Are GLP1s Redefining the Future of Health?
How weight-loss medications are reshaping modern healthcare—and why nutrition, movement, sleep, and behavior are still a critical part of the true foundation of lifelong wellness.
My dear friend, Susie, has been working with me for about six years. Yes, she had been obese for much of her adult life, and yes, her blood sugar levels had skyrocketed to the point that she required medication for Type 2 diabetes. And yes, for many years, she had also been taking medication for high blood pressure.
More often than not, being overweight is a major contributor to heart disease, cancer, fatty liver disease, and many other chronic conditions—much of which can be prevented. Susie had had enough and was finally ready to make a change.
Together, we developed a medically guided nutrition and lifestyle program that included three meals a day, one to two snacks, and a realistic exercise regimen. I coached, encouraged, and educated her every step of the way, and she achieved remarkable results. During her first year, she lost 30–35 pounds and adopted critical lifestyle habits and behaviors that have stayed with her.
That's what this is all about. A healthy relationship with food begins in the mind. It's about the changes you are willing to make, can realistically live with, and can maintain consistently. What it is not is the black-and-white mindset that says you're either "on" or "off" your diet. In more than 40 years of practicing nutrition and lifestyle coaching, I have never seen that approach work for anyone over the long term. Never.
And that "D-I-E-T" word? It's the devil.
Then came the GLP-1 craze.
These medications have actually been around since 2005, when they were approved by the FDA for the treatment of diabetes. In 2021, some GLP-1 medications received FDA approval for chronic weight management in individuals with obesity or overweight and certain related health conditions. Since then, many physicians I work with have described them as "miracle drugs" and "game changers"—not only for successful weight loss but also for their potential anti-inflammatory benefits in patients with cardiovascular disease, kidney disease, sleep apnea, and even certain addictive disorders. The list of potential benefits continues to grow. While researchers do not yet fully understand all of the mechanisms behind these effects, emerging studies continue to demonstrate promising health benefits.
Can there be serious side effects? Absolutely. But what medication doesn't come with some degree of risk? In my experience, many of the side effects associated with GLP-1 medications can be minimized or managed through proper education, monitoring, and nutritional support.
About a year ago, Susie asked me whether she should consider a GLP-1 medication. Although she had maintained her 35-pound weight loss, her weight was still affecting her overall health and long-term longevity. I encouraged her to discuss the option with her physician and assured her that I would support her throughout the journey. She wanted to know more, so here it is.
WHAT IS THE MECHANISM OF GLP-1s?
GLP-1 stands for glucagon-like peptide-1, a hormone that naturally occurs in the body and helps regulate appetite and blood sugar. When released, it signals the brain that we are full after eating, primarily by slowing stomach emptying and digestion. It also helps regulate blood sugar by improving insulin release and reducing excessive glucose entering the bloodstream after meals.
CAN GLP-1s SUBSTITUTE FOR EXERCISE AND HEALTHY LIFESTYLE CHOICES? AFTER ALL, I'M GOING TO LOSE THE WEIGHT.
No. No. No.
Most of the patients I'm currently working with are thrilled that they no longer feel constant hunger. The "food noise"—that continual thinking about food—is often gone. It's remarkable.
Unfortunately, many people respond by skipping meals or eating only once a day. That is one of the quickest paths to failure, malnutrition, hair loss, constipation, muscle loss, and many of the other side effects we commonly see.
There is a right way to succeed with GLP-1 medications, and there is definitely a wrong way. When these medications are not used appropriately, illness or the need to discontinue treatment can result. After working with GLP-1 patients over the past four years, I can confidently say that most unsuccessful outcomes occur because people simply take the injection and continue living exactly as they did before, without making the necessary nutritional and lifestyle changes.
As for exercise, let me remind you that one of the most crucial—perhaps even non-negotiable—healthy habits is regular physical activity. There isn't enough space in this article to summarize all the research demonstrating how exercise protects against chronic disease while improving health span and longevity.
One of the biggest concerns with GLP-1 medications is the loss of lean muscle mass. Beginning around age 30, adults naturally lose approximately 2–3% of their muscle mass per decade, with that decline accelerating after age 60.
You can protect your strength, mobility, balance, healthy body weight, and muscle mass. Remember that nearly every organ in your body contains muscle tissue—especially your heart.
With GLP-1 medications, inadequate calorie and protein intake can lead to malnutrition and muscle loss, slowing your metabolism and contributing to chronic inflammation, which is associated with the progression of many chronic diseases.
Do I have your attention yet?
I can confidently tell you there are extraordinary physical and emotional benefits to using GLP-1 medications appropriately. Success depends on you and the healthcare professionals guiding your care.
As I often tell my patients, we are trading one set of food-related challenges for another set that requires careful attention. When these medications are managed correctly and thoughtfully, the benefits can be life-changing.
So continue to eat well, prioritize adequate protein, and make exercise a daily priority.
WHAT ABOUT THE TERRIBLE SIDE EFFECTS WE KEEP HEARING ABOUT?
Serious side effects, including pancreatitis, gastroparesis (delayed stomach emptying), bowel obstruction, and kidney injury, can occur, although they remain uncommon.
More manageable side effects include hair loss, diarrhea, nausea, constipation, low blood sugar (hypoglycemia), indigestion, abdominal pain, and gallbladder problems.
Remember, these medications significantly change eating habits and appetite.
Many side effects can be prevented, minimized, or resolved through careful monitoring by a registered dietitian nutritionist (RDN) and your physician.
Constipated? We have a plan: more fiber, more fluids, more movement, and fiber supplementation if needed.
Losing your hair? That is often a sign of inadequate nutrition rather than a hormonal issue.
Gallbladder problems? Rapid weight loss—regardless of the method—has always increased the risk of gallbladder disease. That's why losing more than one to two pounds per week is generally not recommended. Slow, steady weight loss is healthier.
Fast forward one year.
Susie has now been taking a GLP-1 medication for a year and feels wonderful. She has lost an additional 25 pounds in a healthy, sustainable way, and her physicians have discontinued both her blood pressure and diabetes medications.
So, can GLP-1 medications truly be the miracle or game changer people describe?
They certainly can—but only when they are used appropriately, combined with healthy lifestyle habits, and carefully monitored by experienced healthcare professionals.
For more information about our in-person (South Florida) or virtual program, which includes endocrinology support, please don't hesitate to reach out.
To your very best health,
Ronni Litz Julien, MS, RDN, LDN
Nutrition and Lifestyle Coach
Julien Nutrition Institute
