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Last updated: May 03, 2022
4 min read

GLP-1 agonists: diabetes medication for weight loss 

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

GLP-1 agonists (also known as glucagon-like peptide-1 receptor agonists) are medications that were initially developed to manage type 2 diabetes

Research has shown that when combined with lifestyle changes like diet and exercise, some of these medications are effective at helping people manage their weight, too. To learn more about diabetes medication for weight loss, we spoke to Ro’s resident metabolic health expert, Dr. Raoul Manalac, M.D., about how these drugs work and if they’re a good option.

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Can diabetes medication help you lose weight?

There are many types of diabetes medications, but the short answer to whether these drugs can help you lose weight is yes. 

“GLP-1 agonists are some of the most powerful medicines for weight management that we have to offer,” says Dr. Manalac, senior director of clinical experience for metabolic health at Ro. 

These drugs were originally developed to help people with type 2 diabetes regulate blood sugar. A side effect researchers noted was those taking these medications often experienced weight loss, too (Vilsbøll, 2012). 

This side effect is a welcome one for some since type 2 diabetes is closely associated with overweight and obesity, which affects 86% of people with the condition (Daousi, 2006). That, and weight loss has been shown to be an effective tool for managing diabetes (Aucott, 2008). 

But what about people without diabetes? Can you use diabetes medication for weight loss if you don’t have the condition? Dr. Manalac says they can. 

The U.S. Food and Drug Administration (FDA) has approved semaglutide (brand name Wegovy) for weight management in people with at least one weight-related condition like high blood pressure, diabetes, or high cholesterol. That means that even people without diabetes can get a prescription for the medication (FDA, 2021).

How do GLP-1 agonists help with weight management?

Researchers aren’t entirely sure yet, but there are a couple of mechanisms that could be at play. 

“They take advantage of the body’s hormonal pathways involved with sugar processing and how food travels through the body,” says Dr. Manalac. “These actions can improve blood sugar and help people feel more full after meals.” 

Researchers suggest that GLP-1 agonists slow down gastric emptying, which is how quickly food moves from your stomach into the rest of your digestive system. This helps with weight loss by keeping food in the stomach for more time, so you eat less.

“These can help patients feel more full for longer or more full on less food,” says Dr. Manalac, “and help patients feel more confident about making lifestyle changes––particularly dietary changes that play an important role in weight management.”

Another theory is that other side effects of GLP-1s (particularly nausea and vomiting) contribute to weight loss. 

As with any approach to weight management, lifestyle changes are key: GLP-1 agonists should be combined with diet and exercise to be effective.

Which diabetes medications work for weight loss?

There are five types of GLP-1 agonists currently in use, and all have been shown to help with weight loss. These include (Htike, 2017): 

A large review study concluded all of these medications were more effective than a placebo for weight loss. While there were few differences between drugs in how much weight participants lost, some drugs were more effective than others.

Currently, only liraglutide and semaglutide are FDA-approved for weight management. 

Both are effective, though studies have found that semaglutide led to more weight loss than liraglutide. The other GLP-1s mentioned can be prescribed off-label for weight loss in people without diabetes. 

Side effects of GLP-1 agonists

Whether you’re using diabetes medication for weight loss, blood sugar management, or both, there is a risk for side effects. Common side effects include: 

  • Nausea
  • Vomiting
  • Diarrhea 
  • Feeling full
  • Skin reaction at the injection site

Some of these side effects, like nausea, go away over time or can be alleviated by reducing the dosage (Collins, 2021; FDA, 2021). Less frequently, people have reported other issues including: 

  • Dizziness
  • Headache
  • Indigestion
  • Constipation
  • Abdominal pain
  • Mild tachycardia (heart palpitations or pounding)

These are not all of the side effects of GLP-1 agonists. If you’re taking any of these drugs and experience side effects, consult with your healthcare provider.

Some people should not use GLP-1 agonists. This includes pregnant women. Diabetes drugs are also not recommended for people with pancreatitis, a history of medullary thyroid cancer, or multiple endocrine neoplasia type 2 (MEN2) (Collins, 2021).

The bottom line 

There are differences among GLP-1 agonists. Your healthcare provider can discuss these with you to determine if they’re the right treatment. Whether you are considering these medications for diabetes treatment, weight loss, or both, a tailored approach is necessary to achieve the best results. 

References

  1. Aucott, L. S. (2008). Influences of weight loss on long-term diabetes outcomes. The Proceedings of the Nutrition Society, 67(1), 54–59. doi:10.1017/S0029665108006022. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18234132/
  2. Collins, L. & Costello, R. A. (2021). Glucagon-like Peptide-1 Receptor Agonists. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551568/
  3. Daousi, C., Casson, I. F., Gill, G. V., et al. (2006). Prevalence of obesity in type 2 diabetes in secondary care: association with cardiovascular risk factors. Postgraduate Medical Journal, 82(966), 280–284. doi:10.1136/pmj.2005.039032. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579635/
  4. Htike, Z. Z., Zaccardi, F., Papamargaritis, D., et al. (2017). Efficacy and safety of glucagon-like peptide-1 receptor agonists in type 2 diabetes: A systematic review and mixed-treatment comparison analysis. Diabetes, Obesity and Metabolism, 19(4), 524–536. doi:10.1111/dom.12849. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27981757/
  5. U.S. Food and Drug Administration (FDA). (2021). FDA approves new drug treatment for Chronic Weight Management, first since 2014. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-treatment-chronic-weight-management-first-2014 
  6. Vilsbøll, T., Christensen, M., Junker, A. E., et al. (2012). Effects of glucagon-like peptide-1 receptor agonists on weight loss: systematic review and meta-analyses of randomised controlled trials. BMJ, 344, d7771. doi:0.1136/bmj.d7771. Retrieved from https://pubmed.ncbi.nlm.nih.gov/22236411/