What is GLP 1? Registered Dietitian Review

By: Hannah Abdulla BS, RD

Photo by RF._.studio

What is GLP 1?

Glucagon-like peptide (GLP-1) is a hormone our body naturally produces. Glucagon-like peptide receptor treatment is a Food and Drug Administration (FDA) approved treatment for individuals with type two diabetes designed to mimic the natural hormone.

 The role of the naturally occurring hormone is to stimulate insulin production when blood sugar levels begin to rise. This hormone is often lacking in diabetic patients, thus the medication steps in. For diabetics, this medication will help the individual to maintain safe and stable blood sugar levels.

Mechanisms of action

The GLP-1 mechanism of action in terms of weight loss is not yet fully clear, according to the Centers for Disease Control (CDC). Once injected, it is thought GLP-1 reaches the hypothalamus in the brain and binds to receptors on neurons responsible for suppressing appetite. This is likely what leads to the medications having appetite suppressant side effects which may result in decreased food consumption and increased feelings of fullness.

Side Effects

There are numerous GLP-1 medications available including, but not limited to Semaglutide, Dulaglutide, Rybelsus, and Exenatide. The side effects listed by the FDA for GLP-1 medications vary depending on the medication selected. These side effects include increased risk of thyroid c-cell tumors, hypoglycemia, acute kidney injury, gastrointestinal issues and more.

The CDC does not recommend GLP-1 medications for those with family history of thyroid cancer, multiple endocrine neoplasia, or pancreatitis.

Is it FDA approved?

Yes and no. In 2014 the first GLP-1 medication was approved by the FDA for weight loss in individuals without diabetes. Since 2014, several other GLP-1 medications have been approved, but not all of them.

Pricing

According to a publication by The New England Journal of medicine, the cost for weekly injections is approximately $400. This totals over $20,000 annually. 

Does it work?

Clinical trials have shown several GLP-1 medications to be effective for weight loss when combined with lifestyle and behavioral interventions. A study published by the New England Journal of Medicine took 2,000 non-diabetic patients with a BMI over 30 who were randomized in a placebo group and a Semaglutide group. Results were reviewed after one year to find the placebo group had minimal change, while the Semaglutide group averaged 13kg of weight loss. However, these successes come at a cost. Nearly half of participants reported gastrointestinal issues such as nausea, vomiting and diarrhea. Additionally, it is important to note when individuals stopped taking GLP-1 they regained weight.

When considering the cost and side effects of GLP-1 medications for non-diabetic individuals seeking weight loss, we believe the first approach should be lifestyle and behavioral modifications with the help of a Registered Dietitian. Working with a Registered Dietitian will provide a tailored non-invasive approach to achieving health goals.

Sources

GLP-1 agonists: Diabetes drugs and weight loss - Mayo Clinic

FDA approves first oral GLP-1 treatment for type 2 diabetes | FDA

Another GLP-1 Receptor Agonist for Weight Management (jwatch.org)