If you want to know more about GLP-1 medications, how they work, and if they are right for you, look no further! Dr. Courtney Whittle, an obesity medicine specialist and an Our Health Our Wellness Advisory Board Member, breaks down how GLP1 medications work, what patients can expect, and the biggest misconceptions surrounding these increasingly popular treatments.
OHOW: What are GLP1 medications are and how they work in the body to promote weight loss?
Dr. Whittle: GLP1s, or glucagonlike peptide agonists, mimic a hormone the body naturally releases to help regulate how we process food. They work in two main ways. First, they slow gastric emptying — meaning food stays in the stomach longer — which helps you feel full and reduces appetite. Second, they improve insulin sensitivity. Insulin is the hormone that lowers blood sugar and helps us process the food we eat, but some people have insulin resistance, prediabetes, or diabetes, where the body makes insulin but doesn’t respond well to it. That leads to higher blood sugar levels and weight gain. GLP1s help correct that process.
OHOW: How do GLP1 medications affect appetite, digestion, and blood sugar?
Dr. Whittle: They keep food in the stomach longer, which helps you feel full. They also reduce the release of ghrelin — the hormone that drives hunger — so overall appetite decreases.
OHOW: What are the most common physical side effects when starting the medication?
Dr. Whittle: The most common side effects are constipation and nausea. Because digestion slows down, stool sits in the intestines longer, and the body pulls more water from it, which causes hardening and constipation. Nausea is the second most common side effect.
OHOW: Beyond those, are there any longterm physical risks or more serious side effects?
Dr. Whittle: Yes, there are more significant but less common side effects. These include gastroparesis, gallstones, diarrhea, headaches, rashes, and hair thinning. Some medications — especially Tirzepatide (like Zepbound or Mounjaro) — can cause dosedependent hypersensitivity. Other reactions such as itching or rashes are more common in people with eczema or allergies.
OHOW: Are there any psychological or emotional effects patients should be aware of?
Dr. Whittle: Yes. There’s emerging research on GLP1s and addiction — specifically how they may help reduce addictive behaviors — and that’s currently being studied. Anecdotally, many of my patients report a major decrease in cravings, especially for alcohol and sweets. People who used to drink daily often lose the desire to drink, and those with strong sweet cravings say they barely think about them anymore. Overall, the medication quiets the “food noise” significantly, which helps reduce behaviors tied to cravings or foodrelated habits.
OHOW: What about individuals with a history of eating disorders or chronic dieting? Are there special considerations before prescribing GLP1s?
Dr. Whittle: Yes. With any patient, you have to assess the individual, but especially with eating disorders. GLP1s can be used, but only under close medical supervision. These are not patients you hand a threemonth prescription and walk away. You need to monitor their weight loss monthtomonth and make sure it isn’t happening too quickly. There’s no strict contraindication to using GLP1s in someone with a past eating disorder. In fact, some patients who were treated for anorexia or bulimia later gain significant weight, which can create anxiety. For them, GLP1s can help quiet the food noise and reduce that distress — but again, only with careful oversight.
OHOW: What role should behavioral health professionals play in supporting patients on GLP1 medications?
Dr. Whittle: I think it’s essential. Many people’s weight stories begin with a difficult relationship with food — often tied to trauma, loss, or using food as a coping mechanism. That creates a pattern of eating for reasons other than nutrition. If you take away the coping mechanism without giving someone a healthier one, they’ll go right back to those maladaptive habits, whether they’re on the medication or not. Behavioral health support helps patients build new coping skills and maintain longterm success.
OHOW: What typically happens when someone stops taking GLP1s, and how can weight regain be minimized?
Dr. Whittle: More than half of people who stop any antiobesity medication regain weight. With GLP1s, it’s even more common because they suppress appetite so strongly. If someone hasn’t changed what they eat — only how much — and they stop the medication, it’s almost guaranteed they’ll regain weight. That’s usually the same pattern that caused weight gain in the first place: overeating calories, especially from fast food or highcarb meals. If you don’t learn how to change the type of calories you eat, stopping the medication means going right back to old habits.
Another key factor is exercise. When you stop a GLP1, your appetite will increase — that’s expected. So you’ll naturally eat more than you did while on the medication. Regular physical activity helps offset those extra calories and reduces the likelihood of regaining weight.
OHOW: With the rapid rise in popularity of GLP1 medications, what do you think is most misunderstood about them?
Dr. Whittle: Expectations. The biggest misconception is what people think these medications will do and how quickly they’ll do it. Social media posts and commercials are advertisements — their goal is to sell a product. They’re not going to show the hard work, the slow progress, or the full timeline. They’ll show someone starting at one weight and ending at another, and they may imply it took three months when it actually took twelve. That’s the art of advertising.
So when people get their information from ads or the internet, they often expect rapid weight loss, like losing ten pounds every month, which isn’t realistic — and honestly, shouldn’t happen. Another misconception is that the medication alone is enough. It’s not. If you rely on the medication without changing your habits, you’re much more likely to regain weight. People need to understand their sources and recognize when someone is trying to sell them something.
OHOW: What advice would you give someone who feels pressured to take GLP1s purely for cosmetic weight loss?
Dr. Whittle: That requires some selfreflection. If seeing a commercial or someone else’s transformation makes you feel pressured to take a medication, it’s worth asking yourself why. Especially when you know those images may not be accurate or may be edited to look more dramatic.
If the pressure is coming from a physician, that’s a different issue — and it may mean that’s not the right physician for you. You should always feel heard, respected, and part of your healthcare team.
But if the pressure is coming from social media or advertising, that may be a sign that social media isn’t a healthy space for you right now. No one should feel pushed into taking a prescription medication because of what they see online.
OHOW: Why do need to shift the narrative when we talk about weight loss drugs?
Dr. Whittle: Yes. It’s important to understand that antiobesity medications are not designed to make people “skinny.” Weight loss is a byproduct. These medications treat obesity because excess body fat increases the risk of other diseases — high blood pressure, joint pain, heart attack, cancer, and diabetes. For some people, GLP1s help prevent those outcomes.
We need to shift the narrative away from “weightloss drugs” and toward “treatment for a chronic disease.” Just like cancer treatment can take time or have relapses, obesity treatment can too. And just like some people with asthma need an inhaler for life, some people may need a GLP1 longterm. When we understand that, expectations become healthier and more realistic. GLP1s should not be used solely because someone wants to lose weight quickly.
What To Remember
GLP1 medications can be helpful tools, but as Dr. Whittle reminds us, they work best when paired with realistic expectations and longterm lifestyle changes. These drugs are meant to reduce long-term health risk and chronic diseases, not solely to deliver quick cosmetic results. Understanding that difference helps patients make informed, grounded decisions about their health.
Additional Resources
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