Quick Answers to Questions on GLP-1 Agonists

1. Do I need to exercise on GLP-1 agonists?

   
   

   -Studies show that weight loss with GLP-1 agonists is not dependent on exercise. HOWEVER, these same studies show that weight is more pronounced when the two are combined. Additionally, should a patient ever come off GLP-1 agonists, exercise has been shown to maintain that weight loss long term.

Long story short, best to exercise even if taking GLP-1 agonists.

2. Are the gastrointestinal side effects terrible?

-There is a lot of social media and reports of patients experiencing terrible complications from using GLP-1 agonists. The truth is that yes, GLP-1 agonists cause slowed emptying of your stomach and intestines, known as gastroparesis and ileus respectively. This is actually how these drugs function to make you feel full and eat less. These drugs can also cause nausea by the same mechanism. However, by finding the right dose and getting through the first few weeks of use, these symptoms can go away over time.

-These drugs have been shown to cause hair loss (alopecia) and muscle loss (sarcopenia). However, the drugs themselves do not cause these symptoms. Insufficient protein intake associated with decreased macronutrient intake while on these drugs is the root cause. To avoid these issues, patients do need to monitor their diets closely and ensure adequate protein intake. Additionally, avoiding muscle loss is another important reason why exercise is strongly encouraged while taking GLP1-agonists.

3. Do I need to take these drugs forever?

-The answer to this one is a bit tricky. Studies show that the weight lost with GLP-1 agonists returns when the medication is stopped. Therefore the drugmakers producing these medications insist that they must be used lifelong. HOWEVER, studies are showing that in patients who have made healthy diet and lifestyle modifications, weight lost while on these drugs does not return once the drugs are stopped. These studies looked at patients who were on GLP-1 agonists and exercising for one year and then in year two stopped the drug but continued exercising.

Therefore, in patients who have adopted healthy nutrition and exercise routines while on GLP-1 agonists, there may not be a need for continued drug use after desired weight loss is achieved.