In a culture where obesity and weight management are prominent topics of discussion, weight loss medications have emerged as an important tool for managing weight. While these medications contribute to weight loss, they may also offer additional benefits, such as lowering blood pressure, improving lipid profiles and heart disease risk, reducing fatty liver disease, and enhancing blood sugar control or reducing the risk of diabetes.
Glucagon-like peptide-1 (GLP-1) is a hormone that plays a key role in blood sugar regulation by stimulating insulin release and reducing glucagon production. GLP-1 also slows digestion, promoting feelings of fullness, which may help with weight loss and management.
Gastric inhibitory polypeptide (GIP) is another peptide hormone that stimulates insulin release and plays a positive role in fat metabolism.
GLP-1 medications have been prescribed for the treatment of diabetes since 2005. However, during clinical trials and post-release surveillance, researchers observed that many patients taking GLP-1 medications also experienced significant weight loss. In 2014, the first GLP-1 medication specifically approved for weight loss became available.
These medications are not intended to be the treatment for obesity but rather a tool in the treatment of obesity. Alongside these medications, behavior and lifestyle changes are also recommended. But what does this mean?
Behavior and lifestyle changes include:
- Reducing portion sizes
- Decreasing intake of high-fat and high-sugar foods and beverages
- Increasing fruit and vegetable consumption
- Boosting fiber intake
- Increasing physical activity and daily step counts
- Improving sleep/wake cycles
- Reducing stress
All these behaviors play a crucial role in weight regulation.
Consider your previous weight loss attempts:
- Did you restrict calories and/or increase physical activity?
- How long were you able to maintain those changes before feeling restricted or deprived?
- Did you see weight loss?
- If not, how did that make you feel?
- If you did see weight loss, did you return to previous eating or activity habits at your goal weight and regain the weight?
- Why were your previous weight loss attempts not sustainable?
Individuals who use these medications as a tool in their weight loss journey often report experiencing “less food noise,” which allows them to focus on the behavior and lifestyle changes that are critical for maintaining weight loss. Additionally, seeing steady progress can be an encouraging factor that motivates them to continue making positive changes.
When working with clients, I emphasize the importance of:
- Including protein at every meal and snack
- Incorporating fiber at every meal
- Maintaining adequate fluid intake
- Increasing physical activity beyond their current level and boosting step counts
- Prioritizing sleep hygiene
- Addressing emotional eating and disordered eating patterns, while exploring new coping mechanisms for stress
I help clients set individual goals in each of these areas, ensuring that the goals are SMART (Specific, Measurable, Achievable, Relevant, and Time-oriented).
When discontinuing GLP-1 or GIP medications, weight regain is a common concern, especially if individuals have not made permanent behavioral changes. This underscores the importance of focusing on long-term habits rather than relying solely on medication.
Sustainable weight loss requires ongoing attention to nutrition, physical activity, sleep, stress management, and emotional well-being. This whole approach to weight management emphasizes that medications like GLP-1s and GIPs are just ONE PART of a larger, comprehensive plan for long-term health and weight management.