What is it like to take GLP-1 RAs (semaglutide, Ozempic, Rybelsus, Wegovy class of medications)?
Key Takeaways
Glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, are a class of medications that can be used to treat diabetes or for weight loss.
These medications slow down emptying of the stomach, which keeps you feeling full for longer after you eat.
They also work in the brain to reduce hunger and cravings. People generally experience less “food noise” (thoughts about food) while taking a GLP-1 RA.
Digestive side effects like nausea and indigestion are common, but usually go away on their own over time.
Weight loss on a GLP-1 RA occurs gradually over time. This is beneficial because very rapid weight loss usually consists mostly of water weight, while more gradual weight loss is more likely to consist of excess fat tissue.
GLP-1 RAs can be continued for the long term. If you choose to stop the medication, paying close attention to certain lifestyle factors can help you to maintain your weight loss.
What are GLP-1 RAs class of medications?
Glucagon-like peptide-1 receptor agonists, or GLP-1 RAs, are a class of medications that mimic a natural hormone in the body. Some GLP-1 RAs are approved for treating diabetes, while others are approved for weight loss. This medication class includes semaglutide (sold under the brand names Ozempic, Rybelsus, and Wegovy), liraglutide (Saxenda and Victoza), and dulaglutide (Trulicity).
When people are considering taking a GLP-1 RA, they may wonder what it’s like to be on one of these medications. What does it feel like to be on a GLP-1 RA?
Feel full faster and longer
One of the primary effects of taking a GLP-1 RA is that it causes you to feel full more quickly, and to stay full for longer after you eat. This happens because the medication slows down the emptying of the stomach. Because it takes significantly longer to digest food, people don’t feel hungry as quickly after finishing a meal.
As a result, people taking a GLP-1 RA often feel full after eating a moderately-sized meal, when previously they may have needed a larger meal to feel full. They then continue to feel comfortably full, as though they’d just eaten, for a much longer time than they used to. Instead of craving food again quickly, they feel satisfied and don’t have the desire to eat usually for many hours after a meal. Because of this, they generally eat less than they used to, without needing to use willpower to avoid eating.
This effect also helps to avoid the blood sugar spike that can sometimes follow a meal, by slowing down the body’s processing of the carbohydrates contained in the food. A blood sugar spike often leads to a crash, which then triggers the desire to eat again – so avoiding the blood sugar spike also tends to help prevent a person from feeling hungry again soon after eating.
Reduction in “food noise” (losing your cravings)
The term “food noise” refers to frequent or intrusive thoughts about food. When people are trying to lose weight by eating less, it’s common to experience a significant increase in food noise. They find themselves thinking about food often, and having cravings for certain foods, usually unhealthy ones.
People taking GLP-1 RAs often report a substantial decrease in food noise, meaning that they feel less preoccupied with food than they used to. They experience fewer cravings, and are less likely to engage in emotional eating. This makes it much easier to resist the temptation to overeat or to eat unhealthy foods that contain a lot of empty calories. Even though they’re eating less, they actually experience less food noise than before they started the medication.
This effect occurs because GLP-1 RAs act not just in the digestive system, but in the brain as well. They modulate activity in certain brain circuits that regulate hunger and cravings. This means that people who are taking a GLP-1 RA not only feel full more quickly and experience fewer blood sugar spikes and crashes, but they’re also less likely to experience strong cravings for foods and to spend a lot of time thinking about food.
Digestive side effects of GLP-1 RAs
Although GLP-1 RAs can have these beneficial effects, they also have some side effects. The most common ones are related to the digestive system, such as:
Nausea and vomiting
Abdominal pain
Constipation or diarrhea
Indigestion
Acid reflux (heartburn)
These digestive side effects commonly occur when a person first starts taking a GLP-1 RA, and they almost always decrease over time. The standard practice of starting with a low dose and gradually working up to a higher one helps to reduce the digestive side effects, by allowing the body time to get used to the medication.
Although these side effects may be unpleasant, they’re not dangerous. In most cases, small changes to your lifestyle can help to reduce the side effects. Taking smaller meals, avoiding very fatty meals, taking plenty of fluids, and avoiding lying down after eating will help to minimize the digestive side effects and keep you comfortable while taking a GLP-1 RA.
In fact, side effects like nausea may actually help with weight loss in some cases – if eating an entire bag of potato chips causes you to feel nauseated, you’re very unlikely to want to reach for those chips again. In this way, nausea may actually help to reprogram your nervous system to prefer healthier foods. Although nausea is certainly not pleasant, it may help to think of it in this way.
If you’re bothered by the side effects of a GLP-1 RA, talk with your doctor about this. There may be ways to manage your side effects so that you feel better. Your doctor might also decide to lower your dose and work you up to a higher dose more slowly, to give your body extra time to get used to the medication. You don’t simply have to live with the side effects of a GLP-1 RA; there are things you can do about these.
How does the dosage of GLP-1 RAs change over time?
When you first begin taking a GLP-1 RA, you’ll start at a very low dose. This is generally increased over time, until you reach your full maintenance dose.
Starting the medication at a lower dose helps to give your body time to get used to it. This tends to reduce the side effects. As the medication gradually builds up in your body, you will start to notice more and more of the effects, such as feeling full for longer after you eat and experiencing fewer cravings. Rather than coming on suddenly, these will develop gradually over time.
It’s important to remember that a GLP-1 RA is a long-term investment. Even though starting at a small dose and increasing gradually means that it takes longer to see the effects (such as improved blood sugar control and weight loss), it’s worth it to reduce the side effects and help your body adjust to taking the medication.
Can you lose weight quickly on GLP-1 RAs?
It’s important to know that, while GLP-1 RAs do cause weight loss, this doesn’t happen immediately. This is partly because the starting dose is low, and it takes a while to ramp up to the full dose. However, it’s also because it takes time to lose fat tissue in a healthy and sustainable way.
In fact, very rapid weight loss is generally due to a loss of water weight, rather than to a reduction in fat tissue. Water weight is not associated with negative health outcomes, and it can also be rapidly regained later. On the other hand, losing excess fat tissue helps to improve your health and reduce your risk of a variety of serious health conditions, and is also more sustainable.
Losing fat tissue always requires eating fewer calories than your body requires. However, your body still requires certain nutrients. If you eat too little, there’s a significant risk of becoming deficient in important vitamins and minerals.
You can also start losing muscle mass, especially if you’re not eating enough protein to meet your body’s needs. To stay healthy while losing weight, it’s important to ensure that you’re still eating enough to get the nutrients that you need from your food. This is part of why very rapid weight loss is not desirable. In general, you can only safely lose about 0.5 to 1kg per week.
For sustainable weight loss that helps to benefit your health, it’s better to lose weight more slowly. Even though it’s very natural to want to see results immediately, it’s important to remember that slower weight loss is more likely to last. With a GLP-1 RA, you can expect to experience gradual weight loss over time.
What happens after you stop taking a GLP-1 RA?
It’s considered to be safe to stay on these medications for the long term, and some people choose to do this to help them maintain their new healthier body weight. However, others choose to stop taking the medication after reaching a weight loss plateau. When people stop taking a GLP-1 RA, it’s common for them to regain much of the weight that was previously lost.
However, weight regain after stopping a GLP-1 RA isn’t inevitable. In fact, it’s definitely possible to maintain your new healthier body weight after you stop taking the medication. Doing this requires paying close attention to your lifestyle, in order to help keep yourself from regaining weight.
Eating a diet that’s higher in protein and healthy fats and lower in carbohydrates will generally help to keep you feeling full for longer, even after you’re no longer taking a GLP-1 RA. It’s also useful to track what you’re eating, to help maintain your new healthier portion sizes. Tracking your food intake for a few weeks before you stop taking the medication will give you a target, and then your goal should be to maintain a similar amount of food intake afterwards. It’s also important to ensure that you’re getting enough daily exercise, and to include resistance training (lifting weights or using resistance bands) a few times a week to help maintain muscle mass.
Most people find it helpful to have support in creating a healthy lifestyle plan that will help them maintain their new healthy body weight. Whether you choose to stay on GLP-1 RAs for the long term, or to stop taking the medication after your weight has stabilized, you’ll want to ensure that you optimize your diet and exercise plan to help maintain your weight loss and protect your long-term health.
This is why our holistic NOVI Optimum Plus medical weight loss program includes support from nutritionists and health coaches. They’ll help you to design a lifestyle plan that works for you, and will also help you stay on track with your plan.