Not Quite The Bottom Line on GLP1s
Can you identify the benefits of GLP1s, or are you being fooled by diet culture? What research is there about GLP1s? And why is this newsletter late? Plus a few links to helpful resources.
To me, June was a blur. It was full of fun, adventure, and well, stuff. As a result, July snuck up on me, which is why this newsletter is three days late. I usually share some recipes, but I am going to save my date caramel bites for July 15th. (They are delicious, so remember to subscribe.)
What’s Happening in July
On July 17, don’t miss the No Weight Loss Required interview with Amanda Martinez Beck, who is the creator of The Fat Dispatch.
If you missed my interview with Digital Diabetes, you can catch Jessica Jones, RD, CDCES, and me on her Digital Diabetes Podcast.
Here are some recent resources I created for The Diabetes Link
In July, I will also be exploring a weight-inclusive approach to GLPs, so be sure to subscribe to the weight-inclusive newsletter, No Weight Loss Required, to stay informed. I wanted to have some fun with the information I am gathering so here is a weight-inclusive quiz about GLP1s.
Is It A GLP1 Benefit or Diet Culture?”
A sassy little self-check for curious minds and compassionate bodies.
1. What exactly is a GLP-1 medication?
A. A secret code for a gym membership
B. A hormone-based medication that helps lower blood sugar and appetite
C. A fancy new protein shake
D. Just another diet trend
✔ Correct answer: B
GLP-1s mimic gut hormones to improve insulin function, lower glucose after meals, and reduce food preoccupation.
2. GLP-1s are only helpful if you lose weight, right?
A. Duh, that’s the point!
B. Not exactly, they have metabolic benefits even without weight loss
C. Only if you're on keto
D. Yes, weight loss or bust
✔ Correct answer: B
They improve insulin sensitivity, lower A1C, reduce inflammation, and may even ease joint pain, independent of weight changes.
3. What’s a potential perk of GLP-1s that has nothing to do with pounds?
A. Better hair
B. Quieter mind (so there is less food chatter)
C. Ability to skip lunch forever
D. Getting out of social events
✔ Correct answer: B
Many people report fewer obsessive food thoughts, which can help support more mindful eating.
4. If your appetite totally disappears on a GLP-1, that’s…
A. A dream come true
B. What diet culture wants you to believe is a success
C. A red flag for malnutrition
D. B and C
✔ Correct answer: D
Low appetite can feel like a win, but under-eating puts you at risk for nutrient gaps, fatigue, and muscle loss.
5. What percentage of people experience GI side effects like nausea or constipation?
A. 10%
B. 25%
C. 74%
D. Only during full moons
✔ Correct answer: C
Yup, GI issues affect about 74% of users, usually mild, but worth planning around.
6. Do GLP-1s make behavior change easier?
A. Yes, they do the hard work for you
B. Yes, they erase all hunger cues
C. Yes, they can slow reactive thoughts
D. Yes, they magically pack your lunches
✔ Correct answer: C
Many folks use the “quiet” to reconnect with their body, build new habits, and escape all-or-nothing thinking.
7. What happens when you stop taking a GLP-1?
A. Nothing changes, GLP-1s last forever
B. Weight and blood sugar may rise again
C. You immediately start craving cupcakes
D. You never want another vegetable again
✔ Correct answer: B
These shifts are biological, not a personal failure. Regain is common and expected if support or behaviors aren’t continued.
8. Up to how much of the weight lost on a GLP-1 can be muscle?
A. None, if you eat clean
B. 5%
C. 25–40%
D. Depends if you do intermittent fasting
✔ Correct answer: C
Without enough protein or strength training, muscle mass takes a hit, which impacts metabolism and strength.
9. What might trigger food shame or disconnection while on a GLP-1?
A. Skipping meals and feeling proud
B. Feeling full but undernourished
C. Internalized diet rules
D. All of the above
✔ Correct answer: D
Diet culture’s influence can sneak in, especially if eating less gets mistaken for doing “better.”
10. What’s one BIG reason to work with a weight-inclusive provider while on a GLP-1?
A. To find low-carb desserts
B. To maximize weight loss
C. To avoid GI issues, muscle loss, and disordered eating
D. To track your macros like a boss
✔ Correct answer: C
Working with a weight-inclusive dietitian helps you nourish, not restrict. Think of it as body respect in action.
Citations
Almandoz, J. P., Lingvay, I., Frías, J. P., Garvey, W. T., Han, J., Gullapalli, D., Wang, Y., & Davies, M. J. (2024). Body weight and cardiometabolic outcomes after withdrawal of once-weekly semaglutide: The STEP 1 extension trial. Obesity, 32(9), 1613–1631. https://doi.org/10.1002/oby.23870
Dong, S., & Sun, C. (2022). Can glucagon-like peptide-1 receptor agonists cause acute kidney injury? An analytical study based on post-marketing approval pharmacovigilance data. Frontiers in Endocrinology, 13, 1032199. https://doi.org/10.3389/fendo.2022.1032199
Gigliotti, L., Warshaw, H., Evert, A., Kushner, R. F., Kahan, S., & Kushner, R. (2025). Incretin-based therapies and lifestyle interventions: The evolving role of registered dietitian nutritionists in obesity care. Journal of the Academy of Nutrition and Dietetics, 125(3), 408–421. https://www.jandonline.org/article/S2212-2672(24)00925-0/fulltext
Gudzune, K. A., & Kushner, R. F. (2024). New medications for obesity treatment: A new era and new challenges. JAMA, 332(7), 571–584. https://doi.org/10.1001/jama.2024.12065
Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., & Kushner, R. F. (2022). Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, 387, 205–216. https://doi.org/10.1056/NEJMoa2206038
Medical Students for Size Inclusivity (MSSI). (2023). GLP-1 informed consent document. https://sizeinclusivemedicine.org/wp-content/uploads/2023/11/MSSI-GLP1-Informed-Consent-1-1.pdf
Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., Lingvay, I., Mosenzon, O., Rosenstock, J., Rubio, M. A., Wadden, T. A., Wharton, S., & Wilding, J. P. H. (2021). Effect of continued weekly subcutaneous semaglutide vs. placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA, 325(14), 1414–1425. https://doi.org/10.1001/jama.2021.3224
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A., & Proietto, J. (2011). Long-term persistence of hormonal adaptations to weight loss. New England Journal of Medicine, 365(17), 1597–1604. https://doi.org/10.1056/NEJMoa1105816
Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L., Campbell-Scherer, D. L., ... & Bissonnette, S. (2023). Practical clinical considerations for the use of obesity pharmacotherapy. Clinical Obesity, 13(1), e12510. https://doi.org/10.1111/cob.12510
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokota, S., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384, 989–1002. https://doi.org/10.1056/NEJMoa2032183