This article is for you if you’re exploring GLP-1 receptor agonist medications or are currently using them. Whatever your choice, the goal is to help you make informed choices, understand how these medications work, and recognise the kind of support you might need along the way.

What Are GLP-1 Receptor Agonists?

Glucagon-like peptide-1 (GLP-1) receptor agonists are medications that mimic some hormones naturally produced by the gut (incretins). They work by promoting insulin secretion, delaying stomach emptying, and enhancing satiety (the feeling of fullness). These effects help regulate blood sugar levels and reduce appetite.

Originally developed to manage type 2 diabetes, certain GLP-1 medications are now also licensed for weight management:

• liraglutide (Saxenda) (daily injection)
• semaglutide (Wegovy) (weekly injection)
• tirzepatide (Mounjaro) (weekly injection)

Wegovy and Mounjaro are currently labelled as “black triangle” drugs in the UK, which means they are under enhanced safety monitoring due to their recent new use for weight loss.

Who Are They For?

When used for weight loss, GLP-1 receptor agonists are typically prescribed for:

• Individuals with a body mass index (BMI) over 30 kg/m²
• Those with a BMI over 27 kg/m² who also have at least one weight-related health conditions such as hypertension, dyslipidaemia or cardiovascular disease

These are prescription-only medications and should always be used under medical supervision. Obtaining them from unreliable sources -such as unregulated websites or without a valid prescription- can pose serious risks, including receiving unsafe products, incorrect dosing, and lack of proper medical monitoring.

How Do GLP-1 Agonists Work?

GLP-1 medications work by:

• Suppressing appetite
• Delaying the emptying of the stomach and therefore enhancing the sensation of fullness
• Influencing how the brain and body communicate about hunger, blood sugar levels, and energy use

These combined effects can reduce energy intake and cause metabolic adaptations that lead to weight loss.

Are They Effective?

Clinical trials show that GLP-1 receptor agonists can lead to significant weight loss, particularly over the first 1–2 years of use. However, there are limitations:

• Stopping the medication is often associated with rapid weight regain, primarily in the form of fat mass.
• Long-term safety and effectiveness data are still limited.
• Most clinical trials involve less diverse populations (white women are overrepresented).
• Pharmaceutical companies are often involved in the research, which may introduce bias.

Literature suggests these medications are less effective when used under real-life conditions than in trials, partly due to lower adherence and dose adjustments. Also, many users discontinue treatment within a year, largely due to high cost or side effects.

What Is “Food Noise” and How Do These Medications Affect It?

“Food noise” refers to persistent, intrusive thoughts about food or heightened sensitivity to food cues. It can contribute to emotional eating or difficulty regulating eating behaviours. GLP-1 medications may reduce food noise for some, but this can also mask underlying issues such as chronic restriction, emotional distress, or a disordered relationship with food. In some cases, the suppression of hunger may disconnect individuals from natural hunger and fullness cues, increasing the risk of nutritional deficiencies and malnutrition.

It’s worth noting that many people refer to food noise as the preoccupation with food that arises from restricted intake or strict dietary rules, something that is completely natural and tends to subside once the person starts eating adequately again and lets go of rigid food rules.

Side Effects to Be Aware Of

Common side effects:

• Nausea
• Vomiting
• Diarrhoea
• Constipation

Less common but more serious risks:

• Hypoglycaemia (even in people without diabetes)
• Gallstones
• Pancreatitis
• Serious allergic reactions

Other concerns include:

• Loss of interest in food
• Disordered eating
• Nutritional deficiencies
• Loss of muscle mass
• Feelings of shame around using them (“cheating” for weight loss)
• Physical and psychological effects from regaining weight after stopping the medication
• Limited availability for those who really need them due to increased demand and inappropriate use when not clinically indicated.

What If You Have a Difficult Relationship with Food?

Research indicates that individuals most interested in trying GLP-1 medications often experience greater body dissatisfaction, internalised weight bias, disordered eating behaviours, and a heightened focus on weight loss. This highlights the importance of carefully considering the suitability of treatment and ensuring that tailored support is provided to address these complex emotional and psychological factors.

For those with a history of disordered eating or a difficult relationship with food, GLP-1 medications may complicate recovery. Appetite suppression may feel rewarding at first, but can reinforce restriction and disconnect from intuitive eating cues. It’s essential to explore the emotional and behavioural roots of eating patterns alongside before deciding to use these medications.

The Role of the Dietitian

If you choose to use GLP-1 medications, working with a dietitian can provide vital support, not only for your physical health, but also your emotional wellbeing. A dietitian can help:

• Conduct a thorough nutritional assessment in order to gain a comprehensive understanding of the individual’s needs before making decisions regarding treatment and the type of support required.
• Optimise nutrition to prevent deficiencies and muscle mass loss during weight loss.
• Provide nutritional support to prevent or manage medication side effects, such as gastrointestinal disturbances.
• Offer psychoeducation and practical advice to build sustainable habits that support long-term health beyond medication use.
• Improve your relationship with food, especially if you’re struggling with dieting, guilt, or disordered eating.

This support is especially important because the changes brought about by these medications can feel unfamiliar or even overwhelming. Having someone to guide you through this process with personalised, evidence-based advice can make a significant difference.

In Summary

GLP-1 receptor agonists may be a helpful tool for some people, but they should always be used under appropriate medical supervision and with the right support. They are not a magic solution. For lasting improvements in health and wellbeing, these medications must be combined with personalised nutrition advice, psychological support, and sustainable lifestyle changes.

References

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