I’m thrilled to delve into an essential topic that intersects with both nutrition and healthcare: GLP-1 agonist medications and their impact on managing diabetes and improving overall health outcomes. We’ll uncover the science behind GLP-1 agonists (do ozempic, wegovy, and manjaro sound familiar?), understand their role in diabetes management, and discover how they can positively influence our health journey. GLP-1 agonists are a class of medications that have been gaining prominence in the treatment of diabetes. But what exactly are they, and how do they work? We’ll demystify these questions and equip ourselves with valuable knowledge about these medications over the next few weeks.

The Obesity and Diabetes Connection

The connection between diabetes and obesity is well-established, with obesity being a major risk factor for the development of type 2 diabetes. This connection mostly happens because of something called insulin resistance. When you have insulin resistance, your cells don’t respond well to insulin, which makes it hard for your body to use sugar properly.

When you gain weight, especially around your belly, the fat cells in your body get bigger. These fat cells don’t just sit there; they start sending out signals that cause inflammation, which makes insulin resistance even worse. So, being overweight doesn’t just affect how you look, it also messes with how your body handles sugar, making diabetes more likely.

What are GLP-1 Medications?

GLP-1 medications play a crucial role in improving diabetes while also promoting weight loss. GLP-1 (glucagon-like peptide-1) is a hormone produced in the gut in response to food intake. It plays several important roles in glucose metabolism, including stimulating insulin secretion, inhibiting glucagon secretion (which helps reduce blood sugar levels), delaying gastric emptying, and promoting feelings of satiety.

GLP-1 medications, also known as GLP-1 receptor agonists, mimic the action of natural GLP-1 in the body. By activating GLP-1 receptors, these medications enhance insulin secretion in response to elevated blood sugar levels, thereby improving glucose control. Additionally, they suppress glucagon secretion, which helps prevent excessive glucose production by the liver.

How do GLP-1 Medications Promote Weight Loss?

One of the most notable effects of GLP-1 medications is their ability to promote weight loss. This weight loss occurs through multiple mechanisms:

Appetite Suppression

  • GLP-1 receptor medications act on the brain to reduce appetite and increase feelings of fullness, leading to reduced food intake.

Slowed Gastric Emptying

  • By delaying gastric emptying, GLP-1 medications help regulate the rate at which food is digested and absorbed, which can contribute to reduced calorie intake and weight loss.

Increased Energy Expenditure

  • Some GLP-1 medications have been shown to increase energy expenditure, potentially further contributing to weight loss.

Reduction in Body Fat

  • GLP-1 medications have been associated with reductions in visceral adipose tissue (fat stored around internal organs), which is particularly beneficial for metabolic health.

By simultaneously improving glucose control and promoting weight loss, GLP-1 medications offer a unique therapeutic approach for individuals with type 2 diabetes, especially those who are overweight or obese. This dual benefit addresses two key aspects of metabolic dysfunction, ultimately leading to improved overall health outcomes for patients.

Who Qualifies?

The eligibility criteria for GLP-1 medications, also known as GLP-1 receptor agonists, typically depend on individual factors such as the severity of type 2 diabetes, overall health status, and response to other diabetes medications or lifestyle interventions. However, here are some general guidelines on who may qualify for GLP-1 medications:

Type 2 Diabetes Diagnosis

  • GLP-1 medications are primarily indicated for the treatment of type 2 diabetes. Individuals with type 2 diabetes who have not achieved adequate blood sugar control with other oral medications or who require additional treatment beyond oral medications may be candidates for GLP-1 therapy.

Inadequate Response to Oral Medications

  • Patients who have tried and failed to achieve target blood sugar levels with oral medications such as metformin, sulfonylureas, or thiazolidinediones may be considered for GLP-1 therapy.

Obesity or Overweight

  • GLP-1 medications are particularly beneficial for individuals who are overweight or obese, as they can help promote weight loss in addition to improving blood sugar control. Therefore, patients with a body mass index (BMI) above a certain threshold (usually ≥30 kg/m²) or those with a BMI ≥27 kg/m² and comorbidities such as hypertension, dyslipidemia, or obstructive sleep apnea may qualify for GLP-1 therapy.

Renal Impairment

  • Certain GLP-1 medications may be suitable for patients with renal impairment, although dosing adjustments may be necessary based on kidney function.

Patient Preference and Tolerance

  • Factors such as patient preference, tolerance of side effects, and convenience of administration (e.g., frequency of injections) may also influence the decision to initiate GLP-1 therapy.

It’s important to note that individual patient characteristics and medical history play a significant role in determining eligibility for GLP-1 medications. Therefore, decisions regarding initiation of GLP-1 therapy should be made in consultation with a healthcare provider who can assess each patient’s unique situation and tailor treatment recommendations accordingly.

Setting Realistic Expectations

When you’re thinking about using GLP-1 agonist medications for diabetes, it’s good to know what to expect with blood sugar, weight, side effects, and getting the medicine.

Blood Sugar Control

  • These meds can help lower blood sugar, but how much varies for each person. Keep an eye on your levels and work with your doctor to adjust the dose if needed.


  • They might help you lose weight by making you feel less hungry. But the amount of weight lost can be different for everyone. Eating healthy and exercising can help too.

Side Effects

  • Like any medicine, they can cause side effects like nausea or diarrhea. These usually get better over time. Working with a dietitian can help optimize your toleration.


  • These meds can be expensive, and insurance might not cover them well. Ask your doctor about cheaper options or programs to help pay for them.

Getting the Medicine

  • Sometimes, there might not be enough of the medication available. Your doctor can help you find alternatives or places where you can get it. Keep in touch with your pharmacy to make sure you don’t run out.


Next we’ll delve into the intricacies of dietary management, exploring strategies for effectively managing diabetes and obesity, regardless of whether GLP-1 medications are part of the equation. As we navigate potential shortages and fluctuations in insurance coverage, it’s crucial to equip ourselves with sustainable healthy behaviors that support our health goals. Stay tuned for practical insights and guidance to empower you on your wellness journey!

Written By Prabha Honrath, RDN