GLP-1 Medications: The Big Picture and What You Should Know

As I sat around with my extended family and friends over the past week (and I could even relate this back to Thanksgiving), the topic of GLP-1’s was certainly in the air. I can attest that over the past year, many of my clients and friends/families have asked thoughtful questions about GLP-1 medications like Ozempic, Wegovy, and Mounjaro to the point that these drugs have become household names, and for good reason: they work, often very effectively, for weight loss and appetite control when prescribed appropriately.

But with increasing popularity comes confusion, misconceptions, and sometimes oversimplified views about what these medications do and what they don’t do.

So if you’ve ever found yourself wondering or have had family/friends asking:

Should I try one of these?
Are they safe long term?
Will the weight stay off when I stop?What about muscle loss or other effects?

…then this article is for you.

Let’s take a deep, evidence-informed look at GLP-1s, not fearing them, not glamorizing them, but understanding them as a tool that can be very helpful for some, yet still requires context, strategy, and lifestyle integration.

GLP-1 receptor agonists were initially developed for Type 2 diabetes, where they help regulate blood glucose and insulin. They mimic a natural hormone (GLP-1) in the body, slowing gastric emptying and influencing hunger signals in the brain, which is why people often report that they feel full faster and less driven to eat throughout the day. In many clinical trials, people lost significant body weight often in the 10–16% range of total body weight over months of treatment. Traditionally, approximately 1% of body weight per week is considered a safe and healthy rate of loss for most individuals on a weight loss program.

But that’s only part of the story and understanding the rest matters just as much.

When people start these medications, appetite drops. Food stays in your stomach longer and signals of satiety hit the brain more strongly, and inevitably hunger often declines. This is why many users describe not being hungry even when “normal” mealtimes roll around, which is very distinct from simply choosing not to eat. Because hunger is lower, some people don’t realize they’re not eating enough. This can lead to nutrient deficiencies (B12, iron, calcium, vitamin D), fatigue, or simply eating too little protein to support muscle maintenance and growth.

Weight loss occurs, often quickly (espectially relative to dietary changes alone), because people are eating less consistently, and often not eating enough calories to sustain their baseline metabolism.

That brings us to a crucial point…

A big part of weight loss, unfortunately, isn’t just fat loss, it can be lean tissue loss too. Recent research shows that a significant portion of weight lost on GLP-1 meds can include muscle tissue, sometimes up to 50% of total weight loss. This is HUGE! Let’s say you lose 30–40lbs of weight, up to 15–20lbs of that is coming in the form of lean tissue.

This is important because:

Lean muscle supports metabolism. When you lose muscle, your metabolic rate can slow down.
Muscle impacts strength and function. Especially as we age, preserving muscle helps with mobility, balance, and overall quality of life.
Muscle matters long-term. Losing it makes weight regain easier and long-term maintenance harder without intentional action.
Laying down muscle takes time, and to lose it makes it even more difficult to get it back, especially in higher amounts.

But here’s the nuance: it’s not necessarily inevitable, especially when GLP-1 use is paired with purposeful lifestyle strategies.

If someone decides to use a GLP-1 medication, the physical stimulus their body receives from:

Strength training (resistance exercise)
Adequate protein intake
Balanced nutrition

…plays a dramatic role in helping preserve lean mass.

Strength training signals the body to use and build muscle, preserve muscle and without it, and combined with the appetite suppression and reduced calorie intake of the medication, the body won’t discriminate between fat and muscle when it comes to needing calories, it will break down whatever nutrient is available to provide energy for the body and that leads to lean tissue breakdown. Likewise, not eating enough protein, especially at a time when hunger signals are muted, can make muscle preservation harder. That’s where intentional planning comes in: aiming for consistent protein across meals and seeking dietary sources that support nutrient needs.

This isn’t optional if long-term health and body composition matter.

I want to share a few points that come up in conversations with clients and online communities:

These Medications Aren’t a “One-Time Fix”

They’re tools, and can be powerful ones, but most people regain significant weight if they discontinue, and haven’t adopted long-term behavior changes around eating, physical activity and strength training. Studies have shown substantial weight regain within a year after stopping GLP-1 use when lifestyle changes haven’t been supported. That’s not the drug “failing”, that’s biology rebalancing itself toward previous homeostasis when the external suppressive signal disappears.

Not Everyone Has the Same Experience

Some people lose a lot quickly, whereas others lose slowly or plateau. Some tolerate the meds well while others struggle with nausea or appetite swings. Anecdotal experiences vary widely with some friends/family/clients reporting rapid results with others reporting minimal changes despite strict adherence, and similarly with side effects, some minimal, some extensive.

Side Effects are more common than not. Most people experience some gastrointestinal issues, nausea, diarrhea, vomiting, or constipation, especially when starting or increasing the dosage. These are usually manageable and often improve as the body adjusts, but they’re real and can be uncomfortable if not anticipated. We still don’t know what long-term side effects can occur and this can be a real problem if we are talking organ damage or cancer risk.

While GLP-1 meds are generally considered safe when prescribed and monitored, there are risks and unknowns especially over the long haul:

Nausea, vomiting, diarrhea, constipation
GI discomfort (due to slower digestion)
Fatigue or headache in some people

Some

Pancreatitis (inflammation of the pancreas), potentially serious if it occurs.
Gallbladder issues, including gallstones.
Potential nutrient deficiencies due to reduced intake.
Other digestive disorders due to slowing of gastric emptying, such as constipation and lower overall bowel movements.

Not everyone experiences these, but they’re worth discussing with your physician and monitoring over time, especially if using the drug long term.

Here’s what I hope people take away, whether they’re considering these medications or already on them:

They can help you get started with weight loss and metabolic improvement, but real, durable changes come from habits you build alongside the medication.

Don’t let medication do all the work. Build muscle, eat enough protein and fiber, and maintain physical activity. This protects metabolism and functional ability.

Talk with your doctor or healthcare team about:

Long-term goals
Protein and nutrient needs
Strength training plans
Monitoring for side effects or deficiencies

Informed use is safe use.

If you plan to eventually stop the medication, talk about a transition strategy so weight doesn’t come back suddenly and you’ve built the sustainable supports you need.

If you’re talking with family or thinking about trying Ozempic, Mounjaro, Wegovy, or similar medications, do it with both curiosity and caution.

Understand:

How they work and why they can be effective
Why weight loss can come with lean tissue loss if you’re not careful
Why strength training and nutrition matter even more on these meds
What longer-term use and discontinuation can mean

And remember: a tool is only as effective as the strategy that surrounds it. If you treat GLP-1s as a bridge and not a guarantee, you’ll be set up for more sustainable success.

Coach Dan

With over 25 years of experience in health and fitness, Dr. Dan helps people balance their nutrition and lifestyle to foster better habits and achieve results. If you’d like to receive more stories, subscribe to get access to these and more.

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This post was previously published on medium.com.