What are GLP-1s?
How do they work?
What are the risks and the benefits?
Who might want to take one and who might not?
Would I recommend these drugs to my friends or family members?
Oh and also, someone who is very close to me is on a GLP right now…
This individual was when we met and since then things have changed some and so I want to share that anecdote with you too, let’s dig in…
What is a GLP-1?
GLP-1 stands for glucagon-like peptide 1 and our bodies actually make it naturally, just in WAY smaller quantities than the folks injecting the drug would reach. It can modify appetite, how full you feel, blood sugar levels and stomach emptying among other things…
I’m sure you noticed that I didn’t say that GLP-1 drugs burn fat because they don’t, they reduce hunger and therefore calorie intake and that’s why people lose weight.
This is a super important distinction because it’s not like you just continue eating the same way and lose fat while taking the drug, it changes your appetite and as a result your calorie intake and therefore results in weight loss.
Meaning, it works via the same fundamental mechanism that every single successful fat loss diet has ever worked…a calorie deficit.
What are some of the potential side effects?
The more common ones are things like nausea, vomiting, diarrhea, constipation, abdominal pain or cramping, bloating, indigestion, heartburn, fatigue, low energy and dizziness.
Some less common side effects are gallstones and gallbladder disease, pancreatitis as well as kidney complications.
Some rare side effects are increased risk of thyroid cancer, this has been seen in rodent research so some GLP’s have this warning written on the box. Another thing that can occur is muscle loss especially if someone isn’t eating enough protein.
And the following side effect is probably the most relevant to the most people considering this drug and it’s weight regain after stopping…this is very common because GLP’s don’t change your habits right and so…
Just like implementing an unsustainable dietary approach to lose weight leads to regain, these drugs often do as well. A study looking at 125,000 people which is substantial found that most folks stopped using a GLP within a year. This could be due to side effects, cost, access, a whole bunch of reasons.
About 60% of the weight that folks lose is regained within a year of stopping the drug and longer term, it looks like about 75% of the weight lost is regained and this makes perfect sense because like I mentioned, a GLP is not changing your lifestyle or habits and so a lot of folks get themselves stuck between a rock and hard place because…
If they stop the drug, they regain the weight or at least most of it being that they haven’t built the nutrition and lifestyle skills necessary to keep it off and so now they’re essentially dependent on this thing.
Nutrient deficiencies are also a concern because a lot of people are nutrient deficient to begin with due to their dietary choices however, if we look at most people that are going to take a GLP, almost certainly the quality of their diet isn’t great by definition because their appetite is dysregulated…that’s why they’re overweight and therefore taking the drug to begin with and so…
What often happens is that folks don’t improve their diet quality, they just eat less low quality food and therefore they get even fewer nutrients and put themselves at a higher risk for deficiencies.
Okay given all of that, who might still benefit from a GLP?
If someone has a bunch of excess weight which is a huge health risk and they’ve decided that they are not going to change their nutrition and lifestyle habits, they may see using one of these drugs as a net win assuming that the potential side effects don’t outweigh the benefits of the weight loss itself.
Another group of folks that may benefit are people that use a GLP as a quote unquote ‘bridge’ meaning, if they’re just having a really hard time getting started on their health journey and they feel like they need some assistance getting their appetite under control for example…this could be another use case…it can be a slippery slope, but it’s a possibility.
Now I do want to mention a sneaky little marketing tactic that these companies are using and that is saying that their drugs improve things like blood pressure for example…
GLP’s themselves do not reduce blood pressure but weight loss sure as heck does and so point being, if you have an excess weight related issue, a GLP in and of itself isn’t going to improve it but the associated weight loss almost certainly will…this is another really important distinction because…
You can change your nutrition and lifestyle habits and get all of the same benefits without the side effects and downsides of using the drug.
Would I recommend a GLP to a friend or family member…personally I would encourage anyone I love to improve their nutrition, movement, sleep and stress management first and foremost because it’s all upside and no downside…there are no negative side effects to eating better, moving your body and prioritizing sleep.
If someone did decide to take one of these things, I would recommend that they change their lifestyle alongside taking the drug and use it as a temporary tool and have a definitive action plan to come off it.
The most important consideration in regards to GLP’s is…being that they reduce appetite and therefore reduce calorie intake and as a result produce weight loss…
The question we want to ask is, why is someone’s appetite dysregulated to begin with right, let’s take a first principles approach here. For example, if you had a rock in your shoe, you could take a drug for the pain or you could simply remove the rock…
How did I get my appetite under control, lose 60 lbs and keep it off for well over decade and counting…and how do I help my clients do the same…
We prioritize single ingredient whole foods in the appropriate portions while making sure to eat enough protein.
This is how we stay full and satiated while losing fat and getting healthier because if your fat loss approach is leaving you hungry, I’ll be honest you’re doing it wrong…hunger isn’t sustainable and therefore it’s crucial that you implement an approach that doesn’t have you white knuckling it all day long.
If you think about it, processed foods are essentially anti-GLP-1’s because they can literally increase your appetite, for example…I’m sure you’ve had this experience…
You feel full and someone offers you a dessert of some kind, you take a bite or two and all of sudden you’re not full and you crush an additional 500+ calories of that treat…the kicker is, if you hadn’t had any dessert to begin, you would have just stayed full.
It’s wild right…because you’d think that eating more calories would always make you feel MORE satiated, but that depends on the source of the calories…because in that same situation if someone offered you more salmon, potatoes and vegg…you’d probably take one bite and be like no thanks whereas…
You take one bite of the treat and as if these processed foods opened up your second stomach.
Now let’s touch on the anecdote…this person that’s close to me went on a GLP about 3 years ago when they were at their unhealthiest and heaviest and they lost roughly 30 lbs and had been maintaining(ish) until we met.
I encouraged this person to begin increasing the quality of their diet and over the course of about 6-8 months, they lost an additional 15 lbs while decreasing their GLP dose.
This person has been getting comments left, right and center from friends and family telling them how much healthier they look…
So they’re now leaner than they were before we met while taking less GLP, it’s like a microdose at this point and this person aims to completely come off because clearly, they do not need it being that their nutrition is now in check.
The kicker is, this person isn’t physiologically dependent on this drug meaning their body doesn’t require it, they have a psychological dependence that they’re working through and this is another side effect that virtually no one talks about…absolutely worth considering.
If I had known this person before they started the GLP, we could have absolutely gotten them to where they are now body composition and health wise without the drug at all, no doubt in my mind however…what’s done is done.
So, as a rule, I recommend taking a food first pharma last approach to your health.
Real food not processed shit manufactured in a factory. Movement, sleep and stress management…these things work like nothing else and they don’t need a side effect label.
If you are committed, you absolutely can lose fat and get healthy without one of these drugs.
Zero judgement if you choose to take one, just know that you don’t need one.
