GLP-1 medications are everywhere right now: in conversations with family and friends, and in targeted ads. With that much information out there, it's confusing to know what's real.
On a recent episode of the Functional Medicine Reality Podcast, TruWellness Medical Director Dr. Mark Su sat down with his co-host, Mary Jo Anderson, who has used a GLP-1 herself. Together they worked through the questions people actually ask. Here are the main takeaways, in plain English.
Listen to the full episode
Episode 37 – GLP-1s: The Science Explained, A Doctor and a Patient's Real Take
What is a GLP-1?
GLP-1s are a type of peptide, and they began as diabetes medications. As Dr. Su explains, the class goes back to around 2005, with newer generations improving over time.
Weight loss was observed after the fact. It wasn't the original intention, so the drugs had to go back and get FDA approval for weight loss. Dr. Su notes this happens from time to time in the pharmaceutical world.
Many people still think of GLP-1s as only a diabetes drug, so they're surprised to learn they can get one without being diabetic.
Semaglutide vs. tirzepatide: two different drugs
Brand names are one of the most confusing parts. Dr. Su breaks it down simply:
Semaglutide
Ozempic® & Wegovy®
- Ozempic®: FDA approved for diabetes
- Wegovy®: FDA approved for weight loss
- Works on: strictly a GLP-1 medication
Tirzepatide
Mounjaro® & Zepbound®
- Mounjaro®: FDA approved for diabetes
- Zepbound®: FDA approved for weight loss
- Works on: two mechanisms, GLP-1 plus a second one
Within each pair, the brands are effectively the exact same thing. The difference is what each is FDA approved for.
- Effectiveness: tirzepatide has been shown over and over by data to be more effective than semaglutide.
- Cost: tirzepatide is more expensive, so most of Dr. Su's patients are on semaglutide, which is still very effective.
- Switching: people who don't get enough benefit from semaglutide often ask to move to tirzepatide.
- Insurance: some patients can get coverage for sleep apnea or heart disease when they meet certain criteria.
Does it really work?
This is the first question most people ask. For weight loss, Dr. Su's experience in practice is clear:
I'd say it's rare that people don't get weight loss.
Dr. Mark Su, MD · Medical Director
He says he can think of fewer than three people who didn't get enough benefit after about two months.
Why it's been so hard before
The people who ask him are often struggling to lose weight. They've tried and tried, and it's not moving the needle enough. Circumstances often play a role.
His co-host found weight very hard to lose, especially in her menopause years. Over two six-month periods on a GLP-1, she says it quieted her food noise, and she dropped 30-plus pounds.
It's not just "being less hungry"
Many patients notice that the constant "food noise" quiets down. In Dr. Su's words, "definitely people have a food noise change and appetite loss."
But he also stresses there are other things going on mechanistically beyond "I'm just not hungry."
Benefits being studied beyond weight
- Evolving research: studies are looking at cancer risk, including breast cancer, and heart disease, sometimes independent of blood sugar and weight loss.
- Other questions people ask: whether it helps skin, joint pain, irritable bowel symptoms or brain fog.
Dr. Su is careful not to oversell, though. He says "it's hard to predict," and that "we're still in this learning observational period."
Let's talk about the stigma
Much of the episode is about something rarely said out loud: the feeling that using a GLP-1 is "the easy way out." Dr. Su says he still sees some anti-GLP-1 messaging, even among health practitioners. For many men, he notes, the reflexive response is "about the gym every day."
His view on the weight-loss benefit is direct:
The pros and cons is such a heavy imbalance that it's a hard argument.
Dr. Mark Su, MD · Medical Director
He also says it plainly: it isn't perfect for everybody.
Being holistic and mindful about nutrition and fitness is important.
Dr. Mark Su, MD · Medical Director
Why the source matters
GLP-1s and other peptides are heavily advertised online, and both Dr. Su and his co-host describe the market as a kind of Wild West.
He points to data showing that some sources, especially of peptides but possibly some GLP-1s too:
- Don't contain what they claim, or
- Are produced in a way that leaves toxins in them
From TruWellness
GLP-1 weight loss at TruWellness in Newburyport
We prescribe all FDA-approved GLP-1 medications, such as Wegovy® and Zepbound®.
Our weight-loss program is led by:
- Dr. Mark Su, MD
- Mary Ramsey Stuckey, PA-C
What to expect
- A real conversation about your history, goals and what you've already tried.
- A plan built around the right FDA-approved medication for you.
Patients come to our Newburyport office from Amesbury, Newbury, Salisbury, Haverhill and across the North Shore and the Merrimack Valley.
Learn more on our GLP-1 Weight Loss page.
Book a ConsultationThis article is for education only and isn't medical advice. Talk with a licensed provider about whether a GLP-1 medication is right for you.