, along with significant milestones in clinical trials. This sparked further advancements, including Novo Nordisk’s development of more potent analogs like liraglutide and semaglutide, with the latter achieving over $12 billion in sales by 2022. Myths about drugs like Mounjaro and Ozempic abound — some outlandish, but some quite believable. Meet Kate, a journalist who takes a holistic approach to health. If you’re considering a GLP-1 agonist, talk to your doctor to learn more about the potential benefits, side effects, and risks. GLP-1 agonists are a class of medications that play an important role in helping people lose weight. By addressing both blood sugar levels and weight, GLP-1 agonists offer a more comprehensive approach to managing type 2 diabetes. GLP-1 agonists are a type of medication that has become very important for people with diabetes and those who are trying to lose weight. These effects are greater than those seen with older weight loss medications (typically ~5% total weight loss) and close to typical weight loss seen with bariatric surgery. GLP-1 medications are not meant to replace healthy lifestyle changes, but they are often prescribed when lifestyle modifications alone haven’t led to meaningful weight loss. This pathway also supports β cell survival and proliferation, ensuring an adequate β cell mass to maintain normal insulin secretion. The PI3K/Akt pathway enhances glucose sensitivity in β cells, promoting insulin secretion. However, this effect is significantly diminished or absent in diabetes.241 As a degradation product of GLP-1(7-36), GLP-1(9–36) has a notable inhibitory effect on glucagon secretion, demonstrated in both in vitro and in vivo studies. By comparing the efficacy and safety profiles of low-dose versus full-dose GLP-1 treatments, researchers can better tailor therapies to the needs of individual patients and improve treatment outcomes. These studies could provide valuable insights into the optimal dosing strategies, helping to determine whether lower doses could offer effective treatment options with fewer side effects. On Instagram, athlete and weight loss influencer Sarah Bäckman is one of many vocal proponents of GLP-1 microdosing. GLP-1 medications are usually injected, but some oral formulations exist.