“Weight loss medication” is currently a buzzing collection of terms in healthcare. In particular, gut hormone peptides, including glucagon-like peptide-1 (GLP-1) agonists (semaglutide, for example), have garnered significant attention, first for their role in diabetes treatment and prevention, and now in medically supervised weight loss. While the scientific basis behind GLP-1 agonists is profound, their potential for promoting healthy weight loss is dependent on expert oversight and supportive lifestyle changes. In functional medicine, weight loss is best supported with a comprehensive and integrative approach, with any added pharmaceutical interventions requiring full personalization and guidance from an expert in weight loss medicine.
Understanding GLP-1 Agonists
GLP-1 is a hormone produced by the cells of the intestine in response to food intake. Its primary functions include stimulating insulin secretion, inhibiting glucagon release, slowing the emptying of the stomach, and promoting satiety. These actions collectively contribute to the regulation of glucose metabolism and energy balance.
GLP-1 agonists are pharmaceutically derived peptides that mimic the action of GLP-1s in the body. By activating the GLP-1 receptor, these medications enhance insulin secretion, suppress glucagon production, and delay the emptying of the stomach. Additionally, GLP-1 agonists help regulate the appetite by affecting the brain pathways involved in hunger and satiety.
Numerous clinical trials have demonstrated the efficacy of GLP-1 agonists in promoting weight loss among individuals with obesity or overweight. These medications have been shown to reduce body weight and waist circumference, independent of their effects on blood sugar control.
Mechanisms Underlying GLP-1-Mediated Weight Loss
GLP-1 agonists promote weight loss through several key mechanisms:
- Appetite Suppression: GLP-1 agonists act on the hypothalamus and brainstem to reduce appetite and increase feelings of satiety. By modulating neural circuits involved in food intake regulation, these medications help individuals consume fewer calories, leading to weight loss.
- Delayed Gastric Emptying: GLP-1 agonists slow down the emptying of the stomach, which prolongs the time it takes for food to leave the stomach and enter the small intestine. This effect contributes to increased feelings of fullness and reduced food intake.
- Enhanced Thermogenesis: Preclinical studies suggest that GLP-1 agonists may stimulate brown adipose tissue activity and increase energy expenditure, thereby promoting fat burning and weight loss.
- Improved Insulin Sensitivity: By enhancing insulin secretion and sensitivity, GLP-1 agonists help optimize glucose metabolism and reduce the risk of insulin resistance-associated weight gain.
- Gut Microbiota Modulation: Emerging research indicates that GLP-1 agonists may influence the composition and function of the gut microbiota, which plays a crucial role in energy metabolism and body weight regulation.
Integrative Approaches to Weight Management
In functional medicine, weight management is viewed through a multifaceted lens that considers the interconnectedness of all systems in the body. While GLP-1 agonists offer a valuable pharmacological intervention for weight loss, they are most effective when combined with comprehensive lifestyle modifications.
Pharmaceutical interventions are typically combined with the following examples of weight management strategies in functional medicine:
- Personalized Nutrition: Tailoring dietary recommendations to individual needs and preferences, focusing on whole foods and adequate protein intake.
- Physical Activity: Encouraging regular exercise, including both aerobic and resistance training, to enhance metabolic health and support sustainable weight loss.
- Stress Management: Implementing stress-reduction techniques such as mindfulness meditation, yoga, and deep breathing exercises to mitigate the impact of stress on eating behaviors and metabolism.
- Sleep Optimization: Prioritizing quality sleep hygiene practices to regulate appetite hormones, optimize metabolic function, and support weight management efforts.
- Mindful Eating: Cultivating awareness and mindfulness during meals, emphasizing the sensory experience of eating and honoring hunger and fullness cues.
Addressing Weight Loss Medication Safety Concerns
Safety concerns typically follow the uptick of a new medication, especially one that addresses such a prominent topic in society. For example, certain brand-named medications that come in the form of auto-injectors can sound convenient but usually include standard dosing which is often too high for an individual. Sourcing and quality issues can also be concerning, including the risk of exposure to sub-standard compounds that have not gone through the appropriate vetting procedures.
Our Approach
In the case of weight loss medications, culling safety concerns primarily comes back to personalized medicine and expert oversight. By utilizing fully vetted, top-quality compounding pharmacies with facilities dedicated to peptides, our providers are able to utilize low dosing which permits lower starting doses and slower dose changes, resulting in fewer side effects and safer use. This also allows for an easier transition off of the medication once and individual’s goals have been achieved. We also utilize this within the context of a strategically designed peptide program that includes monitoring labs for safety and efficacy, and a quarterly functional medicine consultation to aid lifestyle change and support decision making. GLP-1 agonists can also be used within the context of our medically supervised 12-week weight loss program, which also for a personalized approach to dosing with additional one-on-one support.
A hypothetical example of typical an adverse reaction to a brand-name medication protocols with limited oversight includes nausea and the inability to eat sufficient calories to utilize the stimulated insulin response, which can lead to weakness and fatigue. By working with a provider who specializes in personalizing a weight loss medication protocol to the individual, the same patient could instead start with a low dose that increases slowly based on their biofeedback. They could also be supported with information on how and why to eat enough, limit aggressive exercise but keep up daily movement to retain (and even increase) muscle mass, and limit other conflicting supplements. Then, in time, the patient could be guided towards slowly backing off the medication once their goals are reached. A provider can then help monitor their weight loss maintenance and continue supporting their healthy lifestyle habits.
GLP-1 agonists represent a promising therapeutic option for individuals struggling with obesity and overweight. From a functional medicine perspective, these medications offer a valuable tool for addressing the underlying hormonal imbalances and metabolic dysregulation associated with excess weight. But they are just that: a tool. By integrating pharmacological interventions with functional medicine-based lifestyle modifications and expert oversight, an individual can experience optimal outcomes from this fascinating peptide family, supporting long-term weight management and overall better health.
If you think you may benefit from a medically supervised weight loss program, speak to our team today by requesting a Meet & Greet with our team of experts.