GLP-1s: What You Need to Know About the Meds Making Headlines
If you’ve been following the health space lately, you’ve likely heard a lot about GLP-1 receptor agonists,medications like semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda, Victoza). These drugs are getting a lot of attention for their weight loss effects, but there’s far more to them than just dropping body fat.
As a coach who combines exercise science, nutrition, and lifestyle medicine, I think it’s crucial we move beyond the hype and understand what these medications actually do, who they’re for, and how to use them safely and effectively.
What Are GLP-1 Receptor Agonists?
GLP-1 stands for glucagon-like peptide-1. It’s a hormone naturally released in the gut after eating that helps regulate blood glucose by:
- Stimulating insulin release
- Suppressing glucagon (which raises blood sugar)
- Slowing down stomach emptying
- Sending satiety signals to the brain
GLP-1 receptor agonists are medications that mimic this natural hormone. They bind to GLP-1 receptors found throughout the body,in the pancreas, brain, heart, kidneys, and digestive system,resulting in wide-ranging effects.
How Do They Work?
GLP-1s support health through multiple mechanisms:
- In the pancreas, they stimulate insulin and reduce glucagon in a glucose-dependent way,meaning they act only when blood sugar is elevated.
- In the brain, they reduce appetite and food cravings by targeting satiety centres.
- In the gut, they slow gastric emptying, leading to more stable blood sugar levels after meals.
- In the cardiovascular system, they reduce blood pressure, improve blood vessel function, and reduce inflammation.
- In the kidneys, they lower albuminuria (a marker of kidney damage), improve filtration, and reduce the progression of chronic kidney disease.
Beyond Diabetes and Obesity
While GLP-1 receptor agonists are approved for type 2 diabetes and obesity, their clinical benefits extend to other areas of health:
- Heart protection: Large trials show they reduce major cardiovascular events, such as heart attacks and strokes.
- Kidney protection: They slow the progression of kidney disease, even in people without perfect blood sugar control.
- Neuroprotection: There’s growing evidence they may reduce the risk of Alzheimer’s and Parkinson’s disease by lowering brain inflammation and supporting nerve cell survival.
- Liver health: These medications reduce liver fat and improve outcomes in people with non-alcoholic fatty liver disease (NAFLD).
- Mental health: Early research suggests GLP-1s may help with depression and mood regulation, likely through effects on brain chemistry and inflammation.
How Effective Are They?
In clinical trials, GLP-1s consistently show benefits such as:
- Lower HbA1c (average reduction of 1.0–1.5%)
- Weight loss of 5 to 15% of total body weight (sometimes more with higher doses)
- Reduced blood pressure and improved cholesterol levels
- Improved liver function and reduced inflammation markers
Newer drugs like semaglutide and tirzepatide (which also targets GIP receptors) show stronger results than earlier options like liraglutide, though they may come with more pronounced side effects.
Common and Rare Side Effects
Most people experience side effects in the first few weeks of treatment, usually related to the digestive system:
- Nausea
- Vomiting
- Diarrhoea
- Constipation
- Abdominal bloating or pain
These symptoms are generally mild and improve with time and slow dose increases.
More serious but rare side effects include:
- Pancreatitis
- Thyroid tumours, particularly in those with a family history of thyroid cancer
- Sexual dysfunction, such as anorgasmia
- Tinnitus, GERD, dry mouth, taste changes, and even Eustachian tube dysfunction
When GLP-1s are taken alongside metformin, gastrointestinal symptoms may be more intense, but this can often be managed by adjusting the timing of the metformin dose.
What’s Happening at the Cellular Level?
GLP-1s act on several important cellular pathways, including:
- cAMP, which enhances insulin production
- PI3K and MAPK, which support beta-cell growth and survival
- Anti-inflammatory signalling, which improves blood vessel function and reduces oxidative stress
These effects help explain their broad range of benefits across the pancreas, heart, brain, liver, and kidneys.
Who Are They For?
GLP-1s are typically prescribed for:
- Adults with type 2 diabetes not meeting blood sugar targets
- Individuals with obesity (BMI of 30 or more), or overweight (BMI ≥27) with another health issue like hypertension or PCOS
- People at high risk of cardiovascular or kidney complications
They are not meant for cosmetic weight loss or general use in individuals without a clinical indication, although off-label demand is growing.
The Real-World Experience
Many people see meaningful improvements with GLP-1s,but not without challenges. These include:
- High cost or limited insurance coverage
- Frustration with slow or less-than-expected weight loss
- Side effects that affect quality of life
- Social stigma or misinformation
It’s important to approach these medications with realistic expectations and the support of a qualified professional.
Coaching Tip: Supporting Clients on GLP-1s
GLP-1s are not a substitute for lifestyle change,they’re a tool to support it. In my coaching practice, I help clients:
- Incorporate structured, manageable exercise and movement routines tailored to energy levels and goals
- Monitor and troubleshoot side effects during dose escalation
- Maintain healthy habits like consistent sleep, hydration, and recovery
- Work on mindset and confidence, especially around food and body image
- Build long-term plans for life after medication
Medication can make change more accessible, but sustainable habits make it stick.
Final Takeaway
GLP-1 receptor agonists are a major breakthrough in managing metabolic health. They offer benefits that extend well beyond glucose control and weight loss, including protection for the heart, brain, kidneys, and liver. But they’re not a quick fix.
Used wisely,alongside education, movement, mindset work, and practical lifestyle habits,they can be a valuable part of a comprehensive health strategy. As always, the best outcomes come when medication is combined with behaviour change, professional guidance, and patient empowerment.
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