GLP-1 medications are a class of drugs that mimic the action of the glucagon-like peptide-1 hormone, which
plays a role in regulating appetite and glucose metabolism. These medications are primarily used to treat
type 2 diabetes but have gained attention for their effectiveness in weight loss.
Mechanism of Action:
- Appetite Regulation: GLP-1 medications enhance feelings of fullness (satiety) and reduce hunger, leading to decreased calorie intake.
- Glycemic Control: They help regulate blood sugar levels by stimulating insulin secretion in response to meals and slowing gastric emptying.
Role in Weight Loss Therapy
- Weight Reduction: Clinical studies have shown that GLP-1 medications can lead to significant weight loss in individuals, especially those with obesity or overweight conditions.
- Sustained Weight Loss: Many users experience long-term weight maintenance when combined with lifestyle changes such as diet and exercise.
Common GLP-1 Medications:
- Semaglutide (brand names like Ozempic and Wegovy)
- Liraglutide (brand name Saxenda)
Considerations
While GLP-1 medications can be effective for weight loss, they may have side effects such as nausea, vomiting, and
gastrointestinal issues. It’s important for individuals to consult their healthcare provider to determine if GLP-1 therapy
is appropriate for their weight loss strategy
GLP-1 Medications
1. Semaglutide
– Formulation: Injectable (Ozempic, Wegovy) and Oral (Rybelsus)
– Description: Semaglutide mimics GLP-1, helping to regulate blood sugar and reduce appetite. Ozempic is typically used for diabetes management, while Wegovy is specifically approved for weight management.
– Starting Doses:
– Ozempic: 0.25 mg once weekly (titrated to 0.5 mg after four weeks).
– Wegovy: 0.25 mg once weekly (titrated to 2.4 mg).
– Rybelsus: 3 mg once daily (titrated to 7 mg after 30 days, and 14 mg if needed).
2. Liraglutide
– Formulation: Injectable (Saxenda for weight loss, Victoza for diabetes)
– Description: Liraglutide helps control blood sugar and supports weight loss by increasing feelings of fullness.
– Starting Doses:
– Saxenda: 0.6 mg once daily (titrated to 3 mg).
– Victoza: 0.6 mg once daily (titrated to 1.2 mg or 1.8 mg).
3. Dulaglutide
– Formulation: Injectable (Trulicity)
– Description: Dulaglutide is a long-acting GLP-1 receptor agonist that helps improve glycemic control and
promotes weight loss.
– Starting Dose: 0.75 mg once weekly (can increase to 1.5 mg).
4. Exenatide
– Formulation: Injectable (Byetta, Bydureon)
– Description: Exenatide helps lower blood sugar levels and aids in weight loss by reducing appetite.
– Starting Doses:
– Byetta: 5 mcg twice daily (can increase to 10 mcg).
– Bydureon: 2 mg once weekly.
5. Tirzepatide
– Formulation: Injectable (Mounjaro)
– Description: Tirzepatide is a dual GIP and GLP-1 receptor agonist, effective for glycemic control and
significant weight loss.
– Starting Dose: 2.5 mg once weekly (titrated to 5 mg, 7.5 mg, or 10 mg).
Patients who are disqualified from using GLP-1 receptor agonists for weight loss
- ● Personal or Family History of Medullary Thyroid Carcinoma (MTC): Patients with a history of MTC or
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) should avoid GLP-1 therapies.
- Severe Gastrointestinal Disease: Conditions like gastroparesis can be exacerbated by GLP-1 medications, which slow gastric emptying.
- Pancreatitis: A history of pancreatitis may increase the risk of recurrence with GLP-1 therapy.
- Allergic Reactions: Patients with known hypersensitivity to GLP-1 medications or
Patients who cannot use GLP-1 receptor agonists for weight loss may consider the following alternative options:
- Lifestyle Modifications: Emphasizing dietary changes, physical activity, behavioral therapy, and support groups can be effective for weight loss.
Other Medications:
- Orlistat (Alli, Xenical): A lipase inhibitor that reduces fat absorption from the diet.
- Phentermine-topiramate (Qsymia): A combination medication that suppresses appetite and increases satiety
- Bupropion-naltrexone (Contrave): A combination that reduces hunger on the central nervous system.
- Liraglutide (Saxenda): Another GLP-1 receptor agonist approved explicitly for weight management but may have different eligibility criteria.
- Counseling and Support: Engaging in weight loss programs or working with a dietitian or nutritionist can help develop a sustainable weight loss plan.
- Fitness Programs: Structured exercise programs can assist in achieving weight loss goals