GLP-1 Agonists: A New Option for Weight Loss

Did you know that 42% of American adults are obese?

Obesity, or weighing more than what is considered healthy for a given height, is one of today’s most common health issues. It’s also serious. Having obesity increases your risk for many other types of diseases, including high blood pressure (hypertension), type 2 diabetes, coronary heart disease, stroke, gallbladder disease, sleep apnea, cancers, and body pain.

With obesity projected to increase in the United States, providers sometimes utilize prescription medications to help patients with weight loss. Continue reading to learn more about two of these medications.

From Diabetes Drugs to Weight Loss Medications

One avenue for obesity treatment is a class of medication called glucagon-like peptide-1 (GLP-1) agonists. This drug class first gained FDA approval to treat type 2 diabetes but is now also approved for weight management. GLP-1 medications have been shown to help patients with weight loss when combined with a healthy diet and exercise.

Options for Weight Management

While multiple GLP-1 agonists can help with weight management, only two (Wegovy® and Saxenda®) have FDA approval for this specific use.

Wegovy® (semaglutide) is one of the newest approved GLP-1s. It works by mimicking a hormone that targets areas of the brain regulating appetite and food intake. This medication is injected once a week and is used in adults with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol. Dosing with this medication is increased gradually to 2.4mg once weekly to minimize gastrointestinal side effects.

The other approved GLP-1 drug for weight management is Saxenda® (liraglutide). Saxenda® is prescribed for people ages 12 and up who are obese. Saxenda® is a once-a-day injection with a gradual dose increase from 0.6mg to a target dose of 3mg. Just like Wegovy®, the dose increases gradually to reduce gastrointestinal discomfort.

Are there any side effects associated with GLP-1 medications?

Both Wegovy® and Saxenda® have very similar side effects. The most common ones are:

• Nausea
• Diarrhea
• Vomiting
• Constipation
• Stomach pain
• Headache
• Fatigue
• Indigestion
• Dizziness
• Abdominal distension
• Belching
• Gas buildup
• Low blood sugar in patients with type 2 diabetes

Who should avoid using GLP-1s?    

Patients who should avoid taking GLP-1s are those that are already taking a semaglutide or liraglutide containing product or other GLP-1 receptor agonists (Rybelsus®, Ozempic®, Trulicity®, Byetta®, Bydureon®, Adlyxin®, and Victoza®). Taking multiple drugs in this class together can enhance the adverse/toxic effects of these medications. If you are pregnant or plan on becoming pregnant, you should avoid GLP-1s.

If you are already taking a DPP-4 inhibitor (Januvia®, Tradjenta®, Onglyza®, Nesina®), adding a GLP-1 is not recommended due to limited benefits. However, a switch to a GLP-1 from a DPP-4 inhibitor could be appropriate. Patients with a personal or family history of medullary thyroid carcinoma or a rare condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN-2) should also avoid these drugs.

Bottom Line

For patients struggling with obesity, GLP-1 medications provide a new treatment option that may be effective. If you are interested in exploring whether a GLP-1 drug may be able to help you with weight management, consult with your health provider.

References

Ard, J. (2015). Obesity in the US: What is the best role for primary care? BMJ: British Medical Journal, 350. Retrieved July 6, 2021, from https://www.jstor.org/stable/26518153

https://www.cdc.gov/healthyweight/effects/index.html

https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014

https://www.fda.gov/drugs/drug-safety-and-availability/fda-approves-weight-management-drug-patients-aged-12-and-older

https://www.cdc.gov/obesity/data/adult.html