GLP-1 medications (like Ozempic and Wegovy) manage Type 2 diabetes and obesity. They also protect the heart and kidneys in people with higher risks. Ask a clinician who knows your medical history if a GLP-1 could benefit you.
If you’re wondering if you should take a GLP-1, you’re not alone. Whether it’s health news of another GLP-1 benefit, talk from family or friends, or basically anywhere online, GLP-1s are everywhere and on lots of minds. They’ve become game-changers in diabetes and obesity care, transforming how we think about chronic disease. And they’ve become household names in ways that very few medications ever do.
Already, at least 1 in 8 American adults [archived link] have taken a GLP-1 and more than half would qualify to take one, according to the latest estimates [archived link]. But GLP-1s aren’t right for everyone. And no one should feel pressured either way. The decision to start a GLP-1 is individual, based on your own risks and benefits. It’s also a personal decision based on your own preferences. Talking with a clinician who knows your full medical history is the best way to learn whether a GLP-1 might benefit you. In this post, we’ll share some points to help you have the conversation if you decide to.
✨ Going forward, we’ll call GLP-1 medications by their drug class name, GLP-1 RA, which is short for glucagon-like peptide-1 receptor agonists. These medications aren’t exactly the same as the GLP-1 your body makes — and that’s a good thing. The GLP-1 released from the gut after eating only hangs around for a minute or two [archived link]. GLP-1 RAs are designed to last much longer, from the time you take one dose until the time the next is due.
Although not identical, GLP-1 RAs act just like the natural GLP-1 form. They attach to the same receptors (binding sites) and cause the same effects. That’s why the medication forms are receptor agonists. Below, we discuss the effects that GLP-1 RAs have and how they work for diabetes and weight loss. But keep in mind, GLP-1 receptors are located throughout the body. Figure 1 shows some of their effects. GLP-1 RAs are more than weight-loss medications. And they do more than lower blood glucose. They work in complex ways that we’re still learning about!
Source: https://tinyurl.com/mrxacsaj [archived link]
➡️ FDA-APPROVED GLP-1 RAs
Did you know the first GLP-1 RA was approved 20 years ago [archived link]? But it wasn’t until semaglutide hit the market (first as Ozempic [archived link] in 2017 followed by Wegovy [archived link]) in 2021) that GLP-1 RAs captured the world’s attention.
Early GLP-1 RAs (exenatide) [archived link] and exenatide ER [archived link]) were designed after a GLP-1 version found in Gila monster venom [archived link]. Newer GLP-1 RAs like semaglutide are copied after the human GLP-1 form. The most recently approved type, tirzepatide [archived link], is called a “dual agonist” because it mimics the effects of two gut hormones, GLP-1 and GIP (glucose-dependent insulinotropic polypeptide).
Check out Figure 2 below to see the names of specific GLP-1 RA medications and what they’re approved to treat.
FIGURE 2: FDA-APPROVED GLP-1 RA MEDICATIONS
Source: FDA-approved labeling for each medication (as of March 2025)
✨ You can calculate your BMI from height and weight using this online BMI calculator[archived link]. BMI is one tool used to decide who might benefit from taking a GLP-1 RA for weight loss. But BMI is far from perfect and shouldn’t be the only consideration. BMI can over and underestimate body fat [archived link] since it doesn’t distinguish fat from bone and muscle mass. And BMI also doesn’t factor in body fat distribution or consider other health conditions.
➡️ REASONS TO CONSIDER TAKING A GLP-1 RA
Your clinician can help you decide if starting a GLP-1 RA is right for you. Make sure they know your complete medical history and list of current medications.
💡 GLP-1 RAs are chronic medications for long-term use. Most experts recommend taking them indefinitely, the same way people do blood pressure medication.
Below are general points to consider for each FDA-approved use.
The discussion here is limited to FDA-approved uses in adults.
✅ You have Type 2 diabetes.
Your clinician might recommend a GLP-1 RA as part of your Type 2 diabetes care plan. It can be used alone or in combination with other diabetes medication(s).
GLP-1 RAs lower blood glucose. They mainly do this by causing your body to release more insulin while also helping your body respond better to insulin. They also lower glucagon release — a hormone that can raise blood glucose [archived link]. But they work in other ways too, such as by promoting weight loss.
The American Diabetes Association (ADA) recommends [archived link] GLP-1 RAs as first-choice Type 2 diabetes medication options in many cases. Many people living with diabetes also have overweight or obesity and higher risks of kidney [archived link] or heart disease [archived link]. GLP-1 RAs help manage these interconnected chronic conditions.
Diabetes medication is only one part of a treatment plan. The ADA also considers learning about diabetes and getting lifestyle and nutrition support core parts of a diabetes care plan [archived link]. Housing, healthcare, and food security are likewise essential. That’s why the ADA says social determinants of health (SDOH) should be assessed for everyone with diabetes to connect them with available help and resources. Contributing writer MacKenzie Isaac explains SDOH further in this TNG post.
✅ You have weight-loss health goals.
GLP-1 RAs are first-choice medications [archived link] to help adults achieve (and maintain) weight loss. They’re approved for use alongside lifestyle changes, including increased physical activity and decreased caloric intake (usually eating 500 fewer calories per day).
The main way GLP-1 RAs cause weight loss is by helping you eat less. They make food move more slowly through your gut so you feel full for longer. And they also work in the appetite center of the brain to help curb food cravings and “food noise” (constant nagging thoughts of food and eating).
GLP-1 RAs help people lose weight better than lifestyle changes alone, and they work better than other types of weight-loss medication. But note, not everyone experiences the large amounts of weight loss from GLP-1 RAs you may have heard about. However, losing as little as 5% of body weight can have health benefits. So if you weigh 180 pounds (81.6 kilograms), that would mean losing at least 9 pounds (4 kilograms).
Another point to consider is that more weight loss is not necessarily better. Weight loss includes some loss of lean body mass from bones and muscles. And too much weight loss might mean you’re not eating enough of the nutrients needed to support health. Your clinician can help you know if you’d benefit from weight loss, and if so, how much. They can also suggest an eating pattern and exercise plan to support your health goals and preferences. Muscle-strengthening types of exercise, in particular, are an important way to keep your bones strong [archived link].
💡 Studies show people usually regain weight [archived link] after stopping GLP-1 RAs. But that doesn’t mean [archived link] it’s guaranteed to happen or that you have to take a GLP-1 RA forever. Your clinician can guide you if you want (or need) to stop treatment. They might suggest a trial, gradually lowering your GLP-1 RA dose and seeing how your body adjusts. This approach can also help you see if a lower maintenance dose would work for you.
Weight stigma is commonly reported [archived link] in healthcare settings. “Health at every size” [archived link] is one approach suggested for making healthcare more inclusive.
Obesity is complex with many causes. It is not a “lifestyle choice.” Finding a clinician without anti-fat bias [archived link] who is concerned about your overall health and addresses underlying causes is important — regardless of whether you take a GLP-1 RA medication.
✅ You have a higher risk of kidney and/or heart disease.
Increasingly, we’re learning GLP-1 RAs have an important role in managing a common set of chronic diseases called CKM, or cardiovascular-kidney-metabolic syndrome [archived link]. Research suggests GLP-1 RAs help protect organs from inflammation [archived link].
Several GLP-1 RAs have additional FDA approval for:
- Heart protection: Dulaglutide [archived link], liraglutide [archived link], and semaglutide [archived link] have been proven to prevent strokes and heart attacks in people with risk factors, such as diabetes or obesity.
- Kidney protection: About 1 in 3 people [archived link] with diabetes also have kidney disease. Studies show people taking semaglutide for Type 2 diabetes prevented kidney disease [archived link] from getting worse.
💡 More approved uses may come. GLP-1 RAs are being studied [archived link] for use in many other medical conditions, including fatty liver disease, Parkinson’s disease, and substance use disorders, among others. What’s more, over a dozen potential new GLP-1 RAs are being developed [archived link].
✅ You have sleep apnea.
Zepbound (tirzepatide) was recently approved for sleep apnea [archived link]. The American Academy of Sleep Medicine [archived link] says Zepbound is only helpful for sleep apnea when it’s obesity-related.
➡️ WHO SHOULDN’T TAKE A GLP-1 RA?
GLP-1 RAs shouldn’t be taken by anyone with a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome. GLP-1 RAs also shouldn’t be taken when there’s no likely health benefit. Otherwise, you’d only be exposing yourself to possible risks.
Your clinician will help you weigh your own risks of side effects with the likely benefits of treatment to help you decide if taking a GLP-1 RA makes sense for you. Common GLP-1 RA side effects are usually mild to moderate and often get better over time as your body adjusts. Most are gut-related, like nausea, heartburn, and diarrhea or constipation. But more serious rare risks are also possible, including pancreatitis and stomach or gallbladder problems. Although GLP-1 RAs have been on the market for 20 years, it’s also possible new risks may emerge as more people take GLP-1 RAs over many years.
✨GLP-1 RAs aren’t recommended during pregnancy or while nursing. If you have the potential to become pregnant, discuss your birth control plans with your clinician before starting treatment. Tirzepatide can interact with oral contraceptives making them temporarily less effective [archived link]. Your clinician can guide you on managing this interaction. They can also help you plan for a future pregnancy and may recommend waiting for a period of time after stopping a GLP-1 RA before trying to get pregnant. This “wash-out period” helps ensure the medication is fully cleared from your body before pregnancy.
➡️ HOW TO GET A GLP-1 RA
One of the biggest challenges with GLP-1 RA is their cost and accessibility. Talking with your primary care clinician is the best place to start. If treatment is appropriate for you, they can prescribe one and discuss the best way to afford it. Clinicians who specialize in diabetes or obesity care are great options if available to you.
While talking with your own clinician is best, many people don’t have access to one. Increasingly, for-profit telehealth companies are filling the void. If you seek care this way, it’s important to make sure the clinician treating you is licensed, knows your medical history, and considers your overall health needs.
Getting your GLP-1 RA prescription filled at a state-licensed pharmacy that dispenses an FDA-approved product is safest. The ADA doesn’t recommend [archived link] compounded GLP-1 RAs due to “uncertainty about their content, safety, quality, and effectiveness.” The FDA has warned [archived link] about counterfeit and harmful GLP-1 RAs being sold online. Check out their BeSafeRx website [archived link] for tips on safely purchasing prescription medications online.
If you have GLP-1 insurance coverage, your prescriber can help you choose which option might be most affordable. With 10 GLP-1 RA products on the market, including a semaglutide tablet [archived link], sometimes one medication may have a lower copay than another. Likewise, you might be able to get your GLP-1 RA approved based on one of your conditions rather than another.
Without insurance, few people can afford to take a GLP-1 RA. Even FDA-approved generic versions come with a high retail price. For example, a month’s supply of generic Victoza [archived link] costs around $700 [archived link]. Note: Liraglutide’s weight-loss version, Saxenda [archived link], is still brand-only.
Having insurance doesn’t guarantee GLP-1 RA coverage, though. Many insurances, including Medicare, don’t cover any medications used for weight loss alone (though there are proposals to change this). Medicaid coverage varies by state [archived link], and few states cover weight-loss medications. And even when GLP-1 RAs are covered, they may still have high out-of-pocket costs.
Understandably, many people have turned to non-traditional sources to find more affordable GLP-1 RAs. Several years ago, the FDA began allowing [archived link] certain types (503A) of compounding pharmacies to make and sell copies of some branded GLP-1 RA products that were in shortage. Since then, shortages have ended, and the FDA says [archived link] the non-approved compounded versions can no longer be made and sold. In response, a trade group representing compounding pharmacies is suing the FDA.
Recently, manufacturers of Zepbound and Wegovy [archived link] have begun selling their products directly to consumers who have prescriptions but lack insurance coverage. The monthly cash-pay prices are significantly lower than retail but still high at around $500. For people trying to start or continue taking GLP-1 RA medication, access issues are incredibly distressing, especially because GLP-1 RAs are meant to be taken regularly and long-term.
Access issues have major consequences. One study estimated that just in the U.S. alone, over 42,000 deaths [archived link] could be prevented each year if everyone who might benefit from taking a GLP-1 RA had access. People who are most likely to benefit from a GLP-1 RA are sometimes the least likely [archived link] to have access to them. In a future TNG post, contributing writer MacKenzie Isaac, a doctoral student in population health, will cover equity issues surrounding GLP-1 RA access.
Stay informed. Stay med-safe. And stay GLP-1 wise.
Further reading:
Oh Oh Oh Ozempic-is there anything GLP-1 drugs can’t do? by TNG Founding Member Jennifer Dowd!
Taking a GLP-1? Here are foods to limit — and what to prioritize [archived link]
Does Ozempic help with prediabetes? [archived link]
Can New Drugs Help Millions of Americans with Obesity? [archived link]
Link to Original Substack Post
