What They Didn’t Tell You About GLP-1 | GLP 1 Weight Loss and Functional Health
What is a GLP-1, really?
Let’s get one thing out of the way - I am not here to demonize GLP-1s, or tell you whether or not you should take them. But as a functional health practitioner, I question everything - especially in a world drowning in oversimplified health advice and docs who won’t (or can’t) address anything that doesn’t fit neatly into a 15-minute appointment.
I scour for credible research, continue my own nutrition education, and pay attention to what I see in practice with my own clients who are on GLP-1s.
My biggest concern is not the GLP-1 medications themselves - my concern is with the absence of informed consent. It’s true that GLP-1s can improve markers of cardiac and metabolic health - but it is not a magical unicorn 🦄. Every health decision has its risks, and you deserve to be informed of those risks in their entirety.
Hello, my little love handles. I’m Hilary Beckwith, ex-dieter and functional health expert. Women with PCOS/PMOS, IBS, and autoimmune conditions come to see me with signs of adrenal stress, insulin resistance, and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively and fill in the gaps between their lab values and how their body actually feels. Before you continue, click here to read my Medical Disclaimer.
In this article, you’ll learn:
What is a GLP-1 agonist?
Short- and long-term effects of GLP-1 for weight loss
Things to consider before undergoing a GLP-1 weight loss protocol
How to minimize harmful effects if you are already on a GLP-1 weight loss protocol
Root causes of weight gain that are often overlooked
what is a GLP-1?
THE SCIENCE-Y BITS
To understand what a GLP-1 is, it helps to understand receptor sites. Every cell in your body has receptor sites for various hormones, molecules, and proteins. A common example of this that you may already be familiar with is insulin - insulin is a hormone that binds to insulin receptor sites to allow glucose to enter and be metabolized.
Think of the receptor site as a lock, and the hormone/molecule/protein is the key meant to fit into that lock. Receptor types vary from cell to cell, depending on what the cell’s function is.
The difference between a door lock and these receptor sites is that, to unlock a door, you would need a specific key, or an exact replica of that key, and both keys would both have the outcome of opening the lock. But in the case of receptor sites, there are many types of keys that will fit, and each produces a different action, depending on which key is used.
SO, WHAT IS A GLP-1?
Glucagon-like peptide, or GLP, has a similar structure to glucagon (a hormone produced by the pancreas) that enables it to bind to glucagon receptor sites on cells. Put differently, GLP is one of the many types of keys that can unlock the glucagon door, but has a different outcome than glucagon itself.
The number ‘1’ is simply a differentiation between this GLP and other GLPs that stimulate a different action when binding to receptors. GLP-1s are made naturally by the body and are released after eating, binding to glucagon receptor sites. Here’s what that does:
inhibit glucagon release
stimulate insulin release
slow the rate at which your food empties from your stomach into your intestines (called gastric emptying)
SO, WHAT IS GLUCAGON?
Glucagon is a hormone produced by the pancreas in times of low blood sugar or stress, that stimulates the release of stored glucose from the liver and fat tissue. Blood glucose levels rise, insulin is released, and shuttles glucose into cells to be converted into fuel called ATP (adenosine triphosphate). This is the same glucose metabolism that we referred to earlier.
I don’t want to minimize the “stress” component I just mentioned - it is a very important consideration in blood sugar management, but too complex to get into for this post. If you want to learn more about how stress impacts blood sugar, hormone balance, sleep, and inflammation, click HERE.
OKAY, SO WHAT IS A GLP-1 AGONIST?
A GLP-1 agonist is the medication we are discussing in this post - exogenous sources of GLP-1 that have been shown to lower cardiac risk, improve A1c values, and, yes, help people rapidly lose weight. Common examples of GLP-1 agonists include semaglutides, liraglutides, tirzepatides, and exenatides.
The biggest difference between a GLP-1 agonist (exogenous), and GLP-1 produced by your body (endogenous), is that the impacts of endogenous GLP-1 are meant to last only 1-2 minutes, whereas the impacts of exogenous GLP-1 last for about 1 week.
Chances are, your prescriber has only told you that the benefit of exogenous GLP-1 is that it will cut “food noise” and help you feel full for longer so that you’ll eat less (yay?).
What they didn’t tell you is how that prolonged effect negatively impacts digestion, inflammation, gut health, and causes undernourishment, impacting a wide range of body systems.
LET’S SUMMARIZE:
GLUCAGON: a hormone produced by the pancreas in times of stress or low blood sugar, that stimulates the release of stored glucose from the liver and fat tissue, and to some extent, muscle.
ENDOGENOUS GLP-1: a molecule released after meals that binds to glucagon receptor sites to inhibit glucagon release, stimulate insulin release, and slow gastric emptying for about 1-2 minutes, helping to jumpstart glucose metabolism after eating.
EXOGENOUS GLP-1: a synthetic form of endogenous GLP-1 that has the same effect, but for a much longer period - about 7 days.
For the sake of simplicity, I will refer to exogenous GLP-1s (GLP-1 medications) as “GLP-1s” throughout the rest of this post.
GLP-1 weight loss protocols have their downsides
GLP-1 meds are not new. They’ve been used for 10+ years at much lower doses than they currently are for weight loss, to help those with Type II Diabetes manage blood glucose levels more effectively.
They’ve become trendy in recent years because it was discovered that at higher doses, a patient can lose weight rapidly without even trying. And isn’t it our goal, especially as women, to be as small as we can be? (where is the sarcastic font?)
Sarcasm aside, the fact is that people want to lose weight, and they want it to be easy - and GLP-1s make weight loss easy. I get why that’s appealing. For those who have tried ALL the diets, and ALL the workouts, ALL the supplements, this might seem like a dream come true.
Let’s look at the research and talk about some things to consider when starting a GLP-1 weight loss protocol.
health effects of GLP-1 weight loss protocol
IMPROVES CARDIOMETABOLIC MARKERS
YAY! For someone who is at severe, or even moderate, risk for cardio events, suffers from chronic illness that can make preventative actions more difficult, or for someone who has limited capacity to understand and execute this process - great!
HERE’S WHAT’S MISSING:
Cardiometabolic markers include markers like blood pressure, HbA1c, and lipid markers (cholesterol, triglycerides). For someone who is not at severe or even moderate risk for a cardiac event, these markers can be addressed more effectively by addressing early signs of metabolic dysfunction. A GLP-1 might stabilize those numbers while actively taking a GLP-1, but it all falls apart once you discontinue the GLP-1 and have made no changes to your diet or lifestyle.
Early signs of metabolic dysfunction include:
“hangry” between meals
trouble falling asleep, or staying asleep
sugar cravings
inflammatory conditions (acne, eczema, persistent pain, autoimmune diagnoses)
hormone imbalances (PCOS/PMOS diagnosis, irregular periods, mood instability, PMS symptoms.
Addressing these early signs through a functional health lens will ensure the results last beyond the duration of the GLP-1 meds.
QUIETS “FOOD NOISE”
YAY! Many of us are drowning in social media posts and marketing that uses fear-based tactics to get us to eliminate certain food groups, or that one superfood ingredient or supplement will change. our. lives. - this gets us overthinking about food - and that sh*t gets noisy! So, yeah, a medication that cuts that noise is appealing to those of us who feel overstimulated and confused.
HERE’S WHAT’S MISSING:
The mechanism by which GLP-1s eliminate “food noise” is by increasing and prolonging the feeling of satiety. One method it uses to do this is by delaying gastric emptying and slowing digestive motility - for a week!
Slowing down your digestion is a BIG problem. A healthy digestive system is wired to disinfect your food, move waste out of your system, and absorb nutrients that come from the food you are ingesting. Here’s what happens when your digestion moves too slowly:
Constipation - Feces are an important elimination pathway for toxins. When you are constipated, toxins become reabsorbed into your bloodstream, and can then become reactivated. It’s not just toxins from your food that are eliminated by feces - many toxins that are deactivated by the liver, also use feces as an elimination pathway, including:
excess steroid hormones that your liver has deactivated in order to maintain balance (estrogen, progesterone, cortisol, etc.)
debris from harmful viruses, bacteria, or other pathogens that your immune system has fought off
Increased SIBO risk (and other harmful microbes) - Stomach acid and motility are the two primary mechanisms your digestive system uses to eliminate harmful microbes, including opportunistic bacteria (leading to SIBO), parasites, candida/yeast, and viruses. The proliferation of these microbes leads to increased inflammation, increased cortisol levels, and a damaged gut lining (leaky gut, intestinal permeability). The longer food sits in your intestines, the more it will ferment and give these microbes the perfect environment to proliferate.
WEIGHT LOSS
While it may not be true across the board, weight loss is the main appeal for GLP-1 use in the populations I work with. And at higher doses, GLP-1s have been effective for weight loss ultimately by decreasing appetite and thereby restricting calorie intake.
HERE’S WHAT’S MISSING:
Calorie restriction over time actually slows metabolism. While the pounds practically melt off during a GLP-1 weight loss protocol, the research shows that calorie restriction over time will actually slow your body’s natural ability to burn calories. And since the primary weight loss mechanism of GLP-1 meds boils down to calorie restriction - it’s worth considering what life looks like after you stop taking it.
Liver congestion, toxic burden, chronic stress, and underlying infections are common non-calorie causes of weight gain.
If you are someone who really struggles to lose weight even though you’re doing all the “right” things - then calories are likely NOT the reason you can’t lose weight. Your body will hold onto fat stores and inhibit fat breakdown in cases of infection, stress, and hormone imbalances. Click HERE to read more about non-calorie causes of weight gain.
UNDERNOURISHMENT - I cannot overstate how important this topic is. While your scale numbers are going down, your lack of appetite will eventually lead to a body that is using its resources faster than you can replenish them.
Every function in your body requires nutrients. To name a few examples, glucose metabolism requires magnesium and many B- vitamins. Liver function and detoxification requires B vitamins, amino acids, cholesterol, and many minerals. Mood regulation largely relies on amino acids. “Full” does not equal “fueled”.
what the research shows
We’ve talked about the common claims of a GLP-1 weight-loss protocol, and the reality is all of them track. At the right dose, GLP-1s do live up to the hype of weight loss, improved cardiometabolic markers, and cutting the “food noise”.
Each of those claims comes with its own nuance that we also covered. The claims themselves are making it into the informed consent - but the nuances are not.
ADDITIONAL HEALTH EFFECTS OF GLP-1s:
DEHYDRATION: By increasing satiety, GLP-1s also decrease thirst cues, leaving you dehydrated. Why is hydration so important? Optimal hydration is needed for removal of waste through your lymphatic system, sweat, urine, and feces. Optimal hydration can also improve blood pressure by increasing blood volume, and helps lubricate joints, muscles, skin, and eyes. Sufficient hydration requires water AND well-balanced electrolyte minerals to draw the water into cells and tissues - nourishment and hydration go hand-in-hand.
INCREASED RISK OF GALLSTONES: Gallstones form when bile cannot move fluidly through the common bile duct and into your digestive tract. Because bile is formed from cholesterol, the increased movement of fat due to GLP-1s increases the concentration of fat in bile, making it more sluggish and increasing the likelihood of developing gallstones.
WEIGHT REGAIN AFTER GLP-1: A recent systematic review found that 60% of weight lost while on a GLP-1 weight loss protocol was regained in participants. What’s more, another study found that the weight regained came back as fat mass, not the lean mass that was lost.
RETURN OF CARDIOMETABOLIC MARKERS: The HbA1c, the blood pressure, the cholesterol, the lipids - those markers might improve while on a GLP-1 weight loss protocol, but this meta-analysis found that these markers, in addition to 2/3 of lost weight, were regained after discontinuing GLP-1.
BONE DENSITY LOSS DUE TO UNDERNUTRITION: A paper published in December, 2025 by UC Davis pointed out that essential nutrients are being missed when people are underfed, and especially those that support bone health.
how to prepare your body for success even after GLP-1s
As you’ve seen here, the research is very clear - GLP-1s at higher doses help people improve cardiometabolic markers, support the function of insulin, and help people lose weight.
The research is also very clear that slower motility and rapid weight loss have many negative health effects, and that benefits seen while on a GLP-1 nearly reverse after discontinuing.
These are risks worth considering when exploring a GLP-1 weight loss protocol.
Medications like GLP-1 and even nutritional supplements will only go so far if you are not also addressing root causes of the symptoms, issues, or conditions they are meant to support. GLP-1s on their own are only going to help while actively on them, but addressing functional health in addition to GLP-1s can set you up for long-term success.
STEPS FOR ADDRESSING FUNCTIONAL HEALTH WHILE ON A GLP-1 WEIGHT LOSS PROTOCOL:
OPTIMIZE GUT HEALTH: “Gut Health” is more than just digestion and probiotics. It is the health of your intestinal tissues, the state of your microbiota, and the ability for your mucosal immune system to keep you from harmful infections.
CURRENTLY ON A GLP-1: Seek out a functional practitioner trained to assess and address microbiome imbalances, dysbiosis, and inflammation.
BEFORE GLP-1: Seek out a functional practitioner trained to assess and address microbiome imbalances, dysbiosis, and inflammation. Address any findings and optimize inflammation, tissue health, and beneficial bacteria before disrupting it with slowed motility.
OPTIMIZE DIET: Lean mass is primarily what is lost when on a GLP-1 weight loss protocol. Consuming good-quality protein and developing a strong routine for strength training will help to counter this. But when digestion is slowed, as it is with a GLP-1, there is little appetite for protein. Here’s how to get ahead:
CURRENTLY ON A GLP-1: Think “protein-forward” meals. If all you have the appetite for is a few bites of food, prioritize good-quality proteins. Click HERE to learn how to choose good-quality proteins.
BEFORE GLP-1: Get in the habit of consuming sufficient protein before starting your GLP-1 (this will require optimizing digestion, too). Most people with a regular strength training routine need about 1.2-1.8 grams of protein per 1 kilogram of desired body weight.
OPTIMIZE HYDRATION: Sufficient hydration is important for bowel movements, blood pressure, and detoxification, but thirst cues are stunted when on a GLP-1.
CURRENTLY ON A GLP-1: Begin putting tools into action that will help remind you to drink. Phone or watch alarms, visual cues, notes - whatever works best for your lifestyle and habit development. Most individuals with normally functioning kidneys require a minimum of 0.5 fluid ounces per 1 pound of body weight, daily. Electrolyte minerals are also essential to fluid balance within cells and tissues, especially if you may be undernourished from GLP-1 use. This is my favorite electrolyte product.
BEFORE GLP-1: (same as above)
RESISTANCE TRAINING: GLP-1 breaks down lean mass (muscle tissue), and most weight lost while on a GLP-1 weight loss protocol comes back as fat mass. Staying ahead of strength training and muscle-building can help mitigate this effect.
CURRENTLY ON A GLP-1: Begin building a strength training routine 2-3 times per week. Working with a trainer knowledgeable in GLP-1 use is essential, as it may be unsafe to work out too intensely without proper nourishment.
BEFORE GLP-1: Get in the habit of strength training before you start a GLP-1, at least 2-3 times per week. This will support insulin sensitivity, build up a reserve of lean mass, and condition your body to handle resistance training, rather than starting new while on a GLP-1.
PLAN FOR PLEASURE: For many (myself included), food is pleasure, and even comfort. In fact, food can actually release dopamine and endorphins to block pain. If this is you, a GLP-1 will remove an important source of joy and comfort in your life by suppressing your appetite for food. The key is to plan ahead and make sure you have other sources for coping when appetite is suppressed.
CURRENTLY ON A GLP-1: It’s not too late for you. Before you do anything else, make a list. Name 3-5 easy-to-access things that bring you comfort or joy, besides food. No need to reinvent the wheel, just keep it simple and fun, and try to avoid more addictive behaviors like scrolling or substances. Your list might include:
reading a chapter of a book
single-song dance party
gratitude journal
sitting/walking in nature (without headphones)
grab a coffee or tea at your favorite shop
jumping on a trampoline
tell yourself a silly joke (really!)
tell someone else a silly joke
BEFORE GLP-1: Same as above, but now you have time to implement these alternative behaviors before the appetite suppression from a GLP-1 makes it more challenging.
learn something new?
What was your biggest takeaway from this article? Leave your thoughts and questions in the comments below, and I will do my best to respond soon!
Want help getting off a GLP-1 weight loss protocol?
