GLP-1 medications are everywhere—in the news, on social media, and in conversations with friends and family sharing their results. Originally developed to treat diabetes, they've become a breakthrough for weight loss and overall health.
Richard Siegel, MD, an endocrinologist at Tufts Medicine Weight + Wellness in Stoneham, explains how GLP-1 medications work, the latest advances, and how to know if one might be right for you. Here's what's new.
Heart-health benefits of GLP-1 medication
GLP-1 medications are offering more than weight loss — they're showing meaningful benefits for long-term heart health. In a large research trial, adults with obesity and established heart disease (but not diabetes) who took semaglutide (Wegovy) once a week had about a 20% lower risk of heart attack, stroke or cardiovascular-related death.
Options that help protect muscle
Losing weight while keeping your strength is key to staying healthy as you age. Researchers are studying a new combination of medications—semaglutide paired with bimagrumab—that may help people lose fat while preserving more muscle.
Safer, more reliable use
With improved supply of FDA-approved GLP-1 medications, fewer people need to rely on compounded versions. FDA-approved treatments must meet strict safety and quality standards —something compounded versions don't always follow.
Recent research from the SELECT trial also suggests that semaglutide may have kidney-protective benefits, offering another reason to use regulated medications whenever possible.
GLP-1 pills on the horizon
A new generation of GLP-1 medications is on the way, and some of them are pills instead of injections. One of the most promising is orforglipron, a once-daily tablet. In a recent Phase 3 study, people taking orforglipron lost about 12% of their body weight over 72 weeks and saw improvements in blood pressure, cholesterol and inflammation. For anyone who prefers not to use injections or has limited access to refrigeration, an oral option could make treatment feel much easier.
Researchers are also finding heart-health benefits with oral GLP-1 medications. In one study, oral semaglutide was linked to a 14% lower risk of heart attack, stroke or cardiovascular-related death. This early evidence suggests that GLP-1 medications may support long-term heart and vascular health in addition to helping with weight loss.
More conditions approved for treatment
Researchers continue to discover new ways GLP-1 medications can support health beyond weight loss. Tirzepatide (Zepbound) is now approved for adults with obesity who also have obstructive sleep apnea (OSA). A recent study found significantly reduced breathing interruptions during sleep, lowered inflammation and improved patient-reported sleep quality.
GLP-1 benefits for whole-body health
GLP-1 medications may offer benefits that include:
- meaningful weight loss
- improvements in blood sugar for people with type 2 diabetes
- lower blood pressure, cholesterol and inflammation
- a possible reduction in the risk of heart attack or stroke with certain medications
- reduced hunger and cravings, including what many people call "food noise," which is the constant mental chatter around food or urges to eat when you're not hungry
- more options for how and when to take them as new treatments become available
"One of the biggest surprises for patients is how much quieter their minds feel around food," Dr. Siegel says. "When that constant pull toward eating eases, people often feel a sense of control they haven't had in years."
Things to consider before starting GLP-1 medication
Common GLP-1 side effects
Many people experience nausea, diarrhea, constipation or vomiting when they begin the medication or increase the dose. These symptoms usually improve with time.
Muscle loss
Some muscle loss can happen with any weight-loss approach. Your care team can help you maintain muscle through nutrition and strength-building activities.
A long-term weight loss plan
Most people need to stay on GLP-1 medications to maintain their weight loss. Stopping the medication often leads to weight regain.
"These medicines work best when we think of them as long-term tools, They support the lifestyle changes that help people stay healthy."
Dr. Richard Siegel
Be cautious with compounded products
Compounded medications are not the same as FDA-approved products. They may not meet the same safety standards. Always talk with your clinician before considering a compounded version.
Insurance and cost of GLP-1 medications
Coverage varies by plan. Some require a certain BMI, medical condition, or trial of other weight loss medications before use. Your care team can help you understand your benefits.
Who can benefit from GLP-1 medications
You may be a candidate for GLP-1 weight loss medication if you are:
- an adult with obesity
- someone who is overweight with a related health condition like high blood pressure, high cholesterol or type 2 diabetes
- living with obstructive sleep apnea and obesity
- someone who has tried lifestyle changes without enough improvement
- ready to follow a long-term treatment plan with medical support
Frequently asked questions
What is a GLP-1 medication?
It's a medication that acts like a natural hormone in your body to help control blood sugar, slow digestion and reduce appetite.
How do GLP-1 medications work?
GLP-1 medications act like a natural hormone your body already makes. They help your body release insulin when you need it, control blood sugar and slow digestion so you feel full sooner. They also work in the brain to reduce hunger and food noise, which helps many people eat less and stay satisfied longer.
How long does it take for GLP-1 medications to work?
Most people begin to notice changes in appetite within the first few weeks. Weight loss usually becomes more noticeable as your dose increases and your body adjusts. Full results build gradually over several months because the medication is designed to support steady, long-term progress.
How much weight do people typically lose?
Many people lose 15% to 20% of their weight with medications like semaglutide or tirzepatide, especially when paired with healthy habits.
Are the injections painful?
The injections use a very small needle just under the skin. Many patients say it becomes part of their weekly routine.
Are GLP-1 medications safe long term?
Early studies show many long-term benefits, and research is ongoing. Your clinician will monitor your progress and adjust your plan as needed.
Can you take GLP-1 while breastfeeding?
Experts do not currently recommend using GLP-1 medications while breastfeeding. There is not enough research to know how the medication may affect a nursing baby. Your clinician can help you explore safe alternatives until breastfeeding is complete.
Do GLP-1 medications cause hair loss?
It is not clear if GLP-1 medications have direct effects on hair follicles. Some people notice thinning hair while losing weight, which can happen with many types of weight loss. It is often related to stress on the body or changes in nutrition. A clinician can help you manage this and protect overall health during treatment.
Is it safe to buy GLP-1 medications online?
Be careful. Some online sellers offer products that may not be safe. Always get your medication from a trusted pharmacy and clinician.
What happens if I stop taking the medication?
Most people regain weight. GLP-1 medications work best as part of a long-term plan to manage a chronic condition.
The bottom line on GLP-1 medications
GLP-1 medications can be a powerful tool for weight management and overall health. They are not the right choice for everyone, but they can make a meaningful difference for many people.
"The most important message," Dr. Siegel says, "is that no one has to navigate weight management alone. There are effective, evidence-based tools available, and we're here to help patients understand all their options."
The Tufts Medicine Weight + Wellness team can help you find the right combination of strategies, including GLP-1 medication, nutrition guidance, behavioral support and other evidence-based options, to meet your individual health goals.
