Glucagon-like peptide-1 (or GLP-1) is a naturally occurring hormone in the body that is secreted in the gut and targets multiple receptors throughout the body related to appetite and hunger.

Among the many functions GLP-1 performs in the body perhaps the three most powerful are insulin regulation, blood sugar control, and appetite suppression. When it comes to appetite, this can be why some people tend to overeat while others have more instinct about when to stop. The person putting down their fork may have greater natural levels of GLP-1 while the one going back for seconds may have less of this hormone or maybe simply less sensitive to it.

GLP-1 medications are a new breakthrough treatment for obesity and type 2 diabetes. They belong to a class of drugs known as GLP-1 Receptor Agonists and Incretin Mimetics. The first of the medications in this family was FDA approved in 2017 for the treatment of Type 2 diabetes. These medications work in several areas of the body to produce better insulin production and management.

The natural function of GLP-1 is short-lived in the body. It pulses during and after eating, then quickly subsides. Some of us naturally produce more of it than others and similarly to how other hormones decline as we age, studies have shown declining levels of it in fasting serum in aging populations. With the medication, our bodies recognize the full signal to the brain that you are full along with a slower emptying of the stomach, which results in a more efficient processing of our food as well as a reduction in cravings.

• Once injected GLP-1 gut hormone receptors are activated in the pancreas.
• This dominoes into healthy, “just right” insulin secretion from the pancreas to take care of blood sugar after a meal.
• The pancreatic hormone glucagon is then suppressed. Glucagon is an important and well-needed hormone, but you don’t want the liver to overproduce it after eating. Post-meal suppression enables insulin to get its job done and then lower it back down to healthier levels.
• Digestion is slowed and gastric emptying is delayed keeping a feeling of fullness longer.
• The brain is signaled with satiety by GLP-1’s ability to influence the regions of the brain that control the regulation of hunger and fullness.

This will be unique for each person but “lose as much weight in as fast a time as possible” will never be the Trim Healthy approach. While there are published trials that will share the incredible data of fast weight loss of large percentages using GLP-1 medications, this approach requires the maximum dosage and is too extreme for our liking.  The doctors we work alongside, recommend starting at the lowest dosage prescribed and staying there for as long as you can. Even if you do not see drops on the scale every single week, positive shifts will likely be happening in your insulin production, blood sugar levels and overall inflammation. A slower but steady path to weight loss is much healthier for your body. Fast weight loss depletes muscle mass swiftly and can be taxing to your liver. Muscle is your metabolic tissue so you need to keep it around!

GLP-1 medications can produce swift weight loss for some people of more than two to three pounds per week when used in high doses. But when this type of swift weight loss occurs, the body goes into a catabolic state, and a high loss of muscle is depleted along with some loss of fat. Other contributors to the very swift weight loss some achieve with these medications are from a lack of protein and/or skipped meals due to doses that cause extreme appetite suppression. Once again, this results in muscle loss. The best results are not the fastest results. Try to ignore the temptation to “keep up with the Joneses” so to speak. Others who are on higher doses and losing more than one pound per week may gush about their success. You don’t want that because it only looks like success, in reality, it is not. Let your body shed fat safely and slowly while keeping muscle. This will not look like multiple pounds lost every single week but even on low doses, many see excellent results. We suggest at least 90 days on the lowest dose and then regrouping with your medical practitioner to see if an increase is right for you. To avoid that catabolic state, it’s crucial to have a low and slow approach along with a wise diet (one that does not pull out any food groups or meals), ample protein, and a minimum of three days a week of strength training.

Semaglutide was the first GLP-1 med to become sensationalized in the drug market. It started as an effective medication for diabetes. Millions started using it. Millions lost weight. Since then, tirzepatide has gained even greater popularity, not only for its even greater weight loss and blood sugar success but because of diminished common side effects such as nausea and other digestion issues for which semaglutide was known. Tirzepatide targets weight loss not only through the GLP-1 mechanism but also through GIP (glucose-dependent insulinotropic peptide). This turns all the metabolic power of GLP-1 up to the max. Basically, tirzepatide has double action and is also called a ‘twincreatin” medicine as it mimics two groups of hormones which makes it more effective for many (but also more expensive).

The FDA approved the use of GLP-1 medications as an adjunct for weight management in individuals without diabetes, but only when used in conjunction with other weight-loss measures and with a doctor’s supervision. GLP-1 medications can aid in the treatment of obesity when used in conjunction with evidence-based lifestyle treatments like better nutrition and exercise.

These medications can make you feel lower energy, especially at higher doses which can cause too much of a calorie deficit.  This is one of the reasons we recommend 4 protein-centered meals per day, being sure not to exclude healthy carbs such as fruit, sweet potatoes, beans, legumes, and whole grains from your diet.

GLP-1 medications can cause significant appetite suppression for many people. It’s important that you stay on as low of a dose as your medical practitioner feels provides you just the right amount of suppression and not so much that you are skipping meals or completely forgetting to eat. Your meals will likely be smaller than what you’ve been eating due to some appetite suppression so be sure they contain adequate nutrition. The wrong approach is to eat unhealthy food but just less of it. Eat healthy foods so you can receive adequate nutrition in smaller meals.

Focus on small meals that contain lean protein. At all costs, you must avoid losing more muscle mass while you lose fat! Adequate protein will be crucial to ensure this muscle wasting doesn’t happen and adequate is roughly 25 – 30 grams per meal. You may also want to consider the leucine content of your protein. With insufficient leucine (one of the 9 essential amino acids) you cannot protect or build your lean body mass. Your body needs a very minimum of 2 grams of leucine in a protein serving but 3 is optimal. If you can, make use of our ESSENTIAL (amino acid protein formula). This is a powder that you simply mix with water and drink. It gives you the bio-equivalence of 90 grams of protein per serving with a full 3-gram bolus of leucine. Since the amino acids bypass digestion and go straight to your muscles, none of the protein is wasted or stored as fat. ESSENTIAL or any of our other Optimized proteins which contain a 3-gram leucine bolus per serving will ensure against muscle wasting. When you can’t think of eating much, just taking a drink of ESSENTIAL will make certain you get all your protein needs filled. If you can’t purchase ours or don’t want to, find another with similar nutritional stats making sure to get that 3-gram leucine bolus.

These medications work best when paired with healthy eating. Eating fried foods or sugary-filled foods can cause all their gastrointestinal side effects to worsen for many. Just because semaglutide and tirzepatide tend to lower appetite, please don’t fall into the trap of thinking you can now just eat small amounts of devitalized foods and be fine. Yes, you still might lose weight this way, but it is not a healthy approach.

Your appetite may go down somewhat as the emptying of your stomach slows.  If you have suffered from “food noise” where your brain constantly thinks about food, this may also lessen or completely abate. As your desire for food diminishes, you don’t have to eat huge meals but don’t skip them just because you don’t feel your regular amount of hunger. Skipping meals causes a state of LEA (low energy available). It also lowers leptin and thyroid hormones. Include ample protein at every meal and choose from healthy carbs or healthy fats to focus on or smaller amounts of each in the meal. Using semaglutide or tirzepatide as a way to intermittent fast is the wrong approach and it will harm your metabolism in the end by causing harmful loss of muscle.

As mentioned, swift weight loss can be harmful to the body. Recent research has revealed something called “weight loss injury.” This occurs when the outer covering of fat cells (known as the outer cellular matrix) is forced to purge its stores quickly. This results in a stiffening effect and the fat cell no longer works like a healthy one. It becomes inflexible. This stiffening along with a loss of lean body mass, due to the absence of adequate calories and protein, is brutal to long-term metabolism. Body composition starts to rearrange to higher fat levels and lower lean muscle tissue. There might be a lot of success on the scale, but the reality is “skinny fat” with tanked leptin and thyroid levels to boot. Keeping to the lowest dose that makes a difference for you, reduces these effects and is the wiser approach to using these medications in the most body-honoring and healthful way.

Absolutely. If you are doing well at a lower dose, you can stay at that dosage.

The duration of treatment with GLP-1 meds for weight loss will depend on your individual needs and goals. In clinical trials, treatment typically lasted for 68 weeks, but some patients may continue treatment for longer periods of time or to maintain weight loss.

Patients with less weight to lose, or who are more disciplined about combining GLP-1 meds with a healthy diet and exercise may reach their target weight even sooner! If you are diligent about protecting and building your lean body mass (ie – muscle) through protein fueling and strength training while using these medications, it is possible you may no longer need them once you are at your target weight. However, everyone is different, and some people may need to stay on a very small maintenance dose.

Weight training, along with your four protein fuelings a day will be imperative to protect your lean body mass. Use heavy weights (however not too heavy that you injure yourself) and target your glutes and lower body for two of the days and upper body for the other day. Walking is encouraged for two more days per week if you can find the time but the most important exercise sessions while on these medications are your weighted ones.

GLP-1 Meds are considered safe and effective when used as directed. But safe doesn’t mean that there aren’t risks. GLP-1 Meds also carry a boxed warning about thyroid C-cell tumors occurring in rodents (with unknown risk in humans), therefore GLP-1 Meds shouldn’t be used if you or your family have a history of a rare thyroid cancer known as Medullary thyroid cancer. GLP-1 Meds should not be used in people with type-1 diabetes or a history of pancreatitis. GLP-1 Meds may not be right for people on certain other blood sugar-lowering medications.

GLP-1 meds are administered as a subcutaneous injection – “shot” – which is typically given in the fat of the abdomen or thigh once a week. It is done with a very small insulin syringe and is usually rather painless and not difficult to do.

Get emergency medical help if you have signs of an allergic reaction: hives, itching; dizziness, fast heartbeats; difficulty breathing; swelling of your face, lips, tongue, or throat. Vision changes; unusual mood changes, thoughts about hurting yourself; pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; signs of a thyroid tumor–swelling or a lump in your neck, trouble swallowing, a hoarse voice, feeling short of breath; symptoms of pancreatitis–severe pain in your upper stomach spreading to your back, nausea with or without vomiting, fast heart rate; gallbladder problems–upper stomach pain, fever, clay-colored stools, jaundice (yellowing of the skin or eyes); low blood sugar–headache, hunger, weakness, sweating, confusion, irritability, dizziness, fast heart rate, or feeling jittery; kidney problems–swelling, urinating less, feeling tired or short of breath.

Because GLP-1 meds mimic the body’s natural substances, imitating a hormone that the body produces naturally, it is generally considered quite safe and well tolerated – when prescribed by a qualified physician as part of a balanced weight loss plan.

The most common side effects include nausea, diarrhea, vomiting, and constipation. Other possible side effects include abdominal pain, decreased appetite, headache, and fatigue.

These side effects typically subside over time, as the patient’s body becomes used to the medication and they learn the routine of the new reduced fat and caloric intake. Also, there are fewer instances of these side effects with tirzepatide than with semaglutide.

It is important to stay well hydrated and plenty of water (not sugary drinks like sodas or fruit juice). Eat fiber rich foods, healthy proteins and leafy greens and other veggies to combat digestion issues. If needed, teas such as Smooth Move may be helpful if constipation occurs.

If nausea becomes a problem – contact a physician through our portal and they will send you out a well-tolerated medication to help.

Most patients who are prescribed GLP-1 medications find that they do not need additional weight management meds.

However, it is important to note that semaglutide and tirzepatide should not be used in combination with other GLP-1 receptor agonists or medications that increase GLP-1 receptor activity. It may be used in combination with other weight loss medications, but the safety and efficacy of such combinations have not been studied.

Most medications do not interfere with GLP-1 meds but avoid taking any medication including acetaminophen (Tylenol) 1 hour prior to your weekly GLP-1 injection.

There is limited information available about the safety of these meds during pregnancy or breastfeeding. If you are pregnant or breastfeeding, you should generally refrain from taking semaglutide or tirzepatide for weight loss.

GLP-1 meds are also approved for the treatment of type 2 diabetes, so they can be used by people with both obesity and type 2 diabetes. The safety and efficacy for use by type 1 diabetics have not been studied yet.

To complete a Trim Healthy consultation, you will be required to answer our quick online medical questionnaire. Your information will be reviewed by our medical team, and they will confirm if you are eligible for treatment and will write a prescription for those who meet the criteria.

Our services are confidential, and your medical information and order history can only be viewed by our team of medical professionals and pharmacists. You can view our Privacy Policy for more information.

GLP-1 medications do require a prescription. If you’re eligible for treatment based on your answers to our medical questionnaire, our medical providers will issue you a private prescription for the medication they believe is the best fit for you.

Your Rx will typically be a 90-day supply if you’re having success on the entry dose.  If after consulting with a TH+ medical provider, it’s recommended that you titrate up your dosage, it may last 60 days or less.  Two weeks before your last dose, you will be instructed to contact our medical team and request an early renewal. Your order will be billed automatically to your credit card on file. Your medical provider will review your status and have the re-order shipped.

The Trim Healthy sign-up and questionnaire are quick and easy. Answer a few medical and history questions, send us a copy of your state-provided ID, send us a current photo for identity verification and we will complete your file. You will select either semaglutide or tirzepatide as your medication of choice. Once complete, your physician will review the information and start the prescription and shipping process unless there is a reason why you do not qualify.

We provide an inclusive package. We will provide information on the product and the process of administering it on the site. We will take the information you provide, the ID and picture you supply, and your selected product and have it reviewed by our medical team.  Afterward, we will offer online physician follow-up. Shipping is included in the price shown on the website.

Insurance companies generally only cover these meds for those with type 2 diabetes, so we are unable to take insurance for GLP-1 meds.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause severe nausea, vomiting, or low blood sugar.