Diabetic Weight Loss Drugs: What They Are and How They Work

Weight loss drugs have blown up in popularity! It seems like everybody has heard of or knows somebody who is taking them. What gives?

Who are these drugs for?

These drugs are applicable to people who have a BMI of 30 or higher, or people who have a BMI of 27 or higher AND have a diagnosed health condition that could benefit from weight loss/a lowered A1C, such as type 2 diabetes or high blood pressure.

Types

There are two popular classes of diabetic weight loss drugs: GLP-1’s and SGLT-2’s. “GLP” stands for “glucagon-like peptide agonists”.  “SGLT-2” stands for “sodium glucose cotransporter 2”

Common types of GLP-1’s include Ozempic, Wegovy, Trulicity, Rybelsus, and more.

Common types of SGLT-2’s include Steglatro, Invokana, Farxiga, and more.

How They Work

GLP-1 and SGLT-2 weight loss drugs work differently.

GLP-1 drugs are typically taken as a shot either weekly or daily. They help our bodies produce more insulin after we eat a meal, which lowers blood sugar levels as a result. Therefore, GLP-1 drugs can help keep one’s A1C low and keep type 2 diabetes at bay.

SGLT-2 drugs are typically taken by mouth. They work by increasing the amount of glucose that is excreted by our kidneys into our urine. Like GLP-1 drugs, they can help to lower A1Cs.

Side Effects

GLP-1 drugs do cause weight loss, but we aren’t exactly sure how. We know that these drugs slow the movement of food in the small intestine, so it is believed that weight loss occurs due to a decreased appetite. The change in one’s appetite on GLP-1s happens quickly, which means that weight loss can be rapid if the affected person does not purposefully eat enough to combat their decreased appetite. This can result in the face looking hollow, sunken, and even wrinkly.

The decrease in appetite from GLP-1 drugs is partially caused by other related side effects, including nausea, vomiting, constipation and diarrhea. Sometimes appetite is decreased so much that one can develop malnutrition. Malnutrition can do some serious harm to the body, especially if it occurs for a long time. A primary concern of malnutrition is muscle wasting. Without proper nutrition, all of the muscles in the body start to lose mass and function, including the heart! Another concern of malnutrition is deficiency of multiple nutrients. Nutrient deficiencies can cause a plethora of side effects such as slow wound healing, fatigue, hair loss, easy bruising, decreased bone density, rashes, brittle nails, bleeding gums, and more.

Side effects of SGLT-2 drugs include needing to urinate more often, more frequent yeast/urinary tract infections, dehydration, and decreased bone density. Of course, weight loss is also a side effect.

Additionally, research is showing a potential link between both of these drugs and a lower risk of heart disease, blood pressure, and kidney disease. We do not know if this lower risk is caused by the drug itself, or the weight loss that it causes.

Things to Consider

These drugs do not change a person’s eating habits or metabolism in the long term. This means, and it has been shown, that as soon as a person stops taking SGLT-2’s/GLP-1’s, it is very likely that they will start gaining back the weight that they lost. This is because a person’s appetite and digestive function will return to normal after they stop taking these drugs

To permanently reap the side effects of weight loss from these drugs, you must keep taking them. Additionally, most weight loss drugs are not covered by insurance when they are not prescribed for type 2 diabetes and related risks. These drugs are not cheap, and can really start to add up when you have to purchase them weekly/monthly.

Summary

Although it is true that both of these drugs can undoubtedly help with weight loss, these drugs shouldn’t be viewed as the solution for sustainable, long-term weight loss for individuals who don’t meet the recommended prescription criteria. The side effects can range wildly from unnoticeable, to mild, to having a serious impact on one’s life depending on the person.

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Written by Sarah Haaser

Hey, I'm Sarah!

I am an undergraduate senior at Purdue University majoring in Nutrition & Dietetics. I enjoy trying new recipes and thrifting when I’m not in class or studying!  Learn more about the HSH offerings here.