Weight Loss Drugs, Explained

You can’t open a newspaper, scroll social media, or sit in a waiting room these days without hearing about GLP-1. It’s being hailed as revolutionary, controversial, life-changing, overused, underused - depending on which headline you’ve just read.

But what actually is GLP-1? And why is everyone suddenly talking about it like it’s the Beyoncé of hormones?!

As a Nutritional Therapist with 14 years clinical experience,  I’m always interested in what’s happening beneath the surface. I don’t aim to purely manage symptoms, I want to solve them at the root cause. I am not anti-medication in any way, in fact I work closely with a number of incredible physicians in an adjunctive way including endocrinologists prescribing GLP-1s, but my approach is always to work out why the body has got to a place where medication is indicated. This allows for using the lowest effective dose for the shortest period of time, hopefully then getting to a point where its ongoing use isn’t required. Medications are acute care strategies - they save our lives and correct issues that require immediate intervention for our continued survival, but they are now seen as an ongoing answer to maintaining health and that is not where we should be. In fact polypharmacy and overprescription is one of the leading causes of death we face globally. 

So let’s unpack the science in plain English, look at when GLP-1 medications are prescribed, and then explore what we can do from a root-cause, whole-body perspective.

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What Is GLP-1?

GLP-1 stands for glucagon-like peptide-1. Catchy, I know. It’s a hormone made in your gut, specifically released from cells in the small intestine when you eat. Think of it as one of your body’s ‘I’ve eaten now, you can relax’ messengers.

It has several important jobs:

• It stimulates insulin release (but only when glucose is present).
• It reduces glucagon (a hormone that raises blood sugar).
• It slows gastric emptying (so food leaves your stomach more slowly).
• It acts on the brain to reduce appetite and increase satiety.
  

In short: GLP-1 helps regulate blood sugar and appetite. It’s part of your body’s beautifully orchestrated system for managing energy.

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How Does It Work?

When you eat, GLP-1 is released into the bloodstream. It travels to:

The brain, where it signals fullness. This reduces appetite and cravings.

The pancreas, where it encourages insulin secretion in response to rising blood glucose.

The stomach, where it slows down how quickly food empties into the small intestine. This means:

• More stable blood sugar
• Longer-lasting fullness
  
  

The result? Improved blood sugar control and reduced calorie intake.

The challenge is that natural GLP-1 doesn’t hang around long - it’s broken down within minutes. Which is where medications come in.

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When Is GLP-1 Prescribed?

GLP-1 receptor agonists (synthetic versions that mimic GLP-1 but last much longer) were originally developed for type 2 diabetes.

Medications such as Ozempic, Wegovy, Mounjaro and Saxenda are prescribed for:

• Type 2 diabetes
• Weight management (in people with obesity or weight-related health conditions)
• Improving insulin resistance 
• There is also emerging research into the use for neurodegenerative conditions such as Alzheimer's as this has been recognised as insulin resistance within the brain. There is a fascinating book on this called The End of Alzheimer's by Dr Dale Bredesen that explains neurodegenerative disease as a metabolic issue. 

They work by activating GLP-1 receptors in the body, effectively amplifying the natural satiety and blood sugar-regulating effects. For many people, these medications can be genuinely life-changing - improving metabolic markers, reducing cardiovascular risk, and supporting significant weight loss.

And yet.

As with anything in biology, it’s never just about one hormone.

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Supporting GLP-1 Naturally

Here’s where I lean in and ask:

Why might someone’s GLP-1 signalling not be working optimally in the first place?

From a functional medicine perspective, we’re curious about:

• Insulin resistance
• Chronic inflammation
• Ultra-processed diets
• Gut microbiome imbalances - read more here, plus have a scroll through my other posts for more info.
• Chronic stress
• Poor sleep
• Sedentary lifestyle
• Blood sugar volatility
  
  

GLP-1 medications can be incredibly helpful tools, but they don’t fix the underlying terrain. If someone comes to me on or considering a GLP-1 medication, I’m not here to judge them for it. I’m here to support the physiology alongside it. I want and need them metabolically resilient either way.

This is often an under-noted implication of GLP-1 meds - only 60% of mass lost will be fat, at least 40% will be lean mass (muscle and bone) which then progressively makes us less metabolically efficient. This is why osteoporosis and hair loss are noted as significant side effects, and rapid fat gain is an issue if someone comes off of GLP-1s without having invested in building muscle and changing their dietary habits whilst using them.

Now, while we can’t replicate pharmaceutical-strength effects with food alone, we can support the body’s natural GLP-1 production and sensitivity.

Here’s how:

1. Prioritise Protein
   Protein stimulates GLP-1 release and improves satiety.
   Aim for 20–40g per meal, depending on individual needs.
   
   
2. Feed the Microbiome
   Certain gut bacteria produce short-chain fatty acids (like butyrate), which enhance GLP-1 secretion.

Support this with:

• Fibre-rich vegetables
• Resistant starch (e.g. cooked then cooled potatoes and grains, green bananas and plantain)
• Legumes
• Fermented foods

A diverse microbiome supports better metabolic signalling.

3. Balance Blood Sugar
   Stable glucose levels reduce stress on the pancreas and improve insulin sensitivity.

Think:

• Protein and fibre at every meal
• Avoid ‘naked’ carbs
• Eat within a consistent rhythm allowing for 3.5-4 hours between meals and 12-14 hours between dinner and breakfast.
  
  

4. Strength Train
   Muscle is metabolically protective. It improves insulin sensitivity and reduces metabolic burden.

Two to three sessions a week when you challenge your body ~25% above baseline strength can make a profound difference.

5. Sleep
   Sleep deprivation alters appetite hormones, increasing hunger and cravings.
   Poor sleep also worsens insulin resistance.

Seven to nine hours is ideal - and I’ve actually just written another post around decoding sleep, which you can find here.

6. Manage Stress
   Chronic cortisol disrupts blood sugar regulation and appetite signalling.

We can’t eliminate stress, but we can buffer it:

• Nervous system regulation
• Time outdoors
• Breathwork
• Realistic expectations (including of ourselves!)

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The Balanced View

GLP-1 medications are neither miracle cure nor moral failure, they are tools, and for some people, they provide a much-needed metabolic reset. For others, they may mask deeper dysfunction if lifestyle isn’t addressed alongside them.

The goal here isn’t to fight modern medicine, but to work with it,  ensuring that whether someone is on a GLP-1 medication or not, we’re building resilient metabolism, a nourished microbiome, balanced blood sugar, and a relationship with food that isn’t driven purely by pharmacology.

Long-term health is never just about suppressing appetite, it’s about restoring metabolic harmony. And that, as always, starts with the foundations.

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