Noom's microdosing program also offers liraglutide, Egler says, an older generation GLP-1 drug that’s now available in generic form and comes in a pen. Noom uses compounded semaglutide injected using a vial and syringe, not the injector pen that typically comes with Ozempic and similar medications. Doctors then gradually increase it so a patient’s body can get used to the drug, working up to a maximum dose of 2.4 milligrams a week, according to Novo Nordisk, the pharmaceutical company that makes it. Since structured weight loss programs are not typically covered by commercial or government health plans, findings that combine pharmacologic treatments with structured weight loss interventions may not reflect real world weight loss. Prior studies have examined real-world weight change among patients with type 2 diabetes initiating a GLP-1 agonist in other settings. In addition, our results are also in line with the mean 1.6% to 4.6% differential weight loss demonstrated in placebo-controlled cardiovascular outcome trials for liraglutide 1.8mg (LEADER),17 semaglutide 1.0mg (SUSTAIN-6)18 and dulaglutide 1.5mg (REWIND).19 One-third of patients achieved clinically significant weight loss, defined as ≥5% change from baseline. Intermountain Health offers access to weight loss medications through Weight Loss Treatment on Demand for patients 18 and older in Utah, Idaho, Wyoming, Montana and Nevada. "There is no evidence that these drugs are effective at that small amount," said Apovian, who has received grants from Novo Nordisk. It’s possible microdosing could lead to weight loss or help maintain previous weight loss, but that’s never been studied, she adds. Weight loss seems to be dose dependent, so people with obesity won’t see the same results as they would with regular doses, Levy says. FAQs on GLP-1 Weight Loss Drugs for women All these markers returned to the baseline level after around months of patients stopping these medications, the study shows.Tsoukas, Yu, and Peters provided clinical expertise and critically revised the manuscript for important intellectual content.However, even surgical weight loss reaches a peak weight nadir 1 to 2 years after surgery and weight regain tends to occur after.From week 20 to week 68, participants who discontinued the drug regained an average of 6.9% of their baseline body weight, while those who continued treatment lost an additional 7.9%.6 These findings suggest ongoing treatment with GLP-1 RAs is required to maintain improvements in weight and health, highlighting the chronicity of obesity.When heterogeneity was obvious (I2 ≥ 50 %), a random-effects model was used to summarize the RRs; otherwise, a fixed-effect model was applied.The effects of these drugs on fetal development are not well understood, and their use during pregnancy is contraindicated based on expert recommendations.GLP-1 medications have revolutionized weight loss and can reduce body weight in obese patients by between 15% and 25% on average after about 1 year.“If you have access, it’s still a good thing to take the medications to lose the weight. GLP-1 receptor agonists are not recommended during pregnancy. Women relying solely on oral contraception may face unintended pregnancies due to reduced pill absorption caused by GLP-1 medications. Additionally, GLP-1 agonists inhibit gastric emptying, which can affect the absorption of oral contraceptive pills. It is important to note that GLP-1 medications are not fertility aids; rather, they remove obstacles to conception. Improvements in metabolic health can often lead to a return to normal reproductive health sooner than expected. However, patients with type 2 diabetes were included in these trials 52, 53, which could have contributed to the observed differences. In the authors’ anecdotal experience, when further uptitration is not tolerated, but treatment effects are noted, maintaining the patient at the lower tolerated dose may be preferable to discontinuation. Indeed, GLP-1RA therapy appears to be well tolerated overall, and proportions of clinical trial participants discontinuing treatment because of adverse events tend to be low (5.4–9.9%) 10, 37, 39, 43, 46, 47. In individuals without diabetes, the potential for hypoglycemia with GLP-1RA treatment would therefore also be expected to be low. GLP‑1 Drugs for the Brain: Dementia and Alzheimer’s Disease These findings provide a reference for developing inclusion and exclusion criteria for future clinical trials on GLP-1RA drugs. Previous studies have shown that the efficacy of weight reduction medications is influenced by baseline weight, with individuals having higher baseline BMI experiencing larger reductions in weight . Additionally, age should be considered as a crucial factor for randomization and balance in the design of clinical trials for weight reduction medications. In current clinical trials, the maximum administered doses of these drugs are 0.6 mg, 200 mg, 10 mg, 12 mg, 45 mg, and 2.4 mg, corresponding to 70.8 %, 66.4 %, 65.8 %, 60.7 %, 75.2 %, and 77.3 % of their respective Emax values. Woman Loses 130 Pounds and Finally Buys 1 Item of Clothing for the First Time All studies are in agreement that the greatest risk if any does occur in the initial months or year of therapy 200,201,202,203,204. All GLP-1 agents have carried an FDA black-boxed warning of increased risk of C cell thyroid carcinoma and recommended agents used in patients with a personal or family history of multiple endocrine neoplasia type 2A or 2B. Parks and Rosebrough first expressed concerns regarding human safety with liraglutide as early rodent trials demonstrated an increased risk of medullary thyroid carcinoma . Although both the association of retinopathy and NAION can be seen with GLP-1 use, it is worth noting that a majority of cases occurred in patients with type 2 diabetes. The long-term effect of GLP-1 on retinopathy in patients with type 2 diabetes may in fact be beneficial. GLP‑1 receptor agonists reduce liver disease by helping lower triglycerides and reducing fat buildup in the liver. In animal models of Alzheimer’s disease, as well as in small human trials, GLP‑1 agonists lower amyloid plaque buildup and protect nerve cell function while also improving memory and cognitive performance in tests. Doctors are just starting to realize that GLP‑1 drugs may help protect the brain from the cumulative inflammatory and oxidative stress that ultimately leads to dementia. The metabolic and cardiovascular risks of being overweight come from this persistent inflammatory state. This drug from Novo Nordisk also mimics both GLP-1 and amylin, and is being tested as a daily pill and a weekly injection. The once-weekly injection from Novo Nordisk combines cagrilintide, an amylin analog, with semaglutide — the active ingredient in Ozempic and Wegovy. Both of them work at the level of the pancreas and at the level of the brain and other organs in the body,” adds Jay, who has also done consulting work for Novo Nordisk. It’s important not to adjust your dose without consulting a doctor, as this can lead to unnecessary side effects or reduced effectiveness. It’s essential to work with your healthcare provider to find the most effective dose for you. This low dose helps your body become accustomed to GLP-1 without overwhelming it. For most patients, the starting dose is 0.25 mg once a week. A significant disadvantage of using these medications is the high rate of weight regain when they are discontinued. Treating obesity is challenging and calorie restriction often leads to rebound weight gain. 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. In the STEP-9 trial, use of semaglutide led to greater weight loss and improvements in knee pain and physical function compared to placebo in patients with obesity and moderate-to-severe osteoarthritis-related symptoms.45 However, the extent to which these benefits reflect weight loss vs. direct anti-inflammatory or structural effects remains unclear, as the trial did not assess imaging or biochemical markers of joint degeneration.45 Preclinical studies suggest that GLP-1 RAs may exert anti-inflammatory and cartilage-protective effects within the joint,46 but further research is needed to determine whether these translate into structural improvements beyond symptomatic relief. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), originally developed for the management of type 2 diabetes, have gained prominence in managing obesity, offering clinically meaningful weight loss of 15–20% in many clinical trials.1 The approval of liraglutide, semaglutide, and tirzepatide for chronic weight management has significantly expanded their use. Using data from a large integrated healthcare system, we sought to describe the percent change in body weight from baseline among patients with overweight or obesity and type 2 diabetes 72 weeks after starting a GLP-1 agonist. In a cardiovascular outcomes trial of liraglutide 1.8 mg, weight loss was sustained over a median trial period of 3.5 years in patients with type 2 diabetes who had either cardiovascular disease or risk factors for cardiovascular disease . In fact, many subjects experienced this benefit within the first month of starting semaglutide, even at low doses, proving that the weight loss itself was not the cause of this improvement. Weight loss and lowering of blood sugar are well-documented effects of these drugs. It turns out that GLP‑1 medications impact many of the body’s major systems, and they may protect against chronic inflammation, heart and liver disease, addiction, and even mental decline. GLP-1 drugs are not recommended during pregnancy due to unknown effects on fetal development. This summary of current treatments for obesity highlights both its difficulty and importance, as well as obesity’s role in exacerbating other disease processes.Wegovy and Saxenda are also approved for the treatment of children aged 12 and older; the precise BMI cutoffs for children differ by age.GLP-1 agonists demonstrate efficacy for weight loss maintenance, but only while the patient is continuing to use the medication.Many doctors endorse and prescribe compounded GLP-1 weight loss drugs, but others warn explicitly against their use.Many people struggle with weight loss, even when they eat healthily and stay active.Since gastrointestinal adverse effects are rarely severe and tend to diminish over time, they would therefore not be expected to cause a barrier to initiating and continuing treatment for most patients.The Pioneer Woman star shared on her blog in March 2024 that her 50-pound weight loss in 2022 was not due to taking Ozempic or similar medications. The FDA has approved the first generic GLP-1 specifically indicated for weight loss, according to a press release from Teva Pharmaceuticals. Celebrities like Oprah Winfrey and Serena Williams have also spoken about their use of GLP-1 drugs, which scammers have capitalized on by creating fake endorsements. The exploding popularity of GLP-1 drugs like Ozempic and Mounjaro, plus their high cost, can often make the knockoff versions more enticing to those on a tight budget. Social media has been flooded with fake ads and phony websites concerning weight loss methods, which is particularly timely as millions pursue New Year's resolutions to get fit. Finally, as the study included only English-language publications, there may have been a publication bias. Therefore, the final approved dosages or titration schedules for these medications may be subject to changes, which requires a cautious interpretation of the current findings. Second, the data used in this study were derived from literature summaries rather than individual patient data, limiting our ability to access complete patient information and thus affecting the accuracy of our analysis of the factors influencing efficacy. Thus, dropout rates can reflect the safety and efficacy of medications to some extent. For instance, Orforglipron demonstrated the fastest onset (6.4 weeks); conversely, Tirzepatide had the slowest onset (19.5 weeks), taking 46 weeks to reach its efficacy plateau. It helped one-third of the non-diabetic study patients achieve a loss of 10% of their body weight and also helped them sustain their weight loss for upwards of 1 year . However, GLP-1 drugs carry known risks and, since their use for weight loss is recent, may carry unforeseen risks as well. GLP-1 medications have revolutionized weight loss and can reduce body weight in obese patients by between 15% and 25% on average after about 1 year. Some GLP-1 drugs lower the risk of heart attack, stroke, and heart failure, and reduce the incidence of type 2 diabetes, kidney and liver disease among other outcomes. GLP-1 drugs can improve ovulation and menstrual cycles in women with hormonal imbalances caused by obesity and insulin resistance.Liraglutide has a black box warning for thyroid C cell tumors , therefore this therapy is contraindicated for patients with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.In the ACTION study, 3008 individuals with obesity and 606 healthcare providers were questioned on their obesity-related perceptions, attitudes, and behaviors.Values exceeding 80 % suggest that the treatment duration has approached or reached its efficacy plateau.Ultimately, understanding the existing forces that occur in a weight-reduced state may help to understand what may drive weight regain 224,225.Eli Lilly says it doesn’t have any data on the benefits or risks of microdosing tirzepatide, the active ingredient in Zepbound and Mounjaro.Nausea and vomiting were the main side effects that Pickford and Lynn-Pullman experienced in the early days of treatment.The results that led to Zepbound’s approval for sleep apnea came from 2 double-blind, placebo-controlled studies involving 469 adults without type 2 diabetes. 4. Typical efficacy comparison As expected, there was weight regain, but there still was an overall 5.6% net loss of weight by the end of 120 weeks . Therefore, treating hyperphagia is the strategy for both weight loss and weight loss maintenance. In this setting, prevention of weight regain may be better-termed weight loss maintenance. And until we change the food environment, we can’t expect that we’re going to reverse the obesity epidemic,” she said.These findings suggest that within the above ranges, the weight reduction effects of GLP-1RA drugs are independent of baseline weight, BMI, and gender ratio.Patients who stopped taking some of the newer drugs included in the research — semaglutide or tirzepatide — saw their weight return at a much faster rate (0.8 kg/month) and regained their baseline weight much faster, in around 18 months on average.She added, “I want people to feel more comfortable talking about doing it, because I feel like there's this shame,” she continued.They have a drug effect, and the drug effect does many things to the body — many good things.“We have to figure out how to treat that metabolic adaptation,” Wolver added, “and then it won’t be so hard and maybe we won’t have to stay on these medications for life.”"There are a million ways to lose weight, why not do it through something that isn't as boring as working out?" The purpose of this review is to further elucidate the mechanism of action of GLP-1RAs in helping individuals with overweight or obesity to achieve and maintain weight loss. ABased on patients achieving ≥ 5% weight loss during the run-in period Only 27% of patients and 30% of healthcare providers believed prescription AOMs to be completely effective for weight management, and most survey respondents found other interventions to be more effective than AOMs . In the ACTION study, 3008 individuals with obesity and 606 healthcare providers were questioned on their obesity-related perceptions, attitudes, and behaviors. In an extension of the STEP-1 trial, participants originally randomized to semaglutide regained 68% of their lost weight after one year of discontinuing treatment.7 Cardiometabolic improvements achieved with semaglutide also reverted towards baseline for most risk factors after one year. Preclinical studies have shown that GLP-1 RAs reduce oxidative stress, enhance neuronal survival, and improve synaptic plasticity in animal models of diabetes.51,52 Clinical trials have begun to explore these effects with promising results. While weight loss likely contributes to improvements in some of these conditions, such as liver disease or sleep apnea, GLP-1 RAs may also exert direct disease-specific effects, particularly in neurodegenerative and substance use disorders, where central mechanisms appear to play a primary role. This figure summarize evidence from randomized controlled trials and observational studies conducted in individuals with overweight or obesity, with and without diabetes. Lifestyle interventions, alternative anti-obesity medications, and bariatric surgery offer different approaches for weight loss and may provide useful context for evaluating the overall impact of GLP-1 RAs. Most people taking them lose at least 5% of their body weight. Based on current WHO recommendations, GLP-1 medicines may be used as a long-term treatment option for adults with obesity (body mass index ≥30). This study developed pharmacodynamic models for 12 GLP-1RA drugs and conducted quantitative analyses of their time-course relationships, dose-response relationships, factors influencing efficacy, dropout rates, and adverse events. From week 20 to week 68, participants who discontinued the drug regained an average of 6.9% of their baseline body weight, while those who continued treatment lost an additional 7.9%.6 These findings suggest ongoing treatment with GLP-1 RAs is required to maintain improvements in weight and health, highlighting the chronicity of obesity. Evidence from dual-energy X-ray absorptiometry and MRI sub-studies suggests that 25–45% of total weight loss with semaglutide and tirzepatide may come from reductions in lean body mass.90 Although this proportion is similar to that seen with lifestyle interventions,91 the decline in lean mass may have implications for mobility, metabolic rate, and physical function, particularly in older adults or those with sarcopenic obesity. However, these strategies are often insufficient to achieve and sustain weight loss.9,10 Many patients struggle to maintain the necessary behavioral changes long term, leading to modest results which are often inadequate in addressing the complex physiological, genetic, and environmental factors underlying obesity.11 On average, patients regain one-third of the weight lost (5–10% of baseline bodyweight) within the first year of treatment discontinuation, and nearly half of patients return to their initial weight within five years.9 Consequently, lifestyle interventions frequently require supplementation with pharmacological treatments to achieve more substantial weight loss outcomes. Glucagon-like peptide-1 (GLP-1) agonists are injectable weight loss drugs that help people feel fuller and eat less food, leading to weight loss. She admitted to becoming "immediately invested" in Ozempic in 2022, but explained that it was not "livable" for her to take the Type 2 diabetes drug as it hindered her ability to spend time with her son Gene. The Trainwreck star did not hold back when she called out celebrities for not being honest about using Ozempic as a weight loss tool during her June 8, 2023 appearance on Watch What Happens Live. The Titanic star, who was once a target for tabloids when it came to her weight, shared what she thought about the weight loss trend. Much of the recommended annual weight loss diets often seen in US News and World Report reflect a variety of these dietary patterns, highlighting that diets are more than their nutrient content . The low-or very-low fat intake approach is recommended for inducing significant short-term weight loss, but its long-term efficacy is not superior to dietary interventions with higher fat content . Dietary advice historically has seen energy restriction as the foundation for weight loss. The cardiometabolic consequences of obesity such as insulin resistance, glucose intolerance, type 2 diabetes, arterial hypertension, atherosclerosis, and dyslipidemia are all stressors on the heart and vascular system 18,19. Obesity has harmful effects on various body systems, most notably on the cardiovascular and endocrine systems, but also on the kidneys, liver, lungs, joints, and immune system . In addition, phentermine-topiramate is contraindicated in those taking certain antidepressant drugs . Patients with cardiovascular risk factors may therefore find a GLP-1RA more appropriate owing to the improvements in cardiometabolic parameters that have been observed with this drug class 10, 37, 46, 47. For example, naltrexone-bupropion is not suitable for patients with uncontrolled hypertension and phentermine is contraindicated in patients with a history of cardiovascular disease . While gastrointestinal adverse events that occur with GLP-1RAs are mainly mild-to-moderate and transient, occurring particularly during dose escalation, there may be concerns that GLP-1RA-mediated weight loss could be due to these effects. There are various strategies that can be employed to help manage or mitigate potential gastrointestinal adverse events when initiating a GLP-1RA for the treatment of overweight or obesity. Since gastrointestinal adverse effects are rarely severe and tend to diminish over time, they would therefore not be expected to cause a barrier to initiating and continuing treatment for most patients. "A lot of people are going to like that," Levy says. People trying to lose weight may opt for long-acting monthly shots instead of weekly injections in the future. “At least 25% of the patients I see don't want anything to do with needles,” she notes. The pill versions are especially good for “needle phobic” people, Levy says. Key strategies for managing obesity include improving diet and increasing physical activity . There was a significant negative correlation in the exponential pattern between age and weight reduction effect, whereas baseline weight and BMI had no significant impact. Reported onset times ranged from 6.4 weeks (Orforglipron) to 19.5 weeks (Tirzepatide). While it’s not a perfect measure, it gives us a general idea of your health risk. Well-known GLP-1 medications include semaglutide (Wegovy® and Ozempic®) and tirzepatide (Zepbound® and Mounjaro®). Maintaining a healthy diet and regular physical activity are important components of any obesity chronic care programme. They should only be prescribed by a medical practitioner, after taking into account individual health history and clinical indications. GLP-1 therapies (glucagon-like peptide-1 receptor agonists) are a class of medications that mimic the natural GLP-1 hormone, which helps regulate blood sugar and appetite. Packaging that looks tampered with or unfamiliarAuthentic GLP-1 medications come in sealed, tamper-resistant packaging. If you use telehealth or online pharmacies, confirm they are properly licensed and require a prescription. Only a doctor or licensed medical professional can determine if GLP-1 treatment is appropriate for you. In addition to the medical risks, illegitimate storefronts pose a real threat to your private information. While there is optimism that continuing use of GLP-1 treatments will preserve weight loss, most other anti-obesity strategies, including surgical interventions, generally have weight recidivism . Despite the overall efficacy of the incretin-based treatments for weight loss, there is a lack of long-term controlled studies beyond about 4 years available 221,222. It is unclear whether those without type 2 diabetes using GLP-1 for weight loss are at the same risk 197,198. Obesity: GLP-1 therapies She added, “I want people to feel more comfortable talking about doing it, because I feel like there's this shame,” she continued. The Golden Globes host fiercly defended the use of Ozempic in March 2025, calling for people to be more open about using the medication. The comedian has been on the anti-Type 2 diabetes medication Mounjaro since late 2022. “My body's never in my whole life—I've always wanted to have an ab. The Queer Eye star explained in October 2025 that they started using a GLP-1 after a health scare in 2023. They carry a boxed warning for people with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.Wegovy mimics one gut hormone the body produces after eating, GLP-1; and Zepbound mimics two, GLP-1 and GIP.Tirzepatide has demonstrated total lean mass loss as well, although additional studies are needed to determine the impact of this 134,182.The candidates being investigated include MariTide, a drug from Amgen that targets GLP-1 and GIP hormones and is “administered monthly or less frequently,” the company says.GLP-1 therapies (glucagon-like peptide-1 receptor agonists) are a class of medications that mimic the natural GLP-1 hormone, which helps regulate blood sugar and appetite.Eating less is helpful for weight loss, but after about two months on the drug, Lynn-Pullman realized that she wasn't eating enough to meet her body's needs.Early case reports called into question appropriate fasting times for pre-procedural and operative fasting due to retained gastric contents and risk of aspiration in patients taking GLP-1 medications and compounds 213,214.The overall mechanisms of GLP-1 agonists on weight loss are predominantly through the reduction in energy intake and not on energy expenditure.A supportive weight management team approach considers mood changes and how they can affect quality of life 269,270. A small number of users may experience gastrointestinal effects so severe that they need to stop taking the medication. Gastrointestinal issues are usually strongest in first-time users, or when people step up to a larger dosage, but they usually dissipate over time. Wegovy and Saxenda are also approved for the treatment of children aged 12 and older; the precise BMI cutoffs for children differ by age. When there was more than one weight measurement in a given 8-week interval, we randomly selected a weight measurement for that window. GLP-1s can interact with other medications and underlying medical conditions, making a medical evaluation essential. Providers review a patient's BMI, medical history, weight-related conditions, and previous lifestyle attempts to determine if medication is appropriate. Accessing GLP-1 medications usually begins with a visit to a primary care provider or endocrinologist. Both Chen and Batcher stressed that GLP-1s are not a replacement for regular exercise or healthy eating. Both are once-weekly subcutaneous medications and are sold directly for $499 per month.Beyond GLP-1 RAs, current FDA-approved pharmacotherapies for chronic weight management include orlistat (a lipase inhibitor that reduces fat absorption), phentermine-topiramate (a sympathomimetic appetite suppressant combined with a gamma-aminobutyric acid receptor modulator), naltrexone-bupropion (an opioid antagonist combined with a dopamine/norepinephrine reuptake inhibitor), and setmelanotide (a melanocortin-4 receptor agonist).12 Besides setmelanotide, which is indicated for patients with rare genetic forms of obesity, these alternative anti-obesity medications result in modest weight loss, typically ranging from 3 to 9% of baseline body weight.12 These benefits are smaller than the 15–20% weight loss observed with GLP-1 RAs or co-agonists.1The Pennington symposium highlighted potential alternative approaches for nutrition management that may be beneficial for weight loss maintenance.Other studies have found little to no impact of physical activity on maintaining weight loss .An even greater weight loss is seen with this novel dual agonist, achieving upwards of a 22.5% weight loss at 72 weeks 134,135,136.The funding sources had no involvement in the conduct of this study, interpretation of results, or the preparation of this manuscript for publication.Ultimately, Handler stopped using the drug because it wasn't medically necessary for her, adding that she gave away the remaining doses to friends.“The dietary supplement industry is the Wild West, but people have kicked it up another notch by borrowing the name GLP-1,” White tells TODAY.com. Additionally, orforglipron (Eli Lilly) is a soon to be FDA-approved oral non-peptide GLP-1 with efficacy and tolerability profile similar to Wegovy, but easier to dose than oral semaglutide. Both are once-weekly subcutaneous medications and are sold directly for $499 per month. However, the real competition will not be from branded Saxenda, but Wegovy (semaglutide, Novo Nordisk) and Zepbound (tirzepatide, Eli Lilly). A generic Saxenda expands our treatment options. Dr. Filion was involved in the conception and design of the study, provided statistical expertise, and critically revised the manuscript for important intellectual content. Ms. Moiz contributed to the conception and design of the study, analysis and interpretation of data, and drafting of the manuscript. Can biomarkers or clinical characteristics reliably predict individual response to guide personalized therapy? Our new guidance recognizes that obesity is a chronic disease that can be treated with comprehensive and lifelong care,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Obesity is a major global health challenge that WHO is committed to addressing by supporting countries and people worldwide to control it, effectively and equitably. In September 2025, WHO added GLP-1 therapies to its Essential Medicines List for managing type 2 diabetes in high-risk groups. Without decisive action, the number of people with obesity is projected to double by 2030. The maximum weight reduction effect ranged from 4.25 kg (Liraglutide) to 22.6 kg (Retatrutide). Fifty-five studies involving 16,269 participants and 12 GLP-1RAs were included. This systematic review of public databases included placebo-controlled randomized clinical trials of GLP-1RAs. At this time, very little attention is being afforded to the discontinuation of GLP-1 drugs after weight loss has occurred, but this may change if serious consequences of prolonged exposure in young persons are documented. The effect seems principally within the CNS, but combination treatment of GLP-1 with other targets appears to further improve weight loss in early clinical trials. While the area of anti-obesity medication development is expanding, GLP-1 receptor agonists are already available and represent substantial progress in the growing armamentarium for use in weight loss. In a trial in which patients with obesity were treated with or without liraglutide 1.2 mg after diet-induced body weight loss of 12%, smaller decreases in free leptin and higher levels of PYY3-36 were observed with liraglutide vs. without liraglutide .Common side effects of GLP-1 drugs are nausea, vomiting, constipation and diarrhoea.Always consult with a healthcare professional before starting any diet, exercise, or supplementation program, before taking any medication, before starting any treatment program or if you have or suspect you have a health problem.Indeed, alterations in the levels of weight-regulating hormones along with the obesogenic environment explain why many individuals find maintaining a lower weight as challenging as the initial weight loss.They added, “As I've lost weight and I got into Pilates classes at Solidcore, my body has never looked like this,” Jonathan said.While weight loss likely contributes to improvements in some of these conditions, such as liver disease or sleep apnea, GLP-1 RAs may also exert direct disease-specific effects, particularly in neurodegenerative and substance use disorders, where central mechanisms appear to play a primary role.Thus, apart from modifying the specificity of drugs to receptors, enhancing their affinity can significantly improve the weight reduction outcomes of GLP-1RA drugs. Richard Lipman MD Miami Diet Plan 7241 SW 63rd Ave South Miami, FL 33143 +1 ( 670-3259 [email protected] Jastreboff is on the scientific advisory boards of several pharmaceutical companies that make weight-loss medications. But more options are needed, Levy notes, especially since the drugs need to be taken for the long term. Oprah Winfrey is among the high-profile GLP-1 users, and credits the medication with finally helping her find lasting weight loss. However, even surgical weight loss reaches a peak weight nadir 1 to 2 years after surgery and weight regain tends to occur after. Cessation of these drugs to see if weight maintenance could be achieved was largely unsuccessful (Table 3). Developing treatment paradigms for weight loss maintenance remain focused on decreasing hunger, despite the compensatory decrease in energy expenditure . However, even during active weight loss, metabolic adaptation seems to be set into motion, and in fact may be triggered by achieving 11% of total body weight loss 236,237. For those with untreated obesity and seeking active weight loss, decreasing hunger and achieving caloric restriction is seemingly the primary process that needs to occur. Additionally, a minority of users will find it necessary to discontinue the drug because they cannot tolerate the side effects. About 15 percent of Wegovy users and 9 percent of Zepbound users lost less than 5 percent of their body weight. The results of major clinical trials suggest how much weight the average user may expect to lose. Food and Drug Administration (FDA) and may carry greater risks than FDA-approved treatments. Metsera, a company that was recently bought by Pfizer, is also investigating monthly GLP-1 and amylin analog drugs. The known risks of pancreatitis, gastroparesis, and lean body mass loss are variables to be considered as well. These varied treatment responses likely originate from our limited understanding of the mechanisms of weight regulation. Obesity may present itself with multiple clinical phenotypes and also varied treatment responses. Achieving success with pharmacologic treatment and then weaning to avoid future negative effects would be ideal. Yes, GLP-1 drugs can inhibit gastric emptying, potentially affecting the absorption of oral contraceptive pills, leading to unplanned pregnancies. This is not because the drugs specifically promote fertility, but because women might underestimate their fertility potential, explains Dr Kumarr. Dr Kumarr notes that one indirect effect of GLP-1 treatment is the induction of ovulation in women with irregular menstrual cycles or infertility issues due to obesity or metabolic imbalance. Thus, apart from modifying the specificity of drugs to receptors, enhancing their affinity can significantly improve the weight reduction outcomes of GLP-1RA drugs. More data are required to determine whether the weight reduction effects of tri-agonists generally surpass those of dual- and mono-agonists. This study systematically quantitatively assessed the efficacy and safety characteristics of 12 marketed and experimental GLP-1RA drugs. For weight loss, GLP-1 works by slowing down stomach emptying, increasing feelings of fullness, and reducing food cravings. If you’re striving for weight loss, understanding the proper GLP-1 weight loss dosage is crucial for achieving the best results. Maintaining weight loss can be a much larger challenge. You could try and beat the odds by disembarking from the GLP-1 express weight loss train. “I get patients all the time that say, ‘I did nothing different and I’m gaining weight,’” Wolver said. Rapid weight loss can also lead to what is known as an “Ozempic face”, where the cheeks become hollowed out, and wrinkles, as well as eye bags, become more pronounced. GLP-1 medications can cause a range of side effects related to the gastrointestinal system as well as changes in muscle mass and effects on the appearance of the face and loss of hair (Figure 2). The SURMOUNT-1 trial demonstrated a 15 mg dosage of tirzepatide in non-diabetic obese subjects leads to 20.9% weight loss at week 72 with sustained weight loss during a 3-year extension period 134,137. Liraglutide was the first injectable daily GLP-1 receptor agonist that was approved by the FDA for weight loss in 2014. A number of clinical trials in persons with diabetes have been subsequently performed and frequently cited for the clinical efficacy of exendin-4 147,148. Fake GLP-1 and Weight Loss Ads Are Flooding Social Media. 4 Scams to Look Out for We conducted a retrospective cohort study of non-pregnant adults first dispensed a GLP-1a between 2011 and 2018 using electronic health record data from patients receiving care at a large health system. We sought to describe the percent change in body weight 72 weeks after starting a GLP-1a. Weight loss achieved with standard doses of GLP-1 agonists (GLP-1a) among real-world patients with type 2 diabetes has not been determined. Many insurance plans cover GLP-1s for type 2 diabetes, but far fewer cover them for obesity alone, leaving some patients paying out of pocket. These data suggest a potential for long-term benefit of liraglutide treatment in many patients, as weight loss of 5–15% has been shown to improve obesity-related complications including diabetes and cardiovascular disease risk factors 5, 9, 59. In this real-world study using data from over 2,400 patients with overweight or obesity and type 2 diabetes, most patients who started a GLP-1 agonist lost weight through 72 weeks and one third lost a clinically meaningful amount (at least 5% of body weight). Markedly elevated body weight is a well described risk factor for major adverse cardiovascular events and all-cause mortality among patients with type 2 diabetes.1–3 Achieving and maintaining weight loss in this group of patients may result in improved glycemic control and help patients reduce the dosage or number of glucose lowering medications.4,5 In some cases, more substantial weight loss (i.e. ≥10% to 15%) may result in disease remission.6,7 Previous shortages of GLP-1 RAs impacted patient care, leading to concerns that these medications should be reserved for patients with diabetes rather than weight loss in otherwise healthy individuals.94 These concerns highlight the importance of stable supply chains and strategies to mitigate shortages, including increasing production and ensuring fair distribution.95 Public awareness campaigns are also essential to educate individuals about the benefits and potential risks of GLP-1 RAs, fostering informed decision-making and broader acceptance of these treatments. The strength of the findings in this report is enhanced due to the scale and duration of the study including 21 expert authors, the 800 centers, 17,000 subjects and the duration of 2 years, However, the researchers found a link between shrinking waistlines (reduction in waist circumference) and heart benefits, accounting for a third of the drug’s protective effect on the heart after 2 years. More specifically, for every 11 lbs lost( or 2 inches of reduction in waist circumference) there was a 4% reduction in cardiovascular risk. Similarly, we could not examine effects of dulaglutide 3.0 or 4.5 mg in our sample due to the timing of FDA approval for these two dosages (September 2020). These results are nearly identical to ours despite the fact that the study took place in the United Kingdom. Participants who had weight data in the 72-week window were similar to those who did not (Table S4). Overview of emerging therapeutic roles for glucagon-like peptide-1 receptor agonists. The funding sources had no involvement in the conduct of this study, interpretation of results, or the preparation of this manuscript for publication. Future research must address these gaps, focusing on long-term safety, optimizing combination approaches, and evaluating the broader clinical and economic implications of widespread GLP-1 RA use. The results provide quantitative data for the evaluation of new drugs and, optimization of treatment strategies for people with obesity. However, quantitative comparisons of the efficacy of these GLP-1 receptor agonist drugs in obesity treatment, particularly between mono-, dual-, and triple-agonists, are still lacking. These findings suggest that GLP-1 agonists be used in patients who would benefit from weight loss in real-world settings. This suggests that GLP-1 agonists may be used in patients who would benefit from weight loss in real-world settings. Because our study did not include patients using structured weight loss interventions, our findings may better reflect the expected range of weight loss in the real world.20 Even more recently in 2022, a symposium was convened to discuss the state of the science of weight loss maintenance, known as the Pennington Biomedical Scientific Symposium . Other studies confirm the importance of dietary restraint and physical activity in preventing weight regain 247,248. These successful subjects with weight loss maintenance reported high levels of physical activity, high levels of dietary restraint, low calorie, and fat intake, and low levels of overeating (loss of control of eating or disinhibition) . Thus, dropout rates can reflect the safety and efficacy of medications to some extent."Using the medications as a tool to complement a healthy, well-balanced diet and a regular exercise program is really the best recipe for success."You could try and beat the odds by disembarking from the GLP-1 express weight loss train.Keywords were then refined based on the relevance of the results, and additional terms were searched to survey related areas including “cardiometabolic risk factors”, ‘sarcopenia”, “exercise”, “body mass index (BMI)”, and “appetite”.Not everybody responds equally well to these treatments, and it’s impossible to predict how effective any specific weight loss medication will be for you.Raven continued, "Do what you gotta do, just make sure you save the medication for the people who actually need it.""Again, we treat patients first and foremost with intensive lifestyle modifications, and where they can't reach their goals is when we start thinking about augmenting their treatment with these GLP-1s and/or surgery," Chen said.Nobody would ever put someone on blood pressure medicine and say ‘ok, your blood pressure is really well controlled now, let’s take away the medicine and see what happens.’”“But GLP-1 medications produce their best results when patients consume nutrient-dense, protein-based meals while maintaining regular hydration,” she says. Recently updated guidelines for those with diabetes and kidney disease recommend using GLP-1 receptor agonists for those who have not achieved individualized glycemic targets despite metformin and/or insulin. The benefits were also largely independent of how much weight people lost in the first four and a half months of taking the drug. In addition, semaglutide resulted in a 1% decrease in all-cause mortality, independent of the extent of the weight loss. As a nurse practitioner, she was very familiar with weight loss methods and had tried virtually all of them — including healthy eating and workout boot camps — without success. Here, three people who have been taking them talk about the pros and cons, and what to know before taking GLP-1s for weight loss. Together, we’ll create a weight loss plan that supports your long-term health. Common side effects of GLP-1 drugs are nausea, vomiting, constipation and diarrhoea.