GLP-1 and Metabolic Health

One in three Americans are overweight—and even more, about 42%, live with obesity. Recent news suggests glucagon-like peptide-1 (GLP-1) medications, like Ozempic (semaglutide), leading some people to think these meds may be the closest we can get to a "quick fix" for obesity.¹

GLP-1 medications help balance blood sugar; some types even help people lose significant weight. Weight loss has many health benefits for people with metabolic syndrome or related conditions, such as type 2 diabetes and heart disease.

But these medications aren't without side effects. Here's everything you need to know about how popular GLP-1 medications work and how they affect your metabolic health.

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What are GLP-1s and GLP-1 Receptor Agonists?

GLP-1s are naturally occurring molecules in the body that play a crucial role in regulating blood sugar and appetite. When we eat, GLP-1s are released from the gut, signaling the pancreas to release insulin while curbing the release of glucagon, a hormone that raises blood sugar. These hormones also slow digestion, helping keep blood sugar levels steady and contributing to a feeling of fullness after meals.

GLP-1 agonists are the medication versions of the GLP-1 hormone. An agonist is a lab-made substance that mimics the natural version by attaching to a cell receptor and triggering the same action. So GLP-1 agonist meds have the same effect as the natural hormone but to a higher degree—and the higher the dose of the GLP-1 agonist, the more extreme the effects.² 

There are many types of GLP-1s on the market today, including³

• Semaglutide injections (Ozempic)
• Semaglutide tablets (Rybelsus)
• Dulaglutide (Trulicity) 
• Exenatide (Byetta) 
• Exenatide Extended Release (Bydureon BCise) 
• Liraglutide (Victoza) 
• Lixisenatide (Adlyxin) 
• Tirzepatide (Mounjaro)

How Do GLP-1s Affect Metabolic Health?

GLP-1s have a marked impact on metabolic health because they affect blood sugar regulation, appetite control, and fat metabolism. They help prevent blood sugar spikes after meals and promote insulin sensitivity, which reduces the risk of type 2 diabetes. 

GLP-1 agonists also work to suppress appetite, often contributing to weight loss and better management of obesity-related conditions. The mechanisms that work to lower your blood sugar are the same mechanisms that help people lose weight. 

These meds also help lower cholesterol levels and improve fat metabolism, which is why some (including liraglutide and semaglutide) are approved by the U.S. Food & Drug Administration (FDA) for weight loss and to reduce the risk of heart disease in people with obesity or overweight. 

Overall, GLP-1 agonists are effective in helping with metabolic syndrome, a group of health conditions that occur together, including high blood pressure, high blood sugar, excess belly fat, and high cholesterol levels. However, it's important to note that taking these meds works best when you combine them with a healthy diet and regular exercise.⁴

<div class="pro-tip"><strong>Also Read: </strong><a href=supplements-and-foods-that-increase-glp-1>How to Increase Glp-1 Naturally: 8 Foods and Supplements</a></a>.</div>

Are There Any Metabolic Associated Risks?

GLP1-agonists are relatively new—semaglutide (the active ingredient in Ozempic) was first approved by the FDA in 2017. While more research needs to be done on the long-term effects of GLP1-agonists on metabolic health, weight maintenance, and disease risk, we know that these medications have some side effects and risks.

The most commonly reported side effects associated with these medications are gastrointestinal problems and nausea, but that usually occurs when you first start the meds. 

Some of the more serious risks include pancreatitis and pancreatic cancer, thyroid C cell tumors, gallbladder-related adverse events, and retinopathy. Still, researchers say that GLP-1s are well-tolerable and the risk of these adverse effects is low.⁵

Still, many GLP-1 agonists come with a black box warning—the most serious warning from the FDA—about thyroid cancer. These meds, including Ozempic, Wegovy, and Rybelsus, may increase the risk of thyroid tumors, including a type called medullary thyroid carcinoma (MTC). People with a personal or family history of thyroid cancer should not use these GLP-1s. 

Losing Muscle Mass with GLP-1s

While certain GLP-1 receptor agonists can help you lose weight, not all that weight loss will come from body fat. Studies show these medications can cause 25% to 39% of weight loss from muscle over 36 to 72 weeks. In comparison, weight loss from diet alone typically results in 10% to 30% muscle loss. 

While that seems like a big discrepancy, get this: Muscle loss from GLP-1 medications is several times faster than the typical 0.8% yearly loss from age-related muscle loss (sarcopenia) that typically happens after age 40.⁶

Losing muscle has a significant effect on your metabolic health. Studies show that losing muscle slows down metabolism, making it harder to burn calories. Less muscle can lead to insulin resistance, higher fat storage, and weight gain. Plus, losing muscle makes it harder to stay active, which can worsen metabolic health over time. If you're on GLP-1s, staying active and doing strength training can help keep your muscles and metabolism in check.

Frequently Asked Questions

How Does GLP-1 Affect Metabolism?

GLP-1 helps regulate blood sugar by increasing insulin release and slowing gastric emptying. It also promotes satiety and reduces hunger, which can help with weight loss and improve overall metabolic control.

Can Semaglutide Help With Metabolic Syndrome?

Semaglutide can help with metabolic syndrome by improving blood sugar control, promoting weight loss, and reducing risk factors like high blood pressure and cholesterol. Research shows it's effective in managing several areas of metabolic syndrome.

What Are the Downsides of GLP-1?

Some downsides of GLP-1 medications include potential side effects like nausea, vomiting, and digestive issues. There are also concerns about a possible increased risk of thyroid cancer, as well as a potential for pancreatitis in some people.

<div class="pro-tip"><strong>Learn More: </strong><a href=what-is-glp-1>Glp-1 Agonists: What You Need to Know</a>.</div>