The myths and facts about GLP-1s by Amandeep Kahal, MD
Originally, GLP-1s were designed to help manage diabetes because the medication, which comes in the form of an injectable or a pill, controls blood sugar levels.
They also slow down digestion, helping people feel full longer. As a result, people who take GLP-1s often don’t eat as much, which can lead to significant weight loss. In recent years, the Food and Drug Administration approved several of these drugs to treat obesity. The weight-loss side effect generated enthusiasm from the general public.
Amandeep Kahal, MD, family medicine physician at Kaiser Permanente Union City and co-lead of obesity medicine for the Kaiser Permanente Greater Southern Alameda area (which includes the San Leandro and Fremont medical centers) breaks down several misconceptions about GLP-1s and the best approach to using one.
At Kaiser Permanente, who can get GLP-1s, and for what reasons?
Kaiser Permanente physicians will consider numerous factors, including high body mass index, elevated blood pressure, and other weight-related conditions before prescribing them.
At Kaiser Permanente, we follow evidence-based criteria when prescribing these medications. We usually start with lifestyle support and oral medications for weight management first, then move to GLP-1s when they’re the right fit. The best thing any member can do is talk with their doctor about whether they’re a candidate because it depends on their overall health.
Are GLP-1s a quick fix for weight loss?
GLP-1s are not a quick fix. They are a weight-loss tool to help manage obesity, a chronic disease. It takes months to reach an effective dose. Weight loss is gradual, and when combined with lifestyle changes, patients can lose roughly 15 to 20% of their total body weight over 12 to 18 months. As with other medications, patients have a higher chance of weight loss if they use it with lifestyle changes, such as watching calories, exercise, adequate sleep, and stress management.
Do you gain all the weight back if you stop taking the GLP-1?
When people stop the medication, weight tends to return because obesity is a chronic disease that needs to be managed. In recent studies, people regained about two-thirds of what they lost within a year. It’s what happens when you stop treating any chronic condition. If you stop blood pressure medication, your blood pressure will climb again.
Do people still need to exercise or commit to a healthy diet while on GLP-1s?
Yes. In every study that showed successful outcomes, the medication was paired with a healthier diet and more activity, and that’s how Kaiser Permanente doctors prescribe it. In fact, nutrition matters more when taking a GLP-1, because your appetite drops, and every bite must count, especially protein.
The medication quiets the constant hunger and food noise, which is what finally makes lifestyle changes doable for a lot of people. It’s the medication plus the lifestyle changes that give the best, most lasting result.
