GLP-1 Medications: A Nuanced Tool For Weight Loss
Over the past few years, medications like semaglutide (brand names Ozempic and Wegovy) have become headline news. Touted as “miracle weight-loss injections,” these drugs are being praised and prescribed at record speed.
But behind the hype lies a more complicated truth: GLP-1s are an incredible tool for the right population, but without broader lifestyle changes, their benefits are short-lived.
What Are GLP-1 Medications, and How Do They Work?
GLP-1 stands for glucagon-like peptide-1, a hormone that our bodies produce naturally. These medications mimic that hormone, leading to:
Slower digestion
Reduced appetite and cravings
Improved insulin response and blood sugar control
Many people find themselves eating less without constant hunger or food noise, resulting in losing 15-20% of body weight.
Who Are GLP-1s For?
These drugs were originally developed to help manage type 2 diabetes, but have since been approved for obesity treatment in adults with a BMI ≥ 30, or a BMI ≥ 27 with a weight-related health condition (like high blood pressure, sleep apnea, or diabetes).
For these populations, GLP-1s can be life-changing. Beyond weight loss, research shows improvements in:
Blood sugar regulation
Cardiovascular health
Sleep and mobility
Quality of life
The Problem: Overprescription and Misuse
Over time, instead of being seen as a medical treatment for obesity, GLP-1s have started to be marketed (and in some cases prescribed) as a quick fix for anyone who wants to lose a few pounds, creating several problems:
Side effects like nausea, constipation, and GI distress can be significant.
Shortages have made it harder for patients with diabetes to access medication they truly need.
High risk of weight regain once the medication is stopped if no lifestyle changes are in place. The STEP 4 trial (JAMA, 2021) found that participants who discontinued semaglutide regained about two-thirds of the weight they lost within a year.
Why GLP-1s Aren’t “Cheating”
When we understand the complexity of weight loss (influenced by a web of biological, environmental, and social factors), we can also understand why using a GLP-1 is not “cheating.”
Taking medication to help regulate appetite is no different than taking medication to lower blood pressure. It’s a medical intervention, not a moral shortcut.
But here’s the catch: medication alone is rarely enough.
GLP-1s can change hunger cues and quiet food noise, but they cannot:
Teach you how to build balanced meals
Help you cope with stress without turning to food
Preserve muscle mass during weight loss
Shift the environment that shapes your daily choices
That’s where nutrition and behavior coaching come in. The best outcomes happen when medication is paired with lifestyle support.
Questions to Ask Yourself Before Considering a GLP-1
If you’re thinking about starting a GLP-1, here are a few reflective questions:
Have I tried building sustainable habits with coaching or structured support?
Do I have medical conditions (like diabetes, sleep apnea, or hypertension) that would improve with significant weight loss?
Am I prepared to pair this medication with lifestyle changes so I can sustain my results long-term?
If I stop the medication, will I have the tools and habits to maintain progress?
Would working with a coach help me build a strong foundation before starting a prescription?
There’s no right or wrong answer, but asking these questions helps ensure your decision is informed
GLP-1 medications are an incredible tool when used in the right context. They can transform lives, especially for people living with obesity and related health conditions.
But they’re also being overprescribed in the wrong contexts, and without lifestyle changes, the benefits rarely last.
Weight is complex, shaped by biology, psychology, and social determinants of health. Medications can help, but they don’t replace the foundation of sustainable habits.
