What is a GLP-1 medication?
GLP-1 (glucagon-like peptide-1) agonists are a class of drugs that have been shown to aid in weight loss by mimicking the action of a natural hormone called GLP-1. GLP-1 is released from the gut after eating and plays several roles in regulating metabolism, appetite, and blood sugar levels.
How do I know if I am a candidate for a GLP-1?
Candidates are obese with a BMI equal to or greater than 30, or are overweight with a BMI equal to or greater than 27 and a health condition related to being overweight.
If your BMI is less than 27 and you still feel you are overweight, please reach out to us to discuss your individual case. BMI is applied to both men, women, all shapes and sizes of bone mass and muscle mass and is only an estimate.
If you have type 1 diabetes, please consult with your endocrinologist in order to see if you are a candidate for this medication. If you or your close family have a history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2), you should avoid GLP-1’s.
How do GLP-1’s work for weight loss?
Appetite Regulation
- GLP-1 acts on the brain, particularly in the hypothalamus, to reduce appetite and increase feelings of fullness (satiety). This makes people feel less hungry, leading to reduced food intake.
Slower Gastric Emptying
- GLP-1 slows down the rate at which the stomach empties after eating. This delay in gastric emptying can prolong feelings of fullness, which helps reduce overeating or snacking.
Improved Insulin Sensitivity
- GLP-1 enhances insulin secretion in response to meals, helping to regulate blood sugar levels. By improving insulin sensitivity, it may also help prevent fat storage and promote fat loss.
Reduction in Fat Storage
- GLP-1 has been shown to reduce the production of glucagon, a hormone that promotes fat storage and increases blood sugar. This can further aid in fat loss.
Increased Energy Expenditure
- Some studies suggest that GLP-1 may help increase energy expenditure, although this is still being researched.
Other than weight loss and blood sugar management, are there other health benefits of GLP-1’s?
New health benefits and potential health benefits are being discovered almost weekly. GLP-1’s reduce risk of heart attack and stroke. They improve lipid profiles. They may improve liver function for those with fatty liver not due to alcohol consumption. They are neuroprotective and may reduce risk for diseases such as Alzheimer’s and Parkinson’s. They may help with depression and addiction. While they have been linked to certain cancers in animal models, preliminary research suggests GLP-1’s may reduce several types of cancer. In a study of patients receiving GLP-1 treatment compared with patients receiving insulin, the following reductions in cancers were noted: Gallbladder cancer by 65%, Meningioma by 63%, Pancreatic cancer by 59, Hepatocellular carcinoma by 53%, Ovarian cancer by 48%, Colorectal cancer by 46%, Multiple myeloma by 41%, Esophageal cancer by 40%, Endometrial cancer by 26%, and Kidney cancer by 24%
Will I have any side effects?
Common side effects include nausea, vomiting, diarrhea, and stomach discomfort. These can be diminished by starting out on a lower dosage and by avoiding skipping doses. We also offer a 15% discount at our store on supplements that help manage side effects. These side effects are usually temporary and tend to diminish over time as your body adjusts to the medication.
Exercise is important not only as an adjunct for weight loss, but also to prevent loss of bone and muscle mass while taking a GLP-1.
Recent studies suggest an increase in diagnoses of anxiety, depression and suicidal ideation in patients taking GLP-1’s compared to the those who are not. If you are experiencing any of these symptoms, please inform your clinician for proper evaluation.
Any side effects that are severe and persistent should be evaluated promptly by a health professional.
How much weight can I expect to lose taking a GLP-1?
Clinical trials show that GLP-1 agonists can lead to significant weight loss. A study comparing weight loss in patients taking tirzepatide for 1 year showed an average weight loss of 41 pounds per patient. The reason this is so exciting is that it comes very close to a patients who have undergone bariatric surgery losing an average of 46 pounds after 1 year. Patients on semaglutide for one year lose an average of 27 pounds. Results may vary by individual.
Some patients benefit with additional weight loss by using supplements to support GLP-1 agonists. Patients of bellobella automatically receive a 15% discount off our online store. First orders receive 25% off.
Are compounded GLP-1’s as safe as brand name equivalents?
Yes, but only if obtained from a reputable source. At bellobella, we prescribe from compounding pharmacies who third party test every batch of medication. This means an independent party will check your prescription to make sure it is effective and safe and the correct dosage. Sometimes this can cause a slight delay in supply for your refill. Although refills are often dispensed next business day, please try to request your monthly refills one week in advance to avoid missing doses while batches are being tested.
How do I know what dosage of GLP-1 to use?
GLP-1’s are given orally or via injection once per week. Medications like semaglutide are typically prescribed in higher doses for weight management compared to lower doses for diabetes management. We will start you on a low dose to diminish any possible side effects, then titrate up gradually as your body adjusts to the medication. Once you are at a dosage where you are losing weight, that will become your weekly dosage. We recommend you take the lowest effective dose in order to reduce side effects. Some patients prefer to use higher dosages and this can be discussed with your clinician who will guide you through the process.
How long do I need to take a GLP-1?
The official answer to that is currently unknown. What we do know is that on average patients regain half of the weight that they lost back within 1 year of discontinuing the medication. Results vary by individual. In future, there may be a recommendation to stay on GLP-1’s long term, possibly at a reduced dosage, both to maintain weight loss, and due to the multiple potential health benefits that are being discovered. Studies have not yet determined what dosage that would be.
Here at bellobella, we encourage life style changes to optimize maintaining your healthy lower weight after discontinuing the medication.
What can I do to help with side effects of GLP-1’s?
- Start at a low dose. Titrate up slowly
- Some patients report avoiding fatty, greasy and spicy foods helps, as well as eating smaller portions.
- Regular anti-nausea drugs are not recommended as they have not been shown to help. Ginger may be useful. Our supplement store offers some packages of supplements that reduce side effects and enhance weight loss on GLP-1’s.
- Avoid skipping doses. Many patients have experienced frustration using brand name medications due to frequent shortages causing them to miss dosages for weeks at a time and having to retitrate their dosages from the beginning. This can cause a return of side effects. Dosing consistency is easily facilitated by prescribing compounded GLP-1’s as they are more obtainable due to affordability and available supply.
What if I miss a dose of my GLP-1 medication?
If you miss a dose of semaglutide, take it as soon as possible within 5 days after your missed dose. If more than 5 days have passed, skip the dose and take your next dose on your regularly scheduled day. There should be at least 48 hours (2 days) between doses of semaglutide.
If you miss a dose of tirzepatide, take it as soon as possible within 4 days after your missed dose. If more than 4 days have passed, skip the dose and take your next dose on your regularly scheduled day. There should be at least 72 hours (3 days) between doses of tirzepatide.
If you miss several doses, please reach out to your provider as you may need to drop down to a lower dose to reduce experiencing side effects.
Can I still use bellobella for prescriptions if my health insurance covers brand name GLP-1’s?
Most major insurance carriers offer little or no coverage for weight loss medications even though they often cover GLP-1’s for diabetes. If you do have coverage, we can prescribe you the brand name medication if this is your preference or if it is more affordable for you. (If your pharmacy is having any supply issues we can fill in with compounded medication when needed.) If you are obtaining medication through your insurance, please call or text to schedule your appointment with us so you are not overcharged, as our online appointment prices include the cost of compounded semaglutide.
What if I’m not losing weight on a GLP-1?
For some patients, just taking the drug alone is not enough to lose weight. For best results, GLP-1’s should be taken in conjunction with calorie reduction and exercise. Exercise is especially important to reduce loss of muscle mass and bone density.
Stress can also play a factor. By reducing your stress levels, you reduce the stress hormones in your body that can interfere with weight loss.
If I’m adding supplements, how do I know if I can continue my regular vitamins?
Fullscripts, our online dispensary requests that you input all of your current medications and supplements so they can check to avoid over duplication of ingredients. They also offer an app which we highly recommend to all of our patients in order to keep track of your medications and supplements. There is an optional pill reminder and refill reminder function included in the app. You can use this app to manage your medications and supplements even if you don’t order from Fullscripts.
I don’t need to lose weight, but I’ve heard great things about you. Can I still use bellobella for my primary care?
Absolutely! We are just very passionate about health and weight loss but we also provide comprehensive primary care, primarily via telehealth. We also have availability for occasional in person visits if needed either at your home or at our office in Tempe.
For an in person visit, please schedule directly with our staff by texting or calling (602) 363-4627. Please email us at [email protected] if you have any questions.
If you have any additional questions, please don’t hesitate to ask. We can be reached at [email protected] .
All questions will be responded to within 72 hours, but typically sooner/same day.
