The Rise of GLP-1 Medications: A New Era for Weight Loss

By Emily Ismail

I remember my first year as a pharmacist working in a busy community pharmacy—it felt like every prescription I filled was for Ozempic or Mounjaro! Our pharmacy had to be diligent about replenishing these medications, as they would fly off our shelves. Patients would call us daily to ask if we had them in stock, and some were even willing to drive 50+ miles to get their hands on them! The surge in popularity was even more surprising when celebrities like Kelly Clarkson and Khloe Kardashian openly discussed their use of GLP-1 medications for weight loss. Years later, I’m still dispensing these medications frequently. 

Are GLP-1 medications here to stay, or are they just a fad? 

And what exactly are these medications, anyway?!

Let’s get into the science behind GLP-1 medications

Glucagon-like peptide-1 (GLP-1) is a hormone naturally produced in the body in response to food intake. During digestion, the small intestine releases GLP-1, which stimulates the pancreas to secrete insulin while suppressing glucagon production. This process helps regulate blood glucose levels, preventing post-meal sugar spikes. Additionally, GLP-1 slows gastric emptying, promoting prolonged satiety and aiding in appetite control, which are key factors in weight management. GLP-1 medications mimic the effects of the naturally occurring hormone by binding to the same receptors and stimulating similar blood sugar-lowering effects. 

The history of GLP-1 medications

Despite their recent surge in popularity, GLP-1 medications have actually been around for years; they were originally developed for the treatment of Type 2 diabetes. The discovery of GLP-1 was unexpected. While researching glucagon, a hormone that increases blood sugar, scientists studying the glucagon gene in an anglerfish identified two additional genes—GLP-1 and GLP-2. Scientists later found that GLP-1 stimulates insulin release, helps regulate glucose levels, and produces naturally in the gut in response to food intake, where it also slows gastric emptying. This scientific discovery laid the foundation for the development of GLP-1 medications.

In 2005, the first GLP-1 medication, Byetta, was approved by the FDA as an adjunct treatment for Type 2 diabetes. Shortly after, longer-acting GLP-1 medications became available, including Victoza, which requires once-daily dosing, and Trulicity, which offers the convenience of once-weekly dosing. During clinical trials evaluating the long-term safety of GLP-1 medications, researchers observed an unexpected side effect—weight loss. This discovery led to further studies specifically focused on GLP-1 medications for weight management.

In 2014, Saxenda became the first GLP-1 medication to receive FDA approval for weight management in overweight or obese individuals, followed by Wegovy in 2021 and Zepbound in 2023. Clinical trials have shown great results for these medications. In the STEP 1 trial, a clinical trial that studied the effectiveness of Wegovy for weight-loss, participants had an average weight reduction of 14.9% with Wegovy over a period of 68 weeks. While some GLP-1 medications, such as Ozempic and Mounjaro, are not officially approved for weight loss, many diabetic patients experience it as a beneficial side effect when managing their blood sugar levels. In fact, results from the SURMOUNT-1 trial, show that patients achieved an average weight reduction of 20.9% on Mounjaro 15 mg compared to just 3.1% on placebo. The SURMOUNT-1 trial was one of the first clinical trials specifically designed to study the efficacy and safety of Mounjaro in overweight or obese adults who did not have diabetes.

What are the side effects?! These medications seem too good to be true.

Like all medications, GLP-1 receptor agonists come with potential side effects. The most common include nausea, vomiting, and gastrointestinal discomfort, which tend to be more noticeable when first starting the medication and generally subside over time as the body adjusts. Injection-site reactions may also occur. If these side effects become more severe or persistent, it's important to consult your doctor promptly. Rare but serious side effects, such as pancreatitis, acute gallbladder disease, kidney, and thyroid problems can occur. It is important to report new or worsening pain to your doctor as soon as possible. 

GLP-1 medications are not approved for use during pregnancy, so if you are planning to become pregnant or are breastfeeding, it’s essential to speak with your healthcare provider. Additionally, always obtain these medications through a reputable source and with a valid prescription. Many online pharmacies now offer compounded versions of GLP-1 inhibitors, but these may be counterfeit or unsafe, posing potential risks to your health.

How do I know if a GLP-1 medication is right for me?

In my opinion, GLP-1 medications can be an excellent option for those who have struggled with weight management and are at high risk for diabetes or other cardiovascular diseases. Over time, being overweight can increase the risk of serious health conditions, including stroke and heart disease. Maintaining a healthy weight is crucial for reducing these risks. However, for optimal results, GLP-1 medications should be combined with a balanced diet and regular exercise to ensure long-lasting effects. They are not intended as a “quick fix” for weight loss but rather as a tool to support sustainable lifestyle changes. Also, it is important to consult with your doctor and pharmacist before starting any new medication, as GLP-1 medications may not be suitable for everyone. While these medications show many benefits, long-term post-marketing studies are still ongoing, so there may be potential side effects that have not yet been fully identified.

The future of GLP-1 medications

​​GLP-1 medications were initially approved for diabetes, then expanded to weight loss—but what’s next? Ongoing studies are exploring their potential use for conditions such as alcohol withdrawal, osteoarthritis, and even Alzheimer’s disease! It’s fascinating how a drug originally designed to treat Type 2 diabetes is now showing promise in so many other areas. I’m excited to see what the future holds for GLP-1 medications and the potential new ways they may improve health outcomes!

Emily Ismail is a registered pharmacist based in Austin, Texas. She earned her Doctor of Pharmacy degree from the University of Texas and has experience in community, mail order, and academia pharmacy. Emily is dedicated to making a meaningful impact in healthcare by improving patient outcomes and mentoring the next generation of pharmacists.