GLP-1's Miracle or Myth?

Welcome back to Freedom to Nourish. I’m Kathy, and today we’re diving into one of the most talked-about topics in health and wellness right now: GLP-1 medications. You may know them by brand names like Ozempic or Wegovy.

They’ve been called game-changers. They’ve been called miracle drugs. And they’ve been called troubling.

But what’s the truth? And what does it mean for those of us who want to step away from diet culture and toward true nourishment?

What Exactly Are GLP-1s?

So let’s start simple. GLP-1 stands for glucagon-like peptide-1 receptor agonists. That’s a mouthful, but here’s the gist:

• These drugs mimic a natural hormone in the body that regulates blood sugar and slows digestion.

• They were first developed for people with type 2 diabetes, where blood sugar control is critical.

• But researchers noticed something interesting: people on these drugs often lost a significant amount of weight.

And in a world obsessed with weight loss, that got everyone’s attention.

The Hype vs. The Reality

On TikTok, in celebrity magazines, and even in casual conversations, GLP-1s have been labeled the secret to easy weight loss.

But the science tells a more complicated story.

One case study from 2024 followed a 35-year-old man prescribed semaglutide. He lost about 50 pounds in just a few months. Amazing, right? But here’s where things got tricky:

• When his dose was lowered, some of the weight came back.

• When the dose was raised again, he lost weight again.

• Eventually, he stopped the medication and, surprisingly, kept the weight off for about six months—largely thanks to strength training, flexible eating, and lifestyle changes.

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But along the way, something else happened. He developed food intolerances—first to lactose, then to gluten. Tests showed it wasn’t celiac disease or a true allergy. Eventually, he was diagnosed with small intestinal bacterial overgrowth, or SIBO, a gut condition that may have been worsened by semaglutide.

So yes, the drug “worked” for weight loss—but not without complications.

The Risks No One Likes to Talk About

Another study published in JAMA looked at thousands of people using GLP-1s for weight loss. Compared to another weight loss drug, bupropion-naltrexone, GLP-1s were linked with:

• A 9-fold higher risk of pancreatitis (painful inflammation of the pancreas).

• A 4-fold higher risk of bowel obstruction, when the intestines get blocked.

• Nearly a 4-fold higher risk of gastroparesis, sometimes called “stomach paralysis.”

  
  

Now, these aren’t everyday side effects—they’re relatively rare. But they’re serious. And they’re often left out of the glossy magazine headlines.

The Bigger Picture – Why Are We So Desperate?

Here’s what I keep coming back to: why are these drugs in such high demand?

One estimate suggests 93 million Americans could qualify for GLP-1 medications. That’s not just a supply chain nightmare—it’s a reflection of our culture.

We live in a world where body size is often treated as the most important measure of health, success, and even worth. And so when a drug promises weight loss, it’s no wonder it feels irresistible.

But here’s the truth: weight loss doesn’t always equal health. We know people in larger bodies can be metabolically healthy. We also know that weight cycling—the losing and regaining of weight—can be more harmful to long-term health than maintaining a higher weight.

So the bigger question isn’t just do GLP-1s work? The question is: why are we as a society putting so much hope in them?

I want to be clear: I’m not here to shame anyone who uses GLP-1s. For some, they may feel like a lifeline. For others, they may create more harm than good.

But what worries me is the idea that these drugs are the new “fix,” the new promise of control, the new golden ticket. Because we’ve been here before, haven’t we?

Think back—every decade, there’s been a “solution.” From fen-phen in the 90s, to Atkins in the 2000s, to keto, to intermittent fasting. And now, injectables and pills like semaglutide.

Each time, we’re told: This one is different. This one will finally work. And each time, the reality is messier.

What the Research Suggests About Long-Term Use

So, what do the studies suggest?

• Most people regain weight once they stop taking GLP-1s.

• Some—like the man in the case study—maintain, but only with significant lifestyle adjustments.

• For people with type 2 diabetes or heart disease, GLP-1s may offer real benefits beyond weight loss, like lowering blood sugar or reducing cardiovascular risk.

• But for otherwise healthy people, the long-term risk-benefit balance is far less clear.

That’s important. Because while the medical system may frame these drugs as “anti-obesity medications,” the cultural system often frames them as “a way to fit in.”

Reclaiming the Conversation

So where does that leave us, especially if we’re working to make peace with food and our bodies?

Here are a few reminders I want to leave with you today:

1. Your health is not defined by your weight. Movement, connection, stress reduction, sleep, and balanced eating matter just as much—if not more—than the number on the scale.

2. GLP-1s are not magic. They may help some people, but they carry risks and are not a one-size-fits-all solution.

3. Diet culture thrives on quick fixes. It always has. But real nourishment is about sustainability, compassion, and caring for the whole person—not chasing an ideal body type.

   
   

So yes, GLP-1s are making headlines. Yes, they might play a role in medicine. But they are not the answer to our culture’s obsession with thinness.

The real answer? That lies in shifting our values—away from scales and sizes, and toward connection, joy, and health in its fullest sense.

Citations:

Bacon, L., & Aphramor, L. (2011). Weight science: Evaluating the evidence for a paradigm shift. Nutrition Journal, 10(9). https://doi.org/10.1186/1475-2891-10-9

 Canadian Journal of Physilology: Discontinuing semaglutide after weight loss: strategy for

weight maintenance and a possible new side effect

Nicholas W. Carris a

, Shawn Wallaceb

, Christopher G. DuCoinc

, Rahul Mhaskard

, Marilyn Stern e

, and Brian Bunnell

JAMA (Journal of American Medical Assoc): Published Online: October 20, 2023. doi:10.1001/jama.2023.17244 Risk of Gastrointestinal Adverse Events Associated With Glucagon-Like Peptide-1 Receptor Agonists for Weight Loss

Noah Kojima, MD, Centers for Disease Control and Prevention, 1600 Clifton Rd, Mailstop 24/7, Atlanta, GA 30329 (nkojima@cdc.gov). Author Contributions: Drs Kojima and Uyeki had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: Kojima, Uyeki. Acquisition, analysis, or interpretation of data: All authors. Drafting of the manuscript: Kojima, Uyeki. Critical review of the manuscript for important intellectual content: All authors. Statistical analysis: Kojima. Administrative, technical, or material support: Kojima, Peterson, Hawkins. Supervision: Kojima, Allen, Flannery, Uyeki.