How do GLP-1 receptor agonists help with weight loss?

Question

Hello doctor,

I am a 34-year-old male, 6 feet tall, and currently weighs over 250 pounds. I have been struggling with obesity for several years and have tried various diet and exercise regimens without much success. My doctor recently mentioned the possibility of using anti-obesity medication, specifically GLP-1 receptor agonists, to help with weight loss. Could you provide more information about how these medications work, their effectiveness, and any potential side effects? Are there any specific lifestyle changes I should incorporate alongside the medication to improve my chances of successful weight loss?

Kindly assist.

Answer 1

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GLP-1 drugs mimic the action of the naturally occurring GLP-1 (glucagon-like peptide 1) hormone in the intestinal tract. One of GLP-1’s mechanisms of action is increasing the sense of satiety, the feeling of being sated or full, by slowing down the rate at which food leaves the stomach. GLP-1s also impact the brain’s perception of fullness, leading people to reduce food intake. The first GLP-1 drugs were originally studied and approved to treat type 2 diabetes, showing effectiveness at lowering blood sugar levels and A1C or glycated hemoglobin (a blood test showing average blood sugar over the prior two to three months). It became evident during drug trials that some of the GLP-1 drugs were also causing significant weight loss in a large portion of the study population, which led to specific drug trials for that indication. GLP-1 drugs approved for weight loss are all injectable products, dosed either daily or weekly. Once daily (Semaglutide) is the sole oral option.

Some of the more common side effects include vomiting, diarrhea, and nausea. Low blood sugar levels (hypoglycemia) are a more serious risk linked to the GLP-1 class of drugs. However the risk of low blood sugar levels often only goes up if you are also taking another drug known to lower blood sugar at the same time, such as sulfonylureas or insulin. GLP-1 receptor agonists have been shown to reduce appetite, which leads to less food intake. As compared to single weight loss treatment, combination treatment with the GLP-1 receptor agonist liraglutide and a supervised exercise program exhibited greater weight loss maintenance and improved body composition.

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