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Opinion | GLP-1 Drugs for Weight Loss and Diabetes: Full Guide

Key Takeaways

  • GLP-1s are a class of medication for type 2 diabetes and weight loss.
  • GLP-1s include Ozempic® , Wegovy® , Saxenda® , and Zepbound® .
  • They work by lowering blood sugar, suppressing hunger, and making you feel fuller for longer.

GLP-1s (short for glucagon-like peptide-1 receptor agonists) have been in the spotlight lately as more people add them to their weight loss toolbelt — and for good reason. These drugs are very effective at treating obesity and overweight. GLP-1s actually began as a diabetes drug, though, and they’re still used to help people with type 2 diabetes manage their blood sugar. What are GLP-1 medications, how effective are they, and what are the side effects to look out for? We’ll answer all your GLP-1 questions ahead.

What Are GLP-1 Medications?

GLP-1 receptor agonists are a class of medication initially developed to help people with type 2 diabetes manage their blood sugar levels. Weight loss appeared as a surprising side effect, so the drugs are now also used to help people with excess weight or obesity lose weight. You can also stay on a GLP-1 for chronic weight management. This can help you avoid weight gain after a weight loss journey. GLP-1s are only available with a prescription. Most come as an injection you give yourself either once a week or once a day, but you can also get oral GLP-1s in tablet form. In most cases, GLP-1 drugs are prescribed alongside lifestyle changes —like a healthy diet and physical activity —to help people lose weight and manage their weight and blood sugar long-term.

How Do GLP-1 Drugs Work?

GLP-1 drugs work by mimicking the GLP-1 hormone your intestines naturally secrete when you eat. When you take GLP-1 medications, they bind to GLP-1 receptors in the pancreas, triggering the release of insulin. This is why GLP-1 drugs are also known as GLP-1 agonists — they activate these GLP-1 receptors. When you eat carbohydrates, they’re digested into blood sugar (glucose), which circulates in your bloodstream. Insulin is needed to move this blood sugar into your tissues, where it can be used for energy. GLP-1s help get this process going without you having to eat carbs. They tell the pancreas to release more insulin, so your body is using more of the glucose already in your blood. Plus, GLP-1 agonists decrease the secretion of glucagon (which tells the liver to release stored glucose), further reducing blood sugar levels. These medications also slow down how quickly your stomach empties its contents. This helps minimize spikes in blood sugar and makes you feel fuller for longer. GLP-1s also act on parts of the brain that control appetite and cravings. So, beyond all these blood sugar-reducing properties, GLP-1 agonists can:

  • Reduce hunger
  • Increase fullness (satiety)
  • Curb food cravings
  • Reduce food noise (ongoing thoughts about food)

These appetite-changing effects can help you eat more nutritious foods and avoid overeating.

Health Benefits of GLP-1s

Besides blood sugar control and reduced body weight, GLP-1s have other health benefits. Some GLP-1s can help:

  • Lower blood pressure
  • Improve blood lipid disorders (like high cholesterol)
  • Reduce fatty liver
  • Treat sleep apnea
  • Reduce cardiovascular events —like heart attack and stroke —in people with heart disease and obesity or overweight

Btw, drugs like semaglutide and liraglutide are GLP-1s. Tirzepatide is a GLP-1 and a glucose-dependent insulinotropic polypeptide (GIP). It targets two hormone receptors instead of just one.

List of Common GLP-1 Drugs

You might recognize many names of GLP-1 drugs. Some are approved by the Food and Drug Administration (FDA) for type 2 diabetes and sometimes prescribed off-label for weight loss. Others are FDA-approved for weight loss for people with obesity or overweight. Here’s a GLP-1 drug list with some of the most common medications.

Brand NameActive ingredientInjection or pillFDA-approved for
Saxenda®LiraglutideDaily injectionWeight loss
Wegovy®SemaglutideWeekly injectionWeight loss
Zepbound®TirzepatideWeekly injectionWeight loss
Victoza®LiraglutideDaily injectionType 2 diabetes
Trulicity®DulaglutideWeekly injectionType 2 diabetes
Ozempic®SemaglutideWeekly injectionType 2 diabetes
Byetta®ExenatideDaily injectionType 2 diabetes
Mounjaro®TirzepatideWeekly injectionType 2 diabetes
Rybelsus®SemaglutideDaily pillType 2 diabetes
Compounded GLP-1s

There are also compounded GLP-1s. These drugs are available for people with unique needs, like needing a very low starting dose or a personalized maintenance dose. Compounded drugs aren’t evaluated or approved by the FDA for safety, effectiveness, or quality.

Who Are GLP-1s For?

GLP-1s can help people with type 2 diabetes, obesity, and overweight.

Type 2 Diabetes

If you have a type 2 diabetes diagnosis, you may be eligible for a GLP-1 medication, such as:

  • Ozempic®
  • Victoza®
  • Rybelsus®
  • Mounjaro®
  • Trulicity®

Your healthcare provider may recommend trying other diabetes drugs first, like metformin. They can also work with you to find the best GLP-1 for your unique needs and condition.

Weight Loss

When it comes to weight loss, healthcare providers prescribe GLP-1s to people with obesity or overweight, who have a weight-related health condition like:

  • Heart disease
  • Sleep apnea
  • Type 2 diabetes
  • High cholesterol (dyslipidemia)
  • High blood pressure (hypertension)

Your provider will look at your body mass index (BMI) to determine if you have obesity or overweight. BMI is an estimate of body fat and body composition based on your height and weight. Depending on your needs, a provider may prescribe an FDA-approved weight loss medication or prescribe another medication off-label for weight loss.

Weight loss treatment that puts you first

How Effective Are GLP-1s for Weight Loss?

GLP-1s are effective for weight loss and weight management. In fact, clinical trials have shown that GLP-1 medications for weight loss are more effective than placebos or other diabetes medications used for weight loss. Weight loss results vary depending on which GLP-1 you take. But as an example, a 2021 study funded by Novo Nordisk —the manufacturer of Ozempic® and Wegovy®—found that people with excess weight or obesity lost almost 34 pounds over 68 weeks. They took 2.4-milligram (mg) weekly doses of semaglutide. A 2024 analysis — also funded by Novo Nordisk — looked at people with cardiovascular disease and overweight or obesity who took 2.4 mg of semaglutide. The results found that weight loss was sustained over four years, and there was a 20 percent reduction in cardiovascular events. Of course, not every medication works for everyone in the same way. For instance, GLP-1 agonists are consistently more effective for weight loss among people who don’t have diabetes than for people with diabetes. In a 2022 review of 14 studies, researchers found that GLP-1 agonists led to an average weight loss difference of:

  • 4 to 6.2 percent in people with diabetes
  • 6.1 to 17.4 percent in people without diabetes

Plus, some GLP-1s are more effective than others. Semaglutide may be more effective than liraglutide, for example. An Eli Lilly-sponsored study found people taking 15 mg of tirzepatide lost an average of about 21 percent of their starting body weight in 72 weeks. Since results may vary, it’s crucial to talk to your healthcare provider about the best GLP-1 for you. In any case, research shows time and time again that GLP-1 weight loss drugs can target appetite reduction, enhance fullness, and slow digestion — all of which can promote weight loss.

How Effective Are GLP-1s for Diabetes?

GLP-1s are effective at helping people with type 2 diabetes manage their blood sugar levels. One real-world study found that Ozempic® lowered HbA1c (glycated hemoglobin) —a measure of blood sugar levels — by an average of 1.4 percent over about eight months. An Eli Lilly-sponsored study found that tirzepatide (an Eli Lilly product) was more effective at reducing HbA1c than semaglutide in higher doses, and similar in lower doses.

GLP-1 Side Effects and Risks

Like any drug, GLP-1 agonists have potential side effects. The most common side effects of GLP-1s are gastrointestinal and include:

  • Nausea
  • Vomiting
  • Diarrhea
  • Indigestion
  • Abdominal pain
  • Constipation

These side effects are usually mild and go away on their own as your body gets used to the drug. They can crop back up when you move to a higher dose before subsiding again. Some people report mild symptoms like:

  • Dizziness
  • Headaches
  • Reactions at the injection site

You might have heard of “Ozempic® face.” This is when you lose fat and muscle from your face, which can happen with any type of rapid, significant weight loss, whether GLP-1s are involved or not.

Rare Risks and Boxed Warnings

There are potential long-term GLP-1 risks, like inflammation of the pancreas (pancreatitis), gallbladder problems, and kidney problems. These risks are rare, though. GLP-1 drugs also come with boxed warnings from the FDA stating that the active ingredients (semaglutide, tirzepatide, liraglutide, and dulaglutide)cause thyroid tumors in rodents. It’s not clear if this happens in humans — and there’s currently no evidence that it does. If you experience worrying GLP-1 agonist side effects, let your healthcare provider know. They can determine if you need a dose adjustment or an alternative medication.

Who Should Not Take GLP-1s?

GLP-1s are safe for most people, but you shouldn’t take them if you:

  • Are pregnant or breastfeeding
  • Have a personal or family history of medullary thyroid carcinoma (MTC)
  • Have a history of multiple endocrine neoplasia syndrome type 2 (MEN 2)

A healthcare professional can make sure GLP-1 drugs are right for you before prescribing one for weight loss or diabetes.

GLP-1 Alternatives

If you don’t respond well to GLP-1 drugs for weight loss or diabetes, there are alternatives to consider. For weight loss, your options include:

  • Bupropion. Bupropion is an antidepressant medication that can support weight loss.
  • Metformin. Metformin is another weight loss diabetes drug. It’s FDA-approved for diabetes but sometimes prescribed off-label for weight loss. The daily pill can reduce appetite and lower blood sugar levels.
  • Topiramate. Topiramate, sold under the brand name Topamax®, is an antiseizure medication that can also be effective for weight loss.
  • Naltrexone. Naltrexone is a medication used to treat substance use disorders that may support weight loss.

A healthcare provider can talk you through GLP-1 alternatives and recommend the best ones for you. Hers offers access to personalized oral weight loss medication kits that can help support you on your journey. Depending on your needs, your kit may include some combination of bupropion, metformin, topiramate, and naltrexone. Weight loss kits contain compounded medications and haven’t been approved by the FDA. The FDA doesn’t review compounded products for safety, effectiveness, or quality. For type 2 diabetes, your healthcare provider may recommend diabetes drugs like metformin, empagliflozin, or dapagliflozin.

Conclusion

GLP-1 medications aren’t for everyone, but when used as directed, they’re an effective tool for the treatment of obesity and type 2 diabetes. If you’re considering GLP-1 drugs for weight loss, keep these things in mind:

  • They’re only one piece of the puzzle. GLP-1s should be combined with healthy lifestyle habits for long-term success. Prioritize nutrition, exercise, sleep, and positive social support in addition to your prescribed medications.
  • They may cause side effects. Every drug has potential downsides, including GLP-1s. While the most common ones are related to digestion, everyone responds differently. Report any concerns to your primary care provider.
  • There are alternatives. If GLP-1s aren’t a good fit for you, other weight loss medications may be appropriate, like metformin or topiramate.

Ready for change? Start by taking our free weight loss assessment to find out whether GLP-1s could work for you.

Frequently Asked Questions

How often should I take a GLP-1?

How often to take a GLP-1 depends on which GLP-1 you’re taking. You take Rybelsus®, Saxenda®, and Victoza® daily. And you take Ozempic®, Wegovy®, Mounjaro®, Zepbound®, and Trulicity® weekly.

Is GLP-1 the same as Ozempic®?

Not exactly. Ozempic® contains the active ingredient semaglutide, which is one type of GLP-1. GLP-1s are a class of medications that includes semaglutide, tirzepatide, dulaglutide, and liraglutide.

Which GLP-1 is best for weight loss?