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Doctors are increasingly prescribing glucagon-like peptide-1 (GLP-1) medications to help manage type 2 diabetes and obesity—but what are they?
Our bodies naturally produce GLP-1 after eating. It's a hormone that plays a key role in stabilizing blood sugar and regulating appetite.
GLP-1 receptor agonists (RAs) are a class of treatments that mimic this hormone. To help you understand them, we’ve put together this guide on GLP-1 medications, including how they work and potential side effects.
What are GLP-1 RAs?
GLP-1 RAs are a class of medications that mimic the hormone GLP-1. Doctors prescribe them for several conditions, but the two most common are chronic weight management and type 2 diabetes.
Examples of GLP-1 medications include:
- Semaglutide (Ozempic®, Wegovy®)
- Tirzepatide (Mounjaro®, Zepbound®)
- Liraglutide (Victoza®, Saxenda®)
- Exenatide (Byetta®, Bydureon®)
- Dulaglutide (Trulicity®)
- Orforglipron (Foundayo®)
Remember, relying on GLP-1 RAs alone will limit their effectiveness. These medications should be a part of a broader health plan—one that involves nutrition support, regular physical activity, and other lifestyle interventions. You should also seek the support of a care team, who will continually monitor your progress and adjust treatment as needed based on how your body responds.
How do GLP-1 RAs work?
To understand GLP-1 RAs, it helps to know the role GLP-1 plays in our bodies. GLP-1 is an incretin hormone. This means that when blood sugar levels rise, GLP-1 signals the pancreas to release more insulin to bring those levels back into balance. It also suppresses glucagon, a hormone that raises blood sugar, by signaling different cells in the pancreas that secrete insulin and limit glucagon release.
Beyond this, GLP-1 slows the movement of food through your stomach. The longer that food stays there, the longer you feel full. After you eat, GLP-1 also sends fullness signals from the gut to the brain, reducing appetite.
GLP-1 RAs carry out these same functions. The main difference from natural GLP-1 is that GLP-1 RAs are stronger and longer-lasting. And the higher the dose, the more pronounced the effects.
GLP-1 RA administration formats
GLP-1 RAs come in two forms: injectable and oral. GLP-1 RA injections are more common than pills. Doctors typically suggest an injection once a week, in the abdomen, thigh, or upper arm. People on oral GLP-1 RAs generally take them once a day.
The right choice for you will depend on a range of factors, from how you feel about needles to your daily routine. A weekly injection could be easier to maintain than a daily pill. If you’re unsure about the right choice, speak to your doctor, who will help guide your decision.
GLP-1 RAs vs. dual agonists: What’s the difference?
GLP-1 RAs only mimic GLP-1, but dual agonists are a class of drugs that imitate two hormones—GLP-1 plus another.
Tirzepatide is currently the only FDA-approved dual agonist. It mimics GLP-1 and glucose-dependent insulinotropic polypeptide (GIP). Like GLP-1, GIP is an incretin hormone that our bodies release in response to eating. On its own, GIP increases the amount of fat our bodies store. But when combined with GLP-1, it increases the speed at which we process that fat. By coupling the effects of GLP-1 and GIP, tirzepatide treats three conditions: type 2 diabetes, obesity, and obstructive sleep apnea.
Researchers are trialing other dual agonists, too. For instance, Novo Nordisk is studying zenagamtide, also known as amycretin. This drug combines GLP-1 and amylin. Largely, amylin affects satiety and food intake. In early trials, nearly 90% of participants lowered their blood sugar levels, and around 15% lost weight.
In addition, Genetech is researching two dual agonists known as CT-868 and CT-388. Both are GLP-1 and GIP medications. One trial of CT-868 showed meaningful blood sugar improvements compared to participants taking placebos. And during a CT-388 trial, 22.5% of people lost weight, and 73% reached normal blood sugar levels.
GLP-1 RAs for weight loss vs. diabetes
According to research published in Diabetes Research and Clinical Practice, GLP-1 RAs are an effective and safe treatment for both weight loss and diabetes. Clinical trials have found that women on GLP-1 RAs lose an average of 11% of their starting weight. In a separate study, more than half of people with type 2 diabetes on a GLP-1 RA reached their target blood sugar levels.
Semaglutide, tirzepatide, foundayo, and high-dose liraglutide are FDA-approved for chronic weight management. And the agency has approved the following medications for type 2 diabetes care:
- Semaglutide
- Tirzepatide
- Dulaglutide
- Liraglutide
- Exenatide
- Lixisenatide
But it’s important to remember that GLP-1 RAs aren’t wonder drugs. The benefits won’t be nearly as strong if you don’t pair the medication with lifestyle adjustments. That’s why medication should be part of a broader care plan. Positive, sustainable outcomes go hand-in-hand with whole-person, wraparound care.
GLP-1 RA eligibility criteria
In the U.S., the FDA has approved GLP-1 RAs for adults with one of the following:
- Type 2 diabetes
- A BMI of 30 or higher
- A BMI of 27 and at least one weight-related condition, such as hypertension, obstructive sleep apnea, or dyslipidemia
Your broader health picture matters, too. Your doctor will weigh relevant factors—from stage of life to medical history—to determine whether GLP-1 RAs are a good fit.
When GLP-1 medications may not be appropriate
Your doctor likely won’t prescribe GLP-1 RAs if you’re pregnant, planning to conceive, or breastfeeding. Current research doesn’t tell us enough about the effects of these medications on babies’ development to consider them safe, but research is ongoing.
Your medical history also plays a role. Your doctor may advise against GLP-1 RAs if you have a personal or family history of certain conditions, such as medullary thyroid cancer (MTC) or pancreatitis. These conditions can interact with GLP-1 RAs in ways that raise the risk of adverse effects.
Benefits of GLP-1 medications
As FDA-approved medications, GLP-1 RAs are a safe and effective treatment for:
- Type 2 diabetes
- Chronic weight management
- Obstructive sleep apnea
- Certain heart and liver-related conditions
There are also promising studies showing GLP-1 RAs could reduce the risk of developing or worsening substance abuse disorders. Scientists are still researching this point, however.
GLP-1 RA side effects
The most common side effect of GLP-1 RA medications is gastrointestinal (GI) disorders. This can include:
- Nausea (the most common symptom)
- Diarrhea
- Constipation
- Vomiting
- Abdominal pain
- Indigestion
- Headaches
- Dizziness
- Higher heart rate
Rarely, the medications can also lead to pancreatitis and bowel obstruction.
Note: The majority of GLP-1 RA side effects are mild to moderate and typically ease as your body adjusts to treatment.
GLP-1 care from Maven Clinic
GLP-1 medications are a safe and effective way to treat type 2 diabetes and manage chronic weight issues. If you choose to start taking GLP-1 RAs, remember: Your health is unique, so your GLP-1 care plan should be, too.
Factors like your hormonal health, life stage, and medical history all shape the right approach to weight loss. Maven Clinic's GLP-1 Care connects you with specialists who look beyond the prescription to build a plan around your full health picture. Get virtual access to physicians specializing in women's metabolic and hormone health, with or without insurance.
FAQ
How do GLP-1 medications work for chronic weight management?
GLP-1 RAs support chronic weight management in several ways. These include suppressing appetite, helping you feel fuller for longer, and resulting in fewer hunger spikes.
Can I use GLP-1 RAs while pregnant or trying to conceive?
Doctors recommend that you stop taking GLP-1 RAs at least two months before trying to conceive.
At Maven Clinic, we don’t prescribe GLP-1 RAs if you're pregnant or trying to conceive. If you become pregnant while on treatment, your care team will adjust your plan to support both your health and your baby’s.
What are compounded GLP-1 medications?
Compounded GLP-1 medications are drug formulations prepared by pharmacies. They receive less rigorous testing than commercial products and aren’t FDA-approved. They haven’t undergone the same safety and efficacy review as approved medications. We don’t prescribe compounding medications at Maven Clinic.
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