Heart Talk - June 2023
Taking a Deep Dive into the popular weight-loss drugs, GLP-1 receptor agonists
There has been a tremendous amount of attention about a new “miracle weight loss” drug that is in the category of diabetic meds called GLP-1 agonists. This class of medication is known more colloquially by generic names such as Ozempic, Wegovy, Mounjaro, Trulicity, Victoza, Saxenda and Byetta. These drugs have been all over the news and social media as well as new medical guidelines in recent months. As these medications become household names, we thought it may be helpful to break down the science of what we know; what we don’t know; and the benefits, side effects and long-term implications of their use.
First, it is important to note that this class of medication is not new and has been in use for more than a decade in the treatment of Type 2 Diabetes. At a basic level, GLP-1 agonists work by binding to the GLP-1 receptors in the body, stimulating insulin release from the pancreas, reducing glucose (sugar) release from the liver and thus lowering blood sugar levels. The initial medications in this class were used specifically for Type 2 Diabetes but often caused significant side effects of nausea and constipation, limiting their utility in many patients.
The unwelcome side effects of these medications are not actually side effects at all, rather manifestations of the intended mechanism of action of the medication. This class of medication leads to significant weight loss in many patients, in part due to their ability to slow the movement of food in the digestive tract, leading to higher levels of satiety earlier in a meal and lower levels of hunger throughout the day. This slowing of the GI tract, while helpful for weight loss and insulin resistance, also causes nausea in many people, as well as understandable constipation.