Over the past few years, GLP-1 medications such as Ozempic®, Wegovy®, Mounjaro®, and Zepbound® have become some of the most talked-about treatments in healthcare. While much of the conversation has focused on weight loss, these medications were originally developed to help regulate blood sugar and improve metabolic health.

As interest continues to grow, it’s important to understand what these medications do, what results are realistic, and why lifestyle strategies remain essential for long-term success.

What Are GLP-1 Medications?

GLP-1 stands for glucagon-like peptide-1, a hormone naturally released by the intestines after eating. This hormone plays several important roles in regulating appetite, blood sugar, and digestion.

GLP-1 helps the body by:

• Increasing insulin production to support healthy blood sugar regulation
• Reducing glucagon, a hormone that raises blood sugar levels
• Decreasing gluconeogenesis (the production of glucose by the liver)
• Slowing stomach emptying and digestion
• Increasing feelings of fullness after meals
• Reducing cravings and “food noise”

GLP-1 medications work by mimicking this natural hormone and prolonging its effects in the body. The result is improved blood sugar control and, for many individuals, meaningful weight loss.

Common Side Effects

Like any medication, GLP-1 therapies can have side effects. The most commonly reported include:

• Nausea
• Diarrhea
• Constipation
• Vomiting

For many individuals, these symptoms improve over time as the body adjusts to treatment. Working closely with a healthcare provider can help manage side effects and ensure appropriate dosing.

Important Testing Before Starting

Understanding your metabolic baseline before beginning treatment can provide valuable information and help track progress over time.

Some useful assessments may include:

• Blood Sugar regulation markers – ex) fasting glucose and insulin, HgA1c
• Inflammatory Markers – ex) CRP, ESR, Fibrinogen
• Liver Health Markers – ex) GGT, ALT, AST, ALP
• Additional testing – ex) continuous glucose monitoring

Looking Beyond Weight Loss: Long-Term Considerations

While GLP-1 medications can be highly effective, researchers continue to explore their long-term effects. Several important considerations have emerged:

1. Weight Regain After Discontinuation – Studies suggest that approximately two-thirds of lost weight may return within a year after stopping treatment if supportive lifestyle habits are not in place.
2. Muscle Mass Loss – Weight loss can include both fat and muscle tissue. Preserving muscle mass becomes increasingly important as we age, making adequate protein intake and resistance training essential components of any weight loss strategy.
3. Gut Microbiome Changes – Emerging research suggests GLP-1 medications may influence the gut microbiome, which plays a role in blood sugar regulation, inflammation, digestion, and overall health.
4. Gallbladder and Liver Health – Because these medications affect digestion and bile acid metabolism, ongoing monitoring of liver and gallbladder function may be appropriate for some individuals.

Why Lifestyle Still Matters

One of the most interesting findings in recent research is that the greatest weight loss outcomes were achieved when dietary and lifestyle interventions were implemented before medication was introduced.

In one study, participants focused on lifestyle changes for 12 weeks before beginning medication and continued treatment for 60 additional weeks. Over the 72-week study period, participants lost an average of 25% of their original body weight, with approximately 6–7% lost during the initial lifestyle phase alone.

This highlights an important message:

GLP-1 medications work best when they are part of a comprehensive plan—not a replacement for one.

Nutrition, movement, sleep, stress management, muscle preservation, and targeted supplementation all contribute to long-term success and improved metabolic health.

The Bottom Line

GLP-1 medications can be a powerful tool for improving blood sugar regulation, reducing appetite, and supporting weight loss. However, sustainable results depend on much more than the medication itself.

Whether you are considering starting a GLP-1 medication, currently taking one, or planning to transition off treatment, focusing on foundational lifestyle habits remains the key to achieving lasting health outcomes.

The goal isn’t simply losing weight—it’s building a healthier metabolic system that can support your long-term wellbeing.

In health,

Dr Chanel Cressman, ND