It seems like everyone is talking about GLP-1 drugs lately. If you turn on your TV or look at your social media feeds, no doubt you’ll see ads for medicines that promise to help you shed some weight. You may have a friend or co-worker who’s slimmed down and they credit a new drug they are taking.
So, what’s the deal with GLP-1’s? Are they miraculous wonder drugs that help you lose unwanted pounds effortlessly? Or yet another weight-loss fad that won’t live up to expectations?
Privia Medical Group North Texas wants you to have the information you need on GLP-1’s.
What Are GLP-1’s?
The human body – the small intestine, specifically – makes GLP-1 hormones naturally. GLP-1’s play an important role in the metabolism – they trigger the pancreas to release insulin, which helps us convert food into energy. Insulin also lowers our blood sugar levels.
GLP-1 hormones help beat back feelings of hunger in two important ways: they slow the rate at which our stomachs empty, and they also send signals to the part of the brain that deals with hunger and feelings of satisfaction.
GLP-1 medication – technically known as GLP-1 agonists – first came into widespread use over the last decade as a treatment for diabetes. They mimic the naturally-occurring hormones in our body and produce some of the same benefits.
GLP-1s are now recommended as a first-line treatment for those with type 2 diabetes who have additional risk factors. These medicines are beneficial to people with diabetes because they are effective at lowering blood sugar, providing added protection for the heart and kidneys and of course, spurring weight loss.
There are several types of GLP-1 medications used for diabetes treatment. Two types – semaglutide and a higher-dose liragutide – have been approved by the Food and Drug Administration (FDA) as a weight-loss treatment. These are the medications you often see advertised on TV, under brand names such as Zepbound and Wegovy.
Are GLP-1 Drugs Right for Me?
The FDA has approved certain GLP-1’s as a treatment for obesity, defined as someone who has a body mass index (BMI) of 30 or over. A chronic health condition, obesity is a significant risk factor for a variety of health threats, including heart disease, high cholesterol, hypertension and diabetes. Obesity is also increasingly common – according to data from the U.S. Centers for Disease Control & Prevention (CDC), 40% of adults age 20 and over are living with obesity.
“Given that obesity is such a widespread and significant health threat, the emergence of GLP-1 drugs as an effective tool to treat this condition – in concert with dietary changes and increased exercise – is very promising,” says Dr. Triwanna Fisher-Wikoff, a family practice physician in Fort Worth. “Helping people overcome obesity will lead to them living longer and healthier lives.”
In addition to the 40% of Americans who are obese, a significant part of the population is overweight, defined as having a BMI of 25 to 29.9. BMI is calculated based on your height and weight.
Many folks who fall in the overweight range are interested in GLP-1 drugs to help them lose weight. In some cases, your health care provider may agree that’s an appropriate treatment. GLP-1’s are not necessary for everyone, though. If you want to just lose a few pounds, you can probably accomplish your goal by making some dietary adjustments and getting more physical activity in.
Benefits of GLP-1 Drugs
GLP-1 drugs are FDA-approved as a treatment for type 2 diabetes and as a weight-loss tool for those with obesity, as they have been demonstrated to be effective treatments for both conditions. For weight loss, GLP-1’s have been shown to help the majority of patients lose up to 10% of their body weight and many up to 15%. In other words, a 200 lb. person could reasonably expect to lose up to 20 – 30 lbs.
While not FDA-approved for these conditions, studies have shown that GLP-1 agonists may also have additional health benefits, including:
- Reducing blood pressure
- Lowering cholesterol levels
- Reducing heart disease risk
- Improving fatty liver disease
Side Effects & Risks
GLP-1 medications may cause side effects, especially when first taking it. The most common include:
- Nausea
- Vomiting
- Diarrhea
- Reduced appetite
Less common side effects include:
- Dizziness
- Increased heart rate
- Headaches
In rare cases, GLP-1 agonists may cause pancreatitis, allergic reactions and low blood sugar levels.
If You Take GLP-1’s
If your health care provider prescribes a GLP-1 agonist, it will likely be in the form of an injection pen. You will give yourself an injection on a prescribed schedule, usually once a week.
Follow the directions on the medicine prescribed, but usually the injection can be self-administered in the thigh, abdomen or arm.
“People call GLP-1’s wonder drugs, but they are not magic – you will not suddenly lose a bunch of weight after a few injections,” says Dr. Audrey Miklius, a Dallas endocrinologist. “Success with GLP-1 medications comes after sustained use. You are unlikely to see any positive impact if you use the medicine for less than three months, and we often recommend patients stay on them for 12-24 months to increase the likelihood of sustained weight loss.”
Taking the medicine for the long-term helps cement healthier habits – eating less, exercising more – that increase the odds for permanent improvement after getting off the medicine.
Patients with type 2 diabetes will likely need to take the GLP-1 agonist indefinitely.
Insurance Coverage for GLP-1 Medications
Will your health insurance cover GLP-1 medications? Maybe.
If you are prescribed a GLP-1 for treatment for type 2 diabetes, most insurance is likely to cover it.
If the GLP-1 is prescribed only for weight loss, it may or may not be covered. Many plans will cover these drugs if the patient is obese. In some cases, coverage will only kick in if the patient is extremely obese, defined as a BMI of 35 or higher.
Patients who are overweight and have certain comorbidities – specifically, heart disease risk factors – may also find that their insurance will cover the prescription.
However, in many cases, patients who want to take a GLP-1 for weight loss will find that they must pay for their treatment out-of-pocket. These drugs are very expensive and can easily cost several hundred dollars or more each month.
Lack of insurance coverage remains one of the greatest barriers to people accessing GLP-1 drugs.
Talk to Your Provider First
If you think you may benefit from a GLP-1 drug to help with weight loss, make your primary care provider your first call. Yes, there are a lot of websites you can go to, but it’s better to talk to your provider, who can make recommendations based on your health history.
“We are here to help our patients navigate this new world of weight-loss medication,” says Dr. Cynthia English, an OB/GYN in Fort Worth. “And while we want to take advantage of these tools if it makes sense for the patient, we can’t forget that healthy and sustained weight loss – with or without GLP-1 drugs – comes with good lifestyle choices like a balanced diet and plenty of physical activity.”
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
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