GLP-1–based therapies, including medications such as Ozempic (semaglutide) and Mounjaro (tirzepatide) are, in my view, one of the most impactful therapeutic advances we've seen in metabolic medicine in recent years. While they are widely recognised for their role in weight loss, their benefits extend far beyond this and I am about to show you how.
From a cardiometabolic perspective, large clinical trials have shown significant reductions in major adverse cardiovascular events, including heart attacks and cardiovascular deaths. What we are seeing is that GLP-1–based therapies decrease cardiovascular risk not only just through weight loss, but through their effects on the underlying drivers of chronic disease. These drugs are improving insulin sensitivity, reducing systemic inflammation, enhancing endothelial function, and lowering visceral adiposity. These risk reductions are leading to improvements in blood pressure control, plaque reduction and glycaemic control. It is this multi-system impact that positions them as true metabolic therapies, rather than merely "weight loss medications."
What is also particularly exciting is the growing body of research suggesting broader systemic effects. GLP-1–based therapies appear to exert anti-inflammatory and immunomodulatory actions, with emerging evidence exploring potential benefits in conditions such as psoriasis, inflammatory bowel disease, and rheumatoid arthritis to name just a few. While promising, this area is still evolving and requires further large-scale research.
A Window of Opportunity
Clinically, one of the most profound effects I see in practice is the shift in a patient's relationship with food. By reducing appetite and "food noise," these medications create a window of opportunity for patients of any shape and size to reconnect with true hunger cues and build sustainable habits around nutrition, movement, and lifestyle. That said, my approach is intentionally conservative and individualised. Rather than aggressively escalating doses, I aim to keep patients on the lowest effective dose that supports meaningful behavioural change. The goal is not to eliminate hunger, but to restore balance which allow patients to maintain their results long-term without reliance on pharmacotherapy alone. I will never use GLP-1s to suppress appetite, I use them to restore metabolic balance while building sustainable habits.
A Thoughtful, Monitored Approach
It is also important to acknowledge that these medications are not without side effects, and their increasing use, often without adequate structure or monitoring, is something I approach with caution. In my practice, patients are closely monitored, with regular check-ins including body composition analysis (InBody), alongside evaluation of their eating habits and strength training is a MUST. This ensures that weight loss is not only effective, but also metabolically supportive and muscle-preserving.
Ultimately, GLP-1–based therapies are not a shortcut, they are a tool. When used thoughtfully, within a comprehensive and personalised framework, they can be truly transformative.
References
- Batsis, J.A. and Villareal, D.T., 2018. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nature Reviews Endocrinology, 14(9), pp.513–537.
- Blundell, J., Finlayson, G., Axelsen, M., Flint, A., Gibbons, C., Kvist, T., Hjerpsted, J.B. and Astrup, A., 2017. Effects of once-weekly semaglutide on appetite, energy intake, control of eating, food preference and body weight. Diabetes, Obesity and Metabolism, 19(9), pp.1242–1251.
- Drucker, D.J., 2020. Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metabolism, 27(4), pp.740–756.
- Marso, S.P., Daniels, G.H., Brown-Frandsen, K., et al., 2016. Liraglutide and cardiovascular outcomes in type 2 diabetes. New England Journal of Medicine, 375(4), pp.311–322.
- Nauck, M.A. and Quast, D.R., 2021. Cardiovascular safety and benefits of GLP-1 receptor agonists. Cardiovascular Diabetology, 20(1), pp.1–14.
- SELECT Trial Investigators, 2023. Semaglutide and cardiovascular outcomes in obesity without diabetes. New England Journal of Medicine, 389(24), pp.2221–2232.
- Wilding, J.P.H., Batterham, R.L., Calanna, S., et al., 2021. Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), pp.989–1002.