GLP-1 stands for “glucagon-like peptide 1”. When it comes to weight loss medication, GLP-1 usually refers to a class of medications called “glucagon-like peptide 1 receptor agonists” (GLP-1 RA). These medications are designed to mimic the action of glucagon-like peptide 1, which is a hormone our bodies produce naturally in response to eating or drinking.
When we consume food or drinks that contain fats or carbohydrates, our intestinal cells secrete the GLP-1 hormone. GLP-1 helps regulate our blood sugar by triggering the release of insulin from our pancreas. GLP-1 also contributes to a feeling of satiety or fullness by making food move more slowly through our digestive tract and sending a message to our brain that says, “I’m full”. This is all a part of normal digestion and metabolism.
The group of GLP-1 receptor agonist medications currently available in Australia includes semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro) and liraglutide (Saxenda). These medications are all delivered by injection, usually given once per week. There are oral (tablet/capsule) versions currently in development, with some already available in the USA.
These medications must be prescribed by a medical doctor. In Australia they can currently be prescribed for diabetes management and/or weight management.
GLP-1 receptor agonist medications can help people lose weight by reducing their appetite and/or their experience of a condition referred to as "food noise”. People use the term “food noise” to describe constant and persistent thoughts about food and eating, particularly foods that very palatable and energy-dense (aka “junk food”).
GLP-1 medications are not a silver bullet for weight loss – in order to lose weight, people must still reduce their caloric intake. GLP-1 RAs are simply a tool that helps people reduce their caloric intake. For people who struggle with food noise, GLP-1 medications can help people stick to a healthy eating plan and, in doing so, lose weight.
In order to lose weight we must consume fewer calories than we burn, creating what is known as a “calorie deficit”. When a calorie deficit is achieved, the body is forced to use its own fuel stores to provide energy. The body’s primary fuel store is body fat, along with glycogen stored in the liver and muscles. Tissues like muscle and bone can also be used to provide energy, regardless of whether a person is losing weight with or without the assistance of GLP-1 medication. Diet and exercise habits will help determine how much weight is lost as body fat rather than muscle and bone mass.
It is possible to lose weight while consuming a poor-quality diet. This is because a calorie deficit can be achieved while eating foods that are low in nutrients and high in calories. For example, if your calorie requirements for weight loss are 1,200 calories per day, here are two different options for a meal plan:
Option 1 provide five serves of vegetables, more than 25g fibre and more than 90g protein. By comparison, Option 2 provides less than 2 serves of vegetables, 5g fibre under 50g protein. This is well below the requirements of a typical adult.
Both options will lead to weight loss, but Option 2 lacks fibre, protein, vitamins and minerals. This will not impact the number you see on the scales, but it will contribute to constipation, loss of muscle and bone mass, vitamin and mineral deficiency, and increase the likelihood of suffering from diet-related medical conditions in the future.
This is why good nutrition is so important when using a GLP-1 medication – the medication makes calorie restriction easier, but healthy choices are still needed to keep you looking and feeling your best.