While glucagon-like peptide-1 medications – better known as GLP-1s – have been around for years, they have only relatively recently come to the forefront as a successful weight loss treatment.
That said, GLP-1s are still evolving as a treatment method for weight loss, and at Longstreet Clinic Center for Weight Management, providers note that, while GLP-1s offer some incredible results, patients should be aware of all aspects of this medication – and not view them as a “magic bullet” for all weight concerns.
As Center for Weight Management nurse practitioner Maria Mercedes Hall, FNP-C, notes, GLP-1s still must be viewed as part of an overall approach to weight loss – one that requires the patient to accept lifestyle changes. And while new developments in GLP-1 use are exciting, including the appearance of an oral version of the medication and increased Medicare coverage, it is important to evaluate all aspects of GLP-1s before determining if they are the right choice for you.
“GLP-1 medications can be a powerful tool when used in combination with healthy lifestyle changes. They work directly on the hormones involved in hunger and satiety, helping to reduce hunger cues, cravings, and ‘food noise.’ By giving you better control over hunger, they can make it easier to focus on what truly matters: choosing high-quality, nourishing foods, prioritizing protein and nutrition, and staying active,” Hall said, noting that long-term weight loss success depends on adapting numerous facets of your life.
“The goal isn’t simply to lose weight — it’s to improve your overall health and body composition by preserving or building muscle while reducing excess body fat. GLP-1s can help create the foundation, but your nutrition, strength training, and daily movement are what help drive long-term results.”
When it comes to achieving these results, GLP-1s have proven a powerful tool for numerous patients. But these patients still fit into very precise criteria. And GLP-1s should not be viewed as the right choice for every patient. For instance, beginning a GLP-1 regimen demands that you still adjust your diet, sometimes in both the types and amounts of foods and beverages you consume.
“Gastrointestinal side effects such as nausea, bloating, constipation, diarrhea, and reflux can occur and may worsen with large portions or foods high in fat, sugar, and refined carbohydrates,” Hall said. “Prioritizing protein, fiber, hydration, smaller portions, and nutrient-dense foods can improve tolerability.
“GLP-1s are not appropriate for everyone. They should be avoided in people with a personal or family history of medullary thyroid cancer (MTC) or MEN2, and certain conditions, such as severe gastroparesis, require caution. A history of pancreatitis or gallbladder disease should also be discussed with your provider.”
The same goes for the latest development in GLP-1: oral medication. Previously only available as an injectable medication, patients may now access Wegovy tablets and Foundayo.
These advancements may offer a perfect alternative for patients who prefer a pill over an injection or want added convenience, especially when traveling.
“Oral Wegovy contains the same active ingredient as injectable Wegovy (semaglutide), while Foundayo (orforglipron) is a different, non-peptide GLP-1 receptor agonist,” Hall said. “Both have demonstrated meaningful weight loss when combined with healthy nutrition and physical activity.”
Foundayo may also offer a route to success for weight loss patients who are undergoing menopausal stages, including perimenopause and post menopause, which is especially relevant for women experiencing changes in weight and body composition during this transition. Again, however, providers will still need to approach any type of weight treatment with a full understanding of the patient’s health history.
“These medications aren’t necessarily for a specific ‘type’ of patient — the best option depends on your medical history, treatment goals, preferences, and eligibility for anti-obesity medication,” Hall said.
Perhaps the most encouraging recent development related to GLP-1s is financial. Recently, Medicare began to offer the GLP-1 Bridge, which may provide eligible Medicare Part D beneficiaries with certain GLP-1 medications for weight management for $50 per month.
In general, eligibility requires that the patient in question possess:
- A Body Mass Index (BMI) equal to or greater than 35.
- A BMI equal to or greater than 30 with heart failure with preserved ejection fraction, uncontrolled hypertension, or chronic kidney disease (stage 3a or higher).
- A BMI equal to or greater than 27 with prediabetes, prior heart attack, stroke, or symptomatic peripheral artery disease.
“To receive the Medicare Bridge, prior authorization is required, and the medication must be used along with nutrition and physical activity,” Hall said. “If you have Medicare and are considering a GLP-1, you can come see us, or talk with your healthcare provider to determine if you meet the criteria and whether this treatment is appropriate for you.”
To talk with a weight loss provider or to learn more about GLP-1s, please contact the professional, caring staff at Longstreet Clinic Center for Weight Management by calling 770-534-0110.
