GLP-1 receptor agonist

How they work

Natural GLP-1 breaks down quickly in the body. GLP-1 receptor agonists are built to last much longer, some for a full week, so their effects are sustained. They:

• Help the pancreas release insulin when blood sugar is high, which keeps the risk of low blood sugar fairly low when used alone.
• Suppress glucagon, a hormone that raises blood sugar.
• Slow how quickly the stomach empties, so you feel full sooner and for longer.
• Act on appetite centers in the brain to reduce hunger and food 'noise.'

Common medicines in the class

Semaglutide (Ozempic and Rybelsus for type 2 diabetes; Wegovy for weight management and cardiovascular risk reduction), liraglutide, dulaglutide and exenatide are GLP-1 receptor agonists. Tirzepatide is related but also activates the GIP receptor, so it's usually called a dual agonist.

Semaglutide's approved uses now extend beyond diabetes and weight to lowering the risk of heart attack and stroke in certain adults, slowing kidney disease in type 2 diabetes and treating a form of fatty liver disease called MASH.

Side effects

Digestive effects are the most common: nausea, vomiting, diarrhea, constipation, stomach pain, heartburn and burping. They're usually worst when starting or raising the dose, which is why doses are increased gradually. Vomiting and diarrhea can lead to dehydration and, occasionally, kidney injury.

Warnings to know

Several serious risks are part of the labeling:

• Boxed warning: these drugs caused thyroid C-cell tumors in rodents. The human risk is unknown, but they shouldn't be used if you or a family member has had medullary thyroid cancer or if you have MEN 2.
• Pancreatitis: persistent severe stomach pain, sometimes spreading to the back, needs urgent care.
• Gallbladder disease, including gallstones.
• Low blood sugar when combined with insulin or sulfonylureas.
• Not for use in pregnancy; semaglutide should be stopped at least two months before a planned pregnancy.

Branded versus compounded

Compounded semaglutide is not FDA-approved and is not the same as Wegovy or Ozempic. The FDA has documented adverse events linked to compounded semaglutide, many involving dosing errors, such as doses measured or calculated incorrectly, or doses above the approved label. At HealifyMD, semaglutide injection is compounded and starts at $299 per month, confirmed at your eligibility review. A licensed clinician reviews your history, sets the dose and follows up as it's adjusted.

Eating smaller meals, stopping when you feel full, limiting greasy food and staying hydrated can ease digestive side effects. Protein and strength training help preserve muscle while you lose weight.