The list the functions associated with Glucagon Like Peptide-1 Receptor Agonists ie. GLP-1’s. (Zepbound, Mounjaro, Ozempic, Wegovy, etc.) is seemingly endless! Quite often we are informed of a new use for these “drugs of the 21st century” someone has recently discovered. It gives GLP-1’s further credence to that claim. Below I have compiled a list of the more common uses for the drugs which all occur while they are being taken. They are in order of decreasing importance:
Controls blood sugar in patients with diabetes
Causes a 20% body weight loss in a year
Reduces Blood Pressure
Improves Hemoglobin A1c levels
Lowers Total Cholesterol
Shrinks waist circumference
Improves kidney function
Lowers Heart Failure risk
Lowers stroke risk
The anti-inflammatory effects:
Improve blood flow
Delay or prevent dementia
Enhances effects of Calcium and Vit D
Improves hydration
Helps sleep apnea
Reduces severity of Psoriasis
WOW! That’s a long list. These “miracle drugs” have a lot of uses. When you take a GLP-1 RA, all of the functions listed here continue to occur. Of course that’s a good thing. As long as you take a GLP-1 it works. But if you stop taking it, all of the above effects stop, too. That’s not a good thing because, unless something changes, you’ll be stuck taking a very expensive drug forever. If you want to keep your weight off, control your blood sugar, cholesterol and BP, your must stay on the GLP-1 drug. That’s potentially a big negative.
Numerous studies on GLP-1’s comparing them to placebo reveal that as long as the GLP-1 is taken, the effects remain. BUT immediately after stopping the drug, weight gain begins, and cholesterol, blood sugar, BP, and A1c all evade control. The graphs used to illustrate these changes are very impressive. That really shouldn’t pose a problem for patients, but for many it is. One should look at GLP-1’s like you would insulin. Type 1 diabetics need insulin to live, and some take multiple injections every day. It’s something they need to take every day because it keeps them alive and free of ketoacidosis. Taking a GLP-1 every day doesn’t have that degree of importance, but to maintain one’s weight loss, and the other benefits, it is no different than taking insulin every day.
So, what on earth can patients do to maintain the good aspects of GLP-1’s after they’re done taking the medication? It’s not an answer to that question, but it has been shown that patients who lose the most weight are more likely to keep it off than are those patients who lose less weight. “After 1 year, patients who get a more dramatic effect tend to hold on to that weight loss a bit better!” You would think the opposite might occur, but these people are more motivated to lose weight to begin with, and thus are more motivated to keep it off when the drug goes away.
Another solution is called “microdosing,” or taking a lesser dose of GLP-1 less frequently to maintain weight and not continue to lose. This strategy has not been tested, but will be in the near future.
The third option is to “bite the bullet” and continue to take the drug. This requires a financial commitment that can strain the budget, but there’s always a chance it will eventually be covered by your insurance.
It seems after one year of success with GLP-1’s, it is now time to stand back and see what the year ahead holds for patients on these miracle drugs. More innovations and solutions will surely be proposed in the coming months and years, and things should only get better.
Reference: Wilson FP. What comes back when stopping GLP-1’s? Medscape 2025 November 24.
