The use of weight loss drugs has risen dramatically in the last few years, with advertisements for medications like Ozempic, Wegovy, and Zepbound suddenly widespread across television and social media alike. Commercials offer perks like lower blood sugar, reduced risk of major cardiovascular events, and of course rapid weight loss. Are these quickly growing drugs really a safe solution, and how exactly do they work?
Popular drugs like Ozempic fall into the category of GLP-1 receptor agonists. GLP-1 stands for glucagon-like peptide-1, a hormone that the intestines normally produce shortly after you eat a meal. This hormone works by binding to GLP-1 receptors on the outside of cells, where it signals for insulin release, regulates blood sugar levels, decreases hunger signals, and slows the movement of food through the digestive system.
GLP-1 receptor agonists work by imitating this hormone, binding to the same receptors and causing the same physiological responses. These medications are also made to last longer in the body than the normal GLP-1 hormone that gets broken down more quickly, extending its effect.
These drugs were originally intended as a treatment for patients with type 2 diabetes, helping boost insulin secretion and regulate blood sugar levels for patients who aren’t able to produce enough insulin on their own. However, many of these medications have also recently become approved as weight loss drugs, taking on a new role thanks to their powerful side effects of decreased appetite and slower food processing. GLP-1 medications are now frequently prescribed for obesity, another prevalent disease in America: the percentage of adult patients with an overweight/obesity diagnosis who were prescribed a GLP-1 drug rose from 0.30 percent in 2019 to 2.05 percent in 2024, a significant 586% increase.
Are these medications truly a safe new solution to losing weight easily? Union College Biology professor and endocrinologist Professor Cohen was able to shed more light on how these medications work. In addition to prompting insulin release, GLP-1s protect pancreatic cells, reducing cell death and encouraging growth while simultaneously improving their sensitivity to insulin. These drugs also increase metabolic rate, contributing to weight loss in combination with the effects of decreased appetite and food intake.
One downside is that patients usually need to stay on these medications long-term, as people will frequently regain the weight if they stop. GLP-1 drugs also can cause loss of lean muscle, not just fat, and may cause gastrointestinal side effects including nausea, vomiting, and constipation due to the longer period of time food remains in the stomach and digestive tract. When asked about overuse, Professor Cohen noted that while there isn’t much published data available yet, drug resistance would likely eventually develop as users no longer experience the same effects and benefits.
Despite the potential side effects, GLP-1s do offer an extremely effective method for managing obesity and its associated health conditions, including blood pressure and metabolic issues. These medications demonstrate a high success rate, improving on outcomes from recommendations of diet and exercise alone that are often difficult for patients to maintain without support.
“GLP-1 is potentially a miracle drug, but for all of its benefits, there is a little bit of a hidden dark side,” Professor Cohen noted when asked what he hopes people will take away about GLP-1s. “You have to stay on it forever, and there’s the possibility of muscle loss and other risks people don’t think about. But, the lives saved from regulating blood sugar and treating obesity makes it absolutely worth it.”
