GLP-1 for weight loss
Experts explain how GLP-1 works, the benefits and potential side effects
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Glucagon-like peptide-1 (GLP-1) receptor agonists are gaining popularity as a weight loss solution due to their effectiveness in managing appetite and blood sugar levels. We spoke with Dr. Paunel Vukasinov, an internist and obesity medicine specialist in New York, and Dr. Mert Erogul from the division of bariatric surgery at Maimonides Medical Center in New York to explain how GLP-1 medications aid weight loss and their benefits and potential side effects.
GLP-1 receptor agonists help decrease appetite and promote weight loss.
Jump to insightGLP-1 medications are highly effective for weight loss, helping you lose weight in less time than diet changes and exercise alone.
Jump to insightIt’s best to get GLP-1 medications from a weight loss specialist or endocrinologist.
Jump to insightHow does GLP-1 cause weight loss
These days, it seems like everybody is talking about GLP-1 receptor agonists and their association with weight loss. “GLP-1 receptor agonists are popular due to their dual benefits in improving glycemic control for Type 2 diabetes and promoting significant weight loss,” Vukasinov explained.
These medications work so well that they often surpass other traditional weight loss methods, making them effective for those who want to lose weight or have other health conditions related to higher body weight, according to Vukasinov.
Two common GLP-1 medications that are approved by the Food and Drug Administration (FDA) specifically for weight loss are tirzepatide (Zepbound) and semaglutide (Wegovy). Semaglutide was originally approved under the Ozempic brand as a diabetes drug, but Wegovy is only approved for weight loss.
GLP-1 is a natural peptide found in the body in many places, including the gastrointestinal (GI) tract and the brain. Weight loss drugs like Ozempic and Zepbound bind to the GLP-1 receptor in the body. This causes various effects — slowing down digestion, decreasing appetite and feeling fuller sooner — that help people eat fewer calories, which leads to weight loss.
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Benefits and side effects of GLP-1
GLP-1 medications yield better results than other weight loss medications like bupropion/naltrexone (Contrave) and phentermine/topiramate (Qsymia). “And they have been found to reduce major adverse cardiovascular events in at-risk populations and improve cardiac function in patients with heart failure,” Erogul said.
Another potential downside: Medicare doesn’t cover weight loss medications, and many commercial insurances will only pay for GLP-1 medications if you have other weight-related health conditions, such as diabetes or coronary artery disease.
Benefits of GLP-1 medications
Zepbound has been shown in studies to be the most effective medication for weight loss. People lost about 21% of their body weight at the highest dose. Wegovy isn’t far behind — in studies, people lost about 15% of their body weight.
Besides being effective for weight loss, GLP-1 medications have other benefits, including that they can help control blood sugar and that you only have to remember to take them once a week. They can also treat other health conditions like high blood pressure, high cholesterol and fatty liver disease.
“We’ve also noticed that activating the GLP-1 receptor causes a reduction in various addictive behaviors like drinking, smoking and gambling,” Erogul said. One 2024 report in JAMA Psychiatry, for example, looked at the effectiveness of GLP-1 medications in treating alcohol use disorder.
GLP-1 medication side effects
GLP-1 medications come with side effects, including the fact that you need to give yourself a weekly injection in the abdomen. GI side effects are most common and include nausea, vomiting and diarrhea. “All of the weight loss medications have side effects to some degree and so prescribing them becomes a matter of matching desired effect to a particular patient's clinical picture,” Erogul explained.
Gradually increasing the dose can minimize these effects, according to Vukasinov. He also suggests eating smaller, low-fat meals and drinking plenty of water. If nausea and vomiting are more severe, ask your health care provider about adjusting your GLP-1 dose or trying an anti-nausea medication.
GLP-1 medications can also increase the risk of pancreatitis, so they aren’t recommended for those who have had a history of pancreatitis. However, Erogul says this recommendation is being challenged by a 2024 study in the journal Diabetes Research and Clinical Practice. They may also cause gallstones and bowel obstructions, but these, like pancreatitis, aren’t common.
More research needs to be done
More research needs to be done on the long-term risks of GLP-1 medications. The Food and Drug Administration (FDA) is also currently looking into reports of suicidal thoughts or actions in those who are taking GLP-1 medications.
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Comparing GLP-1 with other weight loss options
GLP-1 medications have an impressive history of weight loss, but there are options to consider. For example, one study on the oral medication Qsymia found people lost up to 11% of their body weight after a year on the maximum dose. On the medication Contrave, studies have shown people can achieve a 5% weight loss after 12 weeks of use.
Cost is a factor in choosing weight loss medications. Wegovy currently costs $1,349 for a month's supply, but Qsymia is only about $220 a month out of pocket. Retail prices for Ozempic can range from $1,000 to $1,200 monthly.
“It’s crucial to approach weight management holistically. Lifestyle modifications — nutrition, physical activity and behavioral therapy — remain first-line treatments,” Vukasinov explained. However, for those who have less severe obesity or who don’t have concerns with other metabolic health conditions like diabetes, non-medication approaches may suffice.
All of the weight loss medications have side effects to some degree and so prescribing them becomes a matter of matching desired effect to a particular patient's clinical picture.”
How to access GLP-1 for weight loss
Erogul says that, ideally, you get GLP-1 medications from a weight loss specialist or endocrinologist (a doctor specializing in hormone conditions). These types of health care providers are most familiar with GLP-1s and their side effects.
“A thorough medical history, including personal or family history of thyroid cancers and pancreatitis, is essential,” Vukasinov said. Your health care provider will also want to check your blood pressure and perform blood tests to check kidney and liver function and blood sugar.
Vukasinov explains that a person is a good candidate for GLP-1 medications for weight loss if they have a body mass index (BMI) of 30 or more or a BMI of 27 with “weight-related comorbidities, which may include:
- High blood pressure
- High cholesterol
- Type 2 diabetes
- Moderate to severe sleep apnea
You get GLP-1 medications online, but both Erogul and Vukasinov question the effectiveness and safety of these websites. “Obtaining GLP-1 medications through a licensed health care provider ensures proper evaluation, monitoring and safety. Online sources, especially from unregulated compounding pharmacies, pose risks of contamination, incorrect dosing and counterfeit products,” Vukasinov said.
FAQ
How much do GLP-1 medications cost?
Per month, Zepbound costs about $1,086 and Wegovy is about $1,349. You might get these medications covered by insurance if you have another health condition related to a higher body weight, such as diabetes.
How do GLP-1 medications compare to other weight loss drugs?
GLP-1 medications are more effective at losing excess weight than other weight loss drugs, but they’re also more expensive.
Are there any long-term risks with GLP-1 medications?
GLP-1 medications have been known to cause pancreatitis, hair loss and GI issues, such as bowel obstruction and gallstones.
Article Sources
ConsumerAffairs writers primarily rely on government data, industry experts and original research from other reputable publications to inform their work. Specific sources for this article include:
- Food and Drug Administration (FDA), “FDA Approves New Medication for Chronic Weight Management.” Accessed Feb. 28, 2025.
- FDA, “FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014.” Accessed Feb. 28, 2025.
- New England Journal of Medicine. “Tirzepatide Once Weekly for the Treatment of Obesity.” Accessed Feb. 28, 2025.
- The Lancet, “GLP-1 receptor agonists for weight reduction in people living with obesity but without diabetes: a living benefit–harm modelling study.” Accessed Feb. 28, 2025.
- Cleveland Clinic, “GLP-1 Agonists.” Accessed Feb. 28, 2025.
- JAMA Psychiatry, “Repurposing Semaglutide and Liraglutide for Alcohol Use Disorder.” Accessed Feb. 28, 2025.
- Diabetes Research and Clinical Practice, “The incidence of acute pancreatitis with GLP-1 receptor agonist therapy in individuals with a known history of pancreatitis.” Accessed Feb. 28, 2025.
- Harvard Health, “GLP-1 diabetes and weight-loss drug side effects: "Ozempic face" and more.” Accessed Feb. 28, 2025.
- FDA, “Update on FDA’s ongoing evaluation of reports of suicidal thoughts or actions in patients taking a certain type of medicines approved for type 2 diabetes and obesity.” Accessed Feb. 28, 2025.
- American Family Physician, “Phentermine/Topiramate (Qsymia) for Chronic Weight Management.” Accessed Feb. 28, 2025.