As their popularity continues to soar, you have probably heard of medications like Ozempic, Wegovy, and Mounjaro for weight loss. However, they may be just as controversial as they are popular, especially in the holistic health space. As an Integrative and Functional Nutrition Health Coach, I want to provide a balanced discussion on this topic. In the following post, I’ll explain how GLP-1 medications (like Ozempic, etc.) work and highlight some potential areas of concern. I’ll also give recommendations for those who are taking or are considering taking them for weight loss.
What are GLP-1 agonist medications and how do they work?
Ozempic, Wegovy, and Mounjaro are considered GLP-1 agonists. Their primary ingredient is Semaglutide, which is the synthetic form of the hormone Glucagon-like-peptide-1 (aka GLP-1). GLP-1 is a naturally occurring human hormone, released in the small intestine in response to food, that helps stabilize glucose levels. It also controls appetite and reduces caloric intake by slowing gastric emptying and sending signals to the brain that you’re full. GLP-1 agonist medications, in turn, work by stimulating and mimicking the actions of natural GLP-1 hormones. They have been FDA-approved to help people with diabetes manage blood sugar levels for almost 20 years. Only recently have they been utilized by non-diabetics for weight loss.
What’s the catch?
GLP-1 agonists could cause serious side effects and other health issues.
While these medications may be effective for weight loss, they have also been associated with significant side effects. The most common include nausea, vomiting, constipation, diarrhea, abdominal pain, and malnutrition. They have also been linked to more serious issues like thyroid cancer, pancreatitis, and gallbladder problems. One study found that 90% of individuals experienced adverse side effects in the first eight weeks of treatment, while another study found that 70% of diabetes patients discontinued use after 2 years due to feeling chronically sick. GLP-1 agonists are also quite expensive and often in short supply due to high demand.
Weight loss is not usually sustained over time after you stop taking them.
Another especially important consideration is the finding that weight loss is usually not sustained over time. Multiple studies demonstrate that when people stop using these medications, they regain most of the weight lost within a few months unless they have made diet and lifestyle changes.
GLP-1 agonists could lead to worse metabolic health, including significant loss of muscle mass.
Taking GLP-1 agonists without behavior and lifestyle modification can actually lead to worse metabolic health due to both a loss of muscle mass and nutrient deficiencies. As individuals are losing fat, they are also rapidly losing precious muscle tissue. In fact, 40% of the weight loss while on these medications has been attributed to skeletal muscle mass according to Hone Health. This is concerning because building and maintaining lean muscle mass is crucial for not only weight loss but overall health and longevity. Sarcopenia, or the age-related progressive loss of muscle mass and strength, has serious implications and is becoming more prevalent.
They may cause nutrition deficiencies and hormone imbalances.
GLP-1 agonists can also lead to nutrient deficiencies and hormone imbalances through malnutrition. Simply put, while a severe calorie deficit may prove to be temporarily effective for weight loss, it is not an ideal solution. Ultimately, targeted nutrition that lowers inflammation and mitigates muscle loss during weight loss is essential for lasting results.
Nutrition and Lifestyle Tips for Mimicking the Benefits of GLP-1
Whether you are taking GLP-1 agonists, or considering them, the following strategies will support your weight loss goals:
1. Eat for blood sugar balance.
A blood sugar-balancing plate is composed of a few main categories: protein, healthy fat, fiber, and leafy greens. Together, these foods help you eat for satiety, elongate your blood sugar curve, burn fat, and lower inflammation. Aim to fill 1/2 of your plate with leafy greens and veggies; 1/4 with protein; 1/4 with fiber-rich carbohydrates; and 1-2 tbsp of healthy fats.
2. Incorporate anti-inflammatory foods that naturally promote GLP-1 production.
Interestingly, chronic inflammation reduces natural GLP-1 production, which can contribute to difficulty losing weight. Food choices have a direct impact on inflammation levels in the body. So, I recommend implementing a diet full of high-quality protein, fiber, and vegetables rich in antioxidants and micronutrients. Reduce or eliminate processed foods, excess added sugars, and vegetable oils. Consider adding more herbs like cinnamon, ginseng, fenugreek, ginger, and turmeric into your diet. Studies show these help stimulate the secretion of GLP-1. Additionally, talk to a professional about targeted supplementation, which may help you optimize your nutrient levels.
3. Eat enough quality protein.
Protein is the most satiating macronutrient. It plays an important role in stimulating GLP-1 and satiety at a brain-body level. It is also critical in building and maintaining muscle mass. Protein needs vary, but a general starting point is to aim for 30g of protein per meal and 10-15 g per snack.
4. Build muscle through strength training.
Strength training is incredibly beneficial. It helps the body build muscle, improve resting metabolic rate, utilize and burn calories, and maintain optimal glucose levels. I recommend incorporating strength training into your routine at least 2-3 times per week.
5. Focus on stress management and sleep.
Managing stress and optimizing sleep are often overlooked when it comes to weight loss and metabolic health. They both play important roles in lowering inflammation, maintaining metabolism, and balancing hormones and blood sugar. Aim for 7-8 hours per night and make time for stress-relieving practices like meditation, deep breathing, time in nature or with loved ones.
Final thoughts: Are GLP-1 agonists medications worth it?
Weight loss is an incredibly complex topic, which is why I recommend an integrative approach that can incorporate both conventional and holistic modalities. Weight management can be influenced by many non-modifiable factors like genetic predispositions, age, and ethnicity. It can also be significantly impacted by social, economic, and environmental challenges that individuals may face like limited health education, financial constraints, and lack of social support.
Ultimately, I believe there are certain populations where GLP-1 agonists may be appropriate, beneficial, and promote impactful changes to health. Whether to utilize this type of medication is a decision individuals should discuss with their medical practitioners, taking into consideration their unique bio-individuality and needs.
That being said, rather than utilizing GLP-1 agonist medications as a first or singular line of treatment for obesity and poor metabolic health, individuals should consider working with integrative practitioners who can help them investigate the root cause of their weight loss resistance, address hormonal imbalances, and lower inflammation. These efforts, along with implementing diet and lifestyle changes, will provide the most effective and sustainable outcomes and help inform the decision of whether to use medications or not.
About Amelia Brown Cremin, OTD, OTR/L
Integrative and Functional Nutrition Health Coach
Amelia is an Occupational Therapist and Health Coach based in Nashville, TN. Amelia has always been interested in integrative health and nutrition. Through her clinical practice, she has served patients with all kinds of conditions – heart disease, stroke, autoimmune disease, neurological disorders, etc. Seeing first-hand the suffering that comes with chronic, lifestyle-driven conditions further inspired Amelia to pursue ongoing education and training in functional nutrition, health coaching, and preventative health. She is certified as a Functional Nutrition Health Coach and AIP Certified Coach. Additionally, she loves learning and is always diving into the newest health-related book, podcast, or course. Amelia is also currently pursuing additional certification through the Integrative and Functional Nutrition Academy. Learn more about Amelia and the rest of the MindStream team.