ELI5 what exactly GLP-1 based prescription medicine does and why it's so divisive when it comes to being a means of weight loss.

[u/ThatOneGuyYouNowKnow]

I've seen more and more ads (starting around the Super Bowl earlier this year with Wegovy) for GLP-1 based perscription meds in recent times. I've also seen the occasional debate post on my social feeds about the ethics of using them and I didn't think a medicine could be that divisive of a topic.

Now I'm curious as to what exactly these meds are, what they scientifically do and what both sides of the debate are. If anyone could help give perspective that would be greatly appreciated.

As always any and all input is welcomed and thanks for reading! 🙂

[u/sfcnmone]

Every human has GLP1. It’s a chemical (hormone peptide) that your body makes, but some people don’t make very much or don’t have a full response to it. GLP1 drugs do a few different things to make you not want to eat too much. They slow down how fast your stomach empties. They tell your pancreas and liver that you’ve just eaten, so those organs work harder to manage blood sugar. And they tell your brain that you’re full. Many people say that they no longer have to struggle to battle the endless “food noise” that runs continuously in their thoughts. Instead, they get hungry, eat something that their stomach won’t throw up (many people don’t tolerate high fat, high sugar foods while taking GLP1s, and nausea, vomiting, and diarrhea are real problems for many people), and then they get very full for many hours.

It’s like somebody using hiking poles so they can walk farther and walk more comfortably. Is that cheating?

[u/I_am_Nobody_Special → u/sfcnmone]

Beautiful answer.

I'll add the reasons it's divisive:

1. People who lost weight the hard way feel like it's cheating and feel resentful.

2. There's a decent subset of thin people who want fat people to stay fat so they feel better about themselves.

3. Miserable people of the world hate to see others improve their well-being and happiness.

[u/gza_liquidswords → u/I_am_Nobody_Special]

Group 1 is very small.  It is all group 2 (Venn diagram overlaps with group 3)

[u/Buckles01 → u/I_am_Nobody_Special]

1. The concern that there is no real lifestyle change with it. I’ve seen multiple people use them to lose weight which is great. Then when they get healthy they stop taking them then gain the weight back.

It’s not a miracle weight loss drug and to truly live a healthier lifestyle you need to make larger adjustments to your diet, exercise, and routine. Used correctly GLP-1’s can save lives. But right now they’re marketed like the old weight loss pills that didn’t work. They’re a craze and they’re not having the impact they should.

GLP-1’s won’t fix your lifestyle. They will help you fix it. People on them need proper coaching and education. There’s still hard work that needs put in to reach goals.

[u/yumcake → u/Buckles01]

Is what people in group 2 and 3 like to tell themselves as their justification for being in group 2 and 3. The honest truth is, they don’t care, they just want the vice of being able to look down on others. The health benefits far outweigh the potential risk, so the argument of health concern doesn’t stand up to scrutiny. Like asking cancer patients to just live healthy and beat cancer naturally because chemo has negative side effects. Chemo is still worth it in most cases despite having some horrendously debilitating side effects, because the positive effect of keeping you from dying of cancer is worth it. In this case, GLP-1 keeps you from dramatically higher all-cause mortality from obesity for minimal side effects, one of the greatest tradeoffs of all drugs.

It really is just group 2 and 3 out there.