The Metabolic Classroom with Dr. Ben Bikman

GLP-1 Medications Explained: Benefits, Risks, and What You Need to Know

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Jan 23, 2025

Explore the fascinating role of GLP-1, a hormone vital for appetite regulation and blood sugar stability. Discover how GLP-1 receptor agonists like semaglutide are making waves for weight loss with impressive results. However, there's a catch—these drugs can lead to muscle loss and may have side effects such as depression. Learn about the diminishing effectiveness over time and the importance of pairing medication with healthy eating and resistance training to achieve sustainable results.

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INSIGHT

GLP-1 and its Agonists

GLP-1 receptor agonists, like semaglutide and liraglutide, are effective for weight loss and diabetes management.
These drugs mimic GLP-1, a hormone that slows digestion, suppresses glucagon, and regulates appetite.

INSIGHT

GLP-1: A Multitasking Hormone

GLP-1, or glucagon-like peptide 1, is produced in the intestines in response to food.
It slows gastric emptying, leading to prolonged fullness and regulated blood sugar.

INSIGHT

GLP-1's Effect on Glucagon

GLP-1 suppresses glucagon, a hormone that raises blood sugar.
By inhibiting glucagon, GLP-1 stabilizes blood sugar and improves insulin sensitivity.

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Dr. Bikman’s Metabolic Classroom lecture this week explores the physiological role and implications of GLP-1 (glucagon-like peptide-1) and the GLP-1 receptor agonist drugs used for type 2 diabetes management and weight loss.

Ben begins by explaining GLP-1 as a hormone produced in the intestines in response to food. It plays a vital role in slowing gastric emptying, suppressing glucagon, and regulating appetite by signaling fullness to the brain. These mechanisms contribute to its effects on stabilizing blood sugar and enhancing insulin sensitivity.

He then delves into GLP-1 receptor agonists, drugs that mimic GLP-1’s actions, including semaglutide, liraglutide, and others marketed under brand names like Ozempic and Wegovy. These medications have gained fame for their weight loss efficacy, often leading to reductions in body weight by 15% or more.

However, Ben emphasizes that weight loss involves not only fat but also lean mass, raising concerns about muscle loss and metabolic health. Additionally, he discusses the medications’ side effects, including depression, anhedonia, and potential long-term complications like fat cell development and gallstones.

The lecture also addresses the diminishing returns of these drugs over time, noting that their efficacy in reducing cravings and improving eating control tends to wane after prolonged use. Dr. Bikman highlights that education on healthy eating and resistance training is crucial for maintaining health outcomes, as reliance solely on medication can lead to unintended consequences, such as increased fat regain after discontinuation.

Ben concludes by stressing the importance of combining these drugs with a low-carb diet and resistance training to minimize muscle loss and optimize long-term outcomes. He encourages using the lowest effective dose and underscores the need for lifestyle changes to complement pharmacological interventions.

Show Notes/References:

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