Chances are, you know someone who is using a weekly injectable medication for weight management – or maybe you are already taking one yourself! These blockbuster medications (known collectively as GLP-1 receptor agonists), have been remarkably effective at helping people all over the world shed unwanted pounds and achieve a healthier weight. Many people think these medications are brand-new to the market, but the FDA actually approved the first GLP-1 agonist (exenatide, branded as Byetta) in 2005. These medications initially were approved as a treatment for diabetes and work by mimicking the GLP-1 hormone, which is secreted from the intestine. They activate GLP-1 receptors, which then results in:
- Slowed gastric emptying , so you feel full for a longer period of time
- Decreased ‘food noise’ in your brain, thereby increasing the feeling of satiety
- Enhanced insulin release from your pancreas, thereby lowering the amount of blood sugar in your body
The weight loss benefit from these medications was found to be substantial, so in 2014, the first GLP-1 agonist (liraglutide – branded as Saxenda) – was approved for weight loss in non-diabetics. Since then, other medications have become available on the market. Of the 3 currently on the market today for weight management (Saxenda, Wegovy, and Zepbound), Zebpound has been shown to the the most effective. In the first head-to-head comparison trial between Wegovy and Zepbound, after 72 weeks, adults using Zebpound lost on average 20.2% of their weight, compared to 13.7% with Wegovy. Most people don’t use Saxenda anymore since it requires a daily injection, whereas Wegovy and Zepbound are once-weekly injections. Zepbound is slightly superior to Wegovy because it mimics not only the GLP-1 hormone, but also a second gut hormone (GIP), which increases insulin sensitivity.
Over time, more benefits of these medications beyond weight loss have continued to be identified. In March 2024, the FDA approved a new indication for use for Wegovy (semaglutide): to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and either obesity or overweight. Also, it turns out that since GLP-1 receptors are also present in the brain, these medications may play a role in addiction treatment. There are currently clinical trials underway to assess the effectiveness of these GLP-1 receptor agonists in the treatment of substance and alcohol use disorders.
While GLP-1 RAs can benefit most people who struggle with obesity, there are potential side effects that can be significant (particularly GI side effects), and there are also people for whom these medications would not be appropriate. Also, these medications work most effectively when combined with a healthy lifestyle that includes regular exercise activity and a balanced, nutritious diet.
Here at Wayland Personal Physicians, we have experience prescribing, managing, and monitoring these medications. We encourage you to schedule an appointment with your personal physician if you’d like to learn more about how these medications can help you achieve a healthier life!