Beyond the Hype: What You Need to Know About GLP-1 Medications
These meds are changing the way we understand metabolic health, willpower, & the brain-body connection
ICYMI 👉
If you’ve been following health news lately, you’ve heard about GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound. Maybe you’ve wondered if they’re right for you, or perhaps you’ve felt overwhelmed by conflicting information swirling around social media. Let me cut through the noise with what’s actually happening in the research, because the real story is far more compelling than the headlines suggest.
As a practicing physician, I’ve watched these medications transform not just my patients’ lab values, but their relationship with food and their sense of agency over their health. As the latest research reveals, these aren’t just “weight loss drugs”—they’re sophisticated neurometabolic tools that address some of the most persistent health challenges people face.
How GLP-1 Meds Work
These self-administered injectable peptides work by mimicking a hormone naturally made in your small intestine, called “glucagon-like peptide.” This hormone sends four crucial messages: it tells your pancreas to release insulin when needed, signals your liver to slow sugar release, delays how quickly food leaves your stomach, and—perhaps most importantly—increases the signals to your brain that let you know when you’re actually full.
But here’s what makes these medications extraordinary: they don’t just affect your appetite. They target the part of your brain where ruminations about food originate. Patients consistently describe a phenomenon called “food noise”—the mental calculations about eating that can consume precious cognitive and emotional energy—simply quieting down.
One of my patients who had spent twenty years on extreme diets and strict exercise routines put it perfectly: “For the first time in my life, I’m not constantly thinking about food. I eat when I’m hungry, I stop when I’m satisfied, and my brain is a whole lot quieter.” It wasn’t a lack of “willpower” that fueled her diabetes and weight problems; it was an underlying neurobiological pattern that had become entrenched over decades.
The Expanding Universe of Benefits
While reports of dramatic weight loss grabbed initial headlines, more recent studies reveal some of the benefits of GLP-1s that extend beyond the scale. The research coming out in 2024 and 2025 is pretty game-changing.
Kidney Protection: The FLOW trial showed that semaglutide reduced the risk of major kidney disease events by 24% in people with type 2 diabetes and chronic kidney disease. Just this January, the FDA approved Ozempic to reduce the risk of kidney disease worsening, kidney failure, and death due to cardiovascular disease. This isn’t just about preventing diabetic complications, it’s about preserving one of your body’s most crucial organ systems.
Heart Health: Wegovy became the first weight loss medication approved to reduce the risk of cardiovascular death, heart attack, and stroke in adults with cardiovascular disease and obesity. In the SELECT trial, semaglutide reduced major cardiovascular events by 20% in people with obesity but without diabetes, suggesting the benefits extend beyond traditional diabetic populations.
Sleep Apnea: In December 2024, Zepbound (tirzepatide) became the first FDA-approved medication for moderate-to-severe obstructive sleep apnea in adults with obesity. In clinical trials, patients saw 27-30 fewer apnea events per hour compared to just 4-6 fewer with placebo.
Liver Disease: Preliminary results suggest significant benefits for metabolic dysfunction-associated steatohepatitis (MASH), a serious form of fatty liver disease tied to obesity and diabetes.
As I see in clinical practice, these interconnected conditions often travel together, creating cascading health problems. We’re seeing that GLP-1s, by addressing underlying metabolic dysfunction, can have ripple effects throughout multiple organ systems.
5 Frequently Asked Questions from My Patients
Here are the questions I get asked by patients and readers on a regular basis:
1) “Isn’t taking a GLP-1 medication the easy way out?”
I get this question all the time, even from patients who have successfully improved their metabolic health with a GLP-1. The question reveals how deeply we’ve moralized medical treatments, and how readily we attribute obesity to a lack of willpower. But taking insulin isn’t “cheating” if you have diabetes. Using an inhaler isn’t “the easy way out” if you have asthma. For people with insulin resistance and disrupted satiety signals, GLP-1 medications address underlying biological dysfunction that makes weight management extremely difficult through behavioral approaches alone.
It’s important to remember that GLP-1 medications and strict dietary approaches both affect brain chemistry. Both require ongoing commitment. Both carry potential risks and benefits. The difference is that one approach works with biology rather than constantly fighting against it.
2) “What about side effects?”
Side effects of GLP-1s are not inevitable, despite what the headlines suggest. The tolerability of these medications hinges largely on how they are prescribed and monitored—ideally by a board-certified physician and not some random person on the internet. If side effects occur, the most common complaints are gastrointestinal—nausea, vomiting, diarrhea, and/or constipation. These typically improve over time as your body adjusts. More serious but rare risks include pancreatitis, gallbladder problems, and potential thyroid concerns. There’s also a risk of muscle loss if not combined with adequate protein intake and resistance (strength-building) exercise.
3) “What about other major downsides?”
A major downside for many people is cost. Even if your insurance covers it, you may end up spending hundreds of dollars a month for this medicine. Another potential harm is triggering a latent or active eating disorder. For patients with a history of a restrictive eating disorder, these meds can cause extreme dieting behaviors and promote ill health. Any patient who loses their desire to eat on these meds should be reevaluated, as this may be a sign that the dose is too high or that a pattern of disordered eating has been uncovered. The goal with these medications isn’t to eliminate appetite; it is to restore normal hunger and satiety cues.
4) “Will I need to take this forever?”
This is akin to asking if someone with high blood pressure will need their medication forever. For many people, the GLP-1 medications address chronic metabolic conditions that benefit from longer-term treatment. However, some patients are able to successfully taper off the medications and maintain their weight and metabolic goals with lifestyle maintenance alone. Still others find that continuing the medication at a lower dose for the long-term helps them maintain the neurobiological changes that support their healthier habits.
5) “Are these medications right for me?”
Just because a GLP-1 medication may help you lose weight doesn’t mean you should take it. In other words, not everyone with a weight concern needs a GLP-1 medication. Many of my patients need lunch—not Ozempic—to experience proper satiety. Some need cognitive behavioral therapy—not Ozempic—to work on body acceptance. Others need more sleep and time for meal prep—not Ozempic—to better manage stubborn weight gain.
The right candidates are typically people who have insulin resistance, persistent food cravings despite adequate nutrition, or weight-related health conditions that haven’t responded to comprehensive lifestyle approaches.
A Framework for Thinking About GLP-1 Medications
I encourage patients to think of GLP-1 medications as just another tool in the toolbox for metabolic health. They are not a panacea and should always be part of a comprehensive approach that includes:
Foundation habits: Regular protein intake (aim for 20-30 grams per meal), strength training 2-3 times weekly, post-meal walks, and prioritizing sleep quality.
Stress management: Chronic stress creates insulin resistance even in people eating perfectly. Sometimes addressing work boundaries or family dynamics is as important as any medication.
Realistic expectations: These medications create space for healthier behaviors, but they work best when combined with the lifestyle changes that support long-term metabolic health.
Individual assessment: Your genetics, medical history, current medications, and personal circumstances all influence whether these treatments are appropriate and safe for you.
Looking Forward
We’re likely seeing the tip of the iceberg with GLP-1 medications. Ongoing research is exploring their potential for Alzheimer’s disease, addiction, and other conditions where the brain-body connection plays a crucial role. New formulations in development, including oral versions and combination therapies, may offer more options and potentially better results.
What excites me most isn’t just the medications themselves—it’s how they’re helping us understand that many health conditions we’ve traditionally blamed on “lack of willpower” are actually complex neurobiological patterns that can be addressed with precision tools.
The Upshot
GLP-1 medications represent a paradigm shift in how we understand and treat metabolic health. They’re not magic bullets, and they’re not appropriate for everyone. But for the right patients, they can provide a window of opportunity to break cycles of metabolic dysfunction that have been years or decades in the making.
The goal isn’t pharmaceutical dependence, it’s metabolic flexibility. Whether that’s achieved through medication, lifestyle changes, or a combination of both depends on your individual biology, circumstances, and health goals.
If you’re considering these medications, have an honest conversation with your doctor about your complete health picture. Don’t let cultural biases about “natural” versus “pharmaceutical” approaches prevent you from exploring treatments that could significantly improve your health and quality of life.
The most empowered choice you can make is to evaluate all your options based on evidence, not societal pressures or hyperbolic headlines, and to pick an approach where you feel educated, informed, and supported in your health goals.
What questions do you have about GLP-1 medications? I’d love to hear about your experiences or concerns in the comments!
Disclaimer: The views expressed here are my own and are not a substitute for advice from your personal physician.
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Wow. What an intelligent, apolitical, unbiased and nuanced overview. Thank you.
Lucy, thanks for the plain english discussion on GLP-1 medications...I would add that it would be helpful when you say "Regular protein intake (aim for 20-30 grams per meal)" to add "e.g as in a 6 oz serving of salmon or chicken". Adding that would make 20-30 grams more relatable, at least for me.