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• Posted January 22, 2026

GLP-1 Medications: A Comprehensive Overview

With more studies emerging, GLP-1 and dual GIP/GLP-1 medications have become well-established options for those with obesity or type 2 diabetes.

These treatments can positively affect appetite, metabolism and overall cardiometabolic health, offering a meaningful approach to long-term management for the two diseases.

How GLP-1 medications work

GLP-1 receptor agonists increase hormones that help control hunger, satiety and blood sugar.

They boost the release of insulin in the body when blood sugar rises, reduce glucagon (a hormone that raises blood sugar), slow the speed of digestion (so meals are more satisfying) and signal the brain to promote a feeling of fullness.

Across studies, all of these effects lead to better blood sugar control and significant weight loss.  

In addition to their effects on blood sugar and weight, GLP-1 medications have shown many other health benefits.

They reduce the risk of major cardiovascular events in those with a history of cardiovascular disease and elevated body mass index (BMI).

They can also protect kidney function in people with diabetic chronic kidney disease and improve symptoms and physical function in those with obesity and certain forms of heart failure. 

Who these treatments are for 

GLP-1 medications are approved for adults with:

• Type 2 diabetes

• Obesity (BMI of 30 kg/m² or higher) 

• A BMI of 27 kg/m² or higher with at least one weight-related condition such as high blood pressure  

Among individuals with a BMI of 27 kg/m² or more, additional benefits have been found.

Tirzepatide has been shown to improve moderate to severe obstructive sleep apnea, and semaglutide has been shown to improve heart health in people with established heart disease.

Semaglutide is also FDA-approved to treat metabolic dysfunction-associated steatohepatitis (MASH), a condition that causes inflammation and scarring in the liver, including more serious scarring called advanced fibrosis. 

These medications are not recommended for people who are:

• Pregnant

• Have a personal or family history of medullary thyroid cancer

• Have a condition called multiple endocrine neoplasia type 2

• Have had pancreatitis 

People with serious stomach conditions such as gastroparesis, those with advanced kidney disease and are prone to dehydration, and individuals with pre-existing diabetic eye disease should use these medications carefully and under close supervision by a healthcare provider.

How GLP-1s compare to other treatments 

Compared with other medications for obesity and diabetes, GLP-1s deliver strong benefits.

They typically result in more weight loss than any other medication currently available and, in some cases, reach the level of weight loss seen with metabolic (bariatric) surgery; surgery, however, still offers the most reliable weight loss results of any current obesity intervention.

In terms of blood sugar control, these medications typically work better than oral diabetes medications. While insulin is more potent at lowering blood sugars and is still necessary in some cases, it can lead to problems with low blood sugars and weight gain. 

Compared with the class of oral diabetes medications called SGLT2 inhibitors, GLP-1 therapies usually result in greater weight loss and stronger blood sugar lowering.

SGLT2 inhibitors have shown stronger evidence for reducing hospitalizations related to heart failure. Both classes reduce heart and kidney issues, and together they offer complementary benefits.

Practical trade-offs include gastrointestinal side effects and the fact that most GLP-1s are injections, but overall, they’re both safe and effective. 

Common side effects and how to manage them 

The most common side effects are gastrointestinal in nature, such as nausea, vomiting, diarrhea and constipation. These side effects usually occur early when patients first start taking the medication and often are short-lived.

Slow dosage increases during close follow-up appointments help patients and clinicians address symptoms promptly.

Eating smaller, protein-focused meals and avoiding heavy, fried foods can reduce symptoms. Careful attention to hydration is especially important for anyone experiencing nausea or diarrhea.

Improving adherence and access 

Patients generally do better with these medications when they know what to expect and feel supported by their healthcare provider. Starting low and going slow, scheduling follow-up visits after dose adjustment, and offering practical tips for gastrointestinal symptoms all help patients stay on track.

Small, lower-fat meals, fluids between meals, and over-the-counter fiber or laxatives for constipation can make day-to-day use easier. It’s important not to get discouraged by plateaus and to discuss ongoing lifestyle modifications at each visit. 

It is useful for patients to contact their insurance company about coverage ahead of time.

Integrating GLP-1 therapy into comprehensive care 

GLP-1 therapy is most effective when it is part of a structured program that also targets dietary habits, physical activity (including resistance training to preserve muscle mass), sleep, and stress management.

For people with type 2 diabetes, combining a GLP-1 with an SGLT2 inhibitor can offer complementary benefits for weight, blood sugar, heart health, and kidney protection.

Medications such as statins (for cholesterol lowering) and certain blood pressure medications remain important for reducing long-term cardiovascular risk. 

Referral to bariatric surgery programs may be appropriate for those who do not respond well to the medication or when the medication is not covered by insurance.

Coordination among primary care, cardiology and nephrology (kidney care) helps optimize long-term cardiometabolic goals.  

Advances and next-generation incretin therapies 

The expansion of this class of medications is moving rapidly, and this is likely just the beginning. Dual GIP/GLP-1 agonists, such as tirzepatide, show greater reductions in weight and blood sugar than GLP-1-only medications.

Medications that work on 3 different receptors (GLP-1, GIP, and glucagon) are coming down the pipeline. 

New combinations, such as GLP-1 agents paired with a mimic of the hormone amylin (which helps with fullness and lowering blood sugars), are showing significant promise and will be powerful tools in the toolbox.

Oral options are also being developed to simplify administration and are long-awaited by those patients who are reluctant to use injections.

Long-term use and patient expectations 

GLP-1 therapy should be considered a long-term treatment. When the medication is stopped, most patients regain a significant portion of the weight they lost.

This reflects the chronic and relapsing nature of obesity. Rather than aiming for a short-term fix, treatment goals should be framed as maintaining improvements in health and weight long-term with ongoing support. 

Once someone reaches their lowest sustainable weight or their target health improvements, they should continue with the lowest effective dose that maintains their progress.

Long-term check-ins provide opportunities to reinforce nutrition therapy and resistance training, refresh behavioral skills, monitor side effects and review cardiometabolic risk.

About the expert

Reema Dbouk, MD, is an Assistant Professor of Medicine at Emory University School of Medicine, where she practices obesity medicine and primary care. Dr. Dbouk is passionate about addressing weight bias and stigma, particularly in healthcare settings, and promoting a weight-inclusive, patient-centered approach that addresses the social, cultural, and psychological factors influencing health.