The Pros and Cons of GLP-1 Agonist Drugs
The Pros and Cons of GLP-1 Agonist Drugs
GLP-1 receptor agonists, a class of medications initially developed for managing type 2 diabetes, have recently gained attention for their potential benefits in weight management and cardiovascular health. These drugs mimic the action of glucagon-like peptide-1 (GLP-1), a hormone that plays a crucial role in regulating blood sugar levels and appetite. While they offer several advantages, there are also important considerations to keep in mind.
Here, we’ll explore the pros and cons of GLP-1 agonist drugs, while giving concrete tips on how to mitigate some of the potential problems.
Pros of GLP-1 Agonist Drugs:
1. Effective Blood Sugar Control
One of the primary benefits of GLP-1 agonists is their ability to help control blood sugar levels. By stimulating insulin secretion in response to meals and suppressing the release of glucagon, these drugs can significantly lower A1c levels, a key marker of long-term blood sugar control.
2. Weight Loss
GLP-1 agonists have been shown to promote weight loss by reducing appetite and slowing gastric emptying, leading to a feeling of fullness. This makes them particularly appealing to individuals with type 2 diabetes who struggle with obesity.
3. Cardiovascular Benefits
Research has indicated that GLP-1 agonists can provide cardiovascular benefits, including a reduction in the risk of major adverse cardiovascular events such as heart attack and stroke. This is particularly beneficial for individuals with diabetes, who are at higher risk for cardiovascular disease.
4. Improved Mental Health
In many cases, GLP-1 agonists lead to dramatically improved mental health. Obesity is a chronic and relapsing illness associated with negative feelings including low self-esteem and shame. Losing weight tends to make people feel better about themselves. Being overweight worsens pre-existing mental health challenges. For many individuals. GLP-1 agonists act as a powerful antidepressant.
For some, the medication has the surprising consequence of reducing a wide range of substance use disorders, including excessive alcohol consumption ((Arillotta et al., 2023)
4. Potential in Treating Non-Diabetic Conditions
Emerging evidence suggests that GLP-1 agonists may be effective in treating other conditions, such as non-alcoholic steatohepatitis (NASH) and polycystic ovary syndrome (PCOS) Their impact on weight and metabolism makes them a versatile tool in managing various weight-related health issues (Cena et al., 2020).
Cons of GLP-1 Agonist Drugs
1. Gastrointestinal Side Effects & Helpful Tips
The most common side effects of GLP-1 agonists are gastrointestinal, including nausea, vomiting, and diarrhea. These symptoms can be severe for some individuals and may limit the drug's tolerability and adherence. Often the symptoms improve after a few weeks on the medication.
Tips on Reducing Nausea:
Eat smaller more frequent meals
Only eat when hungry
Avoid sugar, sports drinks, and triggering smells
Avoid straws
Don’t eat before bed
Avoid vigorous physical activity right after the shot
Drink clear drinks, including broth
Try drinking a protein shake before the shot
After the shot, try ginger, crackers, an apple or mint
Tips on Reducing Vomiting:
See above
Emphasize smaller more frequent meals
Stay hydrated
Tips on Reducing Diarrhea:
See above
Stay hydrated
Consider electrolytes
Eat chicken, broth, rice, and carrots (Gorgojo-Martinez et al., 2022)
2. Cost
GLP-1 agonists are often expensive, and the cost can be a barrier for many patients, especially those without insurance or with limited coverage. This can make long-term treatment difficult to sustain financially.
3. Injection Requirement
Most GLP-1 agonists are administered via injection, which can be a drawback for patients who are uncomfortable with needles or prefer oral medications. However, newer formulations are being developed, including oral versions, to address this issue.
4. Potential Risk of Pancreatitis and Thyroid Cancer
There have been concerns about an increased risk of pancreatitis and thyroid cancer with GLP-1 agonist use. Although the evidence is not definitive, these potential risks require careful consideration and monitoring by healthcare providers.
5. Potential Risk of Mental Health Problems
According to a study that analyzed social media posts, GLP-1 agonists may contribute to depression, insomnia, and suicidal thoughts (Arillotta et al., 2023).
6. Loss of Lean Muscle Mass
All weight loss comes with the risk of losing lean body mass – not just fat. Individuals who lose weight by modifying their diet experience a 25-33% reduction in lean body mass. Losing muscle mass increases the risk of eventual weight gain because muscle, especially skeletal muscle, affects resting metabolic rate, or the amount of calories burned at rest. As muscle mass declines, the resting metabolic rate also declines, which makes it easier to regain the weight.
GLP-1 agonists are thought to increase the risk of lean body mass to 30–40% depending on the specific dose and type of medication (Sargeant et al., 2019).
Strategies to prevent the loss of lean body mass include resistance training and getting extra protein.
6. Individual Variability
The effectiveness and tolerability of GLP-1 agonists can vary significantly among individuals. Factors such as genetics, underlying health conditions, and other medications can influence how well a patient responds to treatment.
Conclusion
GLP-1 agonist drugs offer a range of benefits, particularly in managing type 2 diabetes and promoting weight loss. They may also support cardiovascular health and improve other conditions. However, the GI side effects, cost, injection requirement, and potential risks must be carefully weighed. As with any medication, patients should work closely with their healthcare providers to determine the best treatment plan based on their individual needs and circumstances.
Patients should also work closely with their nutritionist to assist with managing potential GI symptoms and to meet their nutritional needs while eating less. Priorities include getting enough protein and fiber on a low-calorie diet as well as encouraging resistance training.
Avoid GLP-1 medications if you are pregnant or lactating.
Be aware that GLP-1 agonist drugs may carry unknown long-term risks and that there is currently a class action lawsuit in Pennsylvania for patients who have suffered vision loss or gallbladder damage while taking the medication.
Disclaimer
The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider.
References:
Arillotta, D., Floresta, G., Guirguis, A., Corkery, J. M., Catalani, V., Martinotti, G., Sensi, S. L., & Schifano, F. (2023). GLP-1 Receptor Agonists and Related Mental Health Issues; Insights from a Range of Social Media Platforms Using a Mixed-Methods Approach. Brain sciences, 13(11), 1503. https://doi.org/10.3390/brainsci13111503
Cena, H., Chiovato, L., & Nappi, R. E. (2020). Obesity, Polycystic Ovary Syndrome, and Infertility: A New Avenue for GLP-1 Receptor Agonists. The Journal of clinical endocrinology and metabolism, 105(8), e2695–e2709. https://doi.org/10.1210/clinem/dgaa285
Gorgojo-Martínez, J. J., Mezquita-Raya, P., Carretero-Gómez, J., Castro, A., Cebrián-Cuenca, A., de Torres-Sánchez, A., García-de-Lucas, M. D., Núñez, J., Obaya, J. C., Soler, M. J., Górriz, J. L., & Rubio-Herrera, M. Á. (2022). Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. Journal of clinical medicine, 12(1), 145. https://doi.org/10.3390/jcm12010145
Sargeant, J. A., Henson, J., King, J. A., Yates, T., Khunti, K., & Davies, M. J. (2019). A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans. Endocrinology and metabolism (Seoul, Korea), 34(3), 247–262. https://doi.org/10.3803/EnM.2019.34.3.247