GLP-1 Weight Loss medications are the biggest advancement in the medical treatment of weight loss since the advent of Bariatric Surgery in the 1980’s. Our practice has embraced these medications and we routinely prescribe them for preoperative Bariatric Surgery patients, postoperative patients and plenty of patients who are not interested in Bariatric Surgery at all.
GLP-1 medications are a class of drugs that stimulate our Glucagon Like Peptide type 1 (GLP-1) receptors. There are many different GLP-1 agonist medications that are approved for use in the United States. The most commonly used are Mounjaro (tirzepatide), Semaglutide (Wegovy, Ozempic an Rybelsus) and liraglutide (Victoza or Saxenda). Insurance companies are starting to cover these medications for weight loss.
GLP-1 is a hormone that is typically released after a meal and works to increase our metabolism and decrease our appetite. The GLP-1 that we release naturally is relatively short-lived – our body will metabolize it within a few hours. However, the GLP-1 agonist medications that are currently being used for weight loss are very slow to be broken down in our body. A single injection of Mounjaro or Wegovy can last for over a week, driving continuous changes in our hunger, metabolism and food preferences.
There is a lot about weight loss that these medications can teach us. While GLP-1 medications are relatively new, the idea of intestinal hormones driving durable weight loss is not. Our initial belief that Bariatric Surgery drives weight loss through restricting calorie intake or preventing calorie absorption has been proven wrong. We now recognize that weight loss after Bariatric Surgery is caused by a change in the way our body responds to and releases many different intestinal hormones as a result of the anatomic change made in the operating room. GLP-1 has long been recognized as one of the hormones that change significantly after Bariatric Surgery.
I’ve written extensively about intestinal hormones and their effect on our body weight for nearly a decade. My first book, A Pound of Cure discussed how a nutrient-dense diet can alter the levels of these hormones and help drive durable weight loss without requiring calorie restriction. The Pound of Cure program was developed after listening to patients discuss the change in their food preferences after surgery. The surgery resulted in hormonal changes that favored weight loss and these hormonal changes encouraged my patients to choose nutrient-dense foods over calorie-dense, processed foods.
I’m now seeing the exact same response in my patients who we start on GLP-1 agonist medications. I’m seeing many people who’ve struggled for decades to make the right food choices easily choosing vegetables and fruit over fast food and sweets. These medications do not just work by decreasing your appetite – they also encourage you to make better choices about the foods that you eat.
This concept of hormonal shifts triggering weight loss and changing taste preferences is critical to our understanding of what we should be eating and also why we eat what we do. I’ve long believed that nutritional changes were driven by much more than willpower and determination. What we eat is determined as much, if not more, by our biology than it is by our decision-making. Making good food choices and developing the right mindset are very important for anyone who is trying to lose weight, but it turns out, weight loss medications and weight loss surgery can make these changes a lot easier.
There is so much that you can learn about the right way you should be eating once you start taking GLP-1 medications. I’ve always respected the idea of intuitive eating where we are mindful of our hunger and how food makes us feel, but the problem is, our first intuition is often a cheeseburger and fries or a piece of chocolate cake. Rejecting our primal drive for calories is a battle most of us spend our lives fighting. Once you start GLP-1 medications, this primal drive decreases and allows us to align our hunger drive and food preferences with our weight loss efforts.
Our practice offers a nutrition program that is open to anyone, anywhere, not just our patients. We’ve found that the same Pound of Cure program that was initially designed to help post-Bariatric Surgery patients maximize their weight loss is equally effective in helping patients using GLP-1 agonist medications reduce the side effects (nausea) of these meds and maximize weight loss. We offer nutritional support groups for people taking GLP-1 medications through our nutrition program.
To fully harness the power of GLP-1 medications, you must make substantial changes to your diet and change your mindset. The good news is that these medications make these changes much easier.