GLP-1s Decoded: Ozempic, Wegovy, Mounjaro & Beyond
In five years, GLP-1 receptor agonists have gone from a niche second-line diabetes medication to the most-prescribed weight-loss therapy in modern medicine. Here is the plain-English breakdown.
What GLP-1s actually do
GLP-1 (glucagon-like peptide-1) is a hormone your gut releases after meals. It tells your pancreas to make insulin, slows stomach emptying, and signals fullness to your brain. GLP-1 medications mimic this hormone, but last for days, not minutes.
The net effect: lower post-meal glucose spikes, reduced appetite, and significant weight loss for most users.
The current lineup
| Brand | Generic | Class | Frequency | Approved For |
|---|---|---|---|---|
| Ozempic | Semaglutide | GLP-1 | Weekly | Type 2 Diabetes |
| Wegovy | Semaglutide (higher dose) | GLP-1 | Weekly | Weight management |
| Rybelsus | Semaglutide (oral) | GLP-1 | Daily pill | Type 2 Diabetes |
| Mounjaro | Tirzepatide | GLP-1 + GIP dual | Weekly | Type 2 Diabetes |
| Zepbound | Tirzepatide | GLP-1 + GIP dual | Weekly | Weight management |
| Trulicity | Dulaglutide | GLP-1 | Weekly | Type 2 Diabetes |
| Victoza | Liraglutide | GLP-1 | Daily | Type 2 Diabetes |
The benefits the studies confirm
- A1C reduction of 1.0–2.0 percentage points for semaglutide and tirzepatide
- Weight loss of 15–22% of body weight over 12+ months on the highest doses
- Cardiovascular protection, reduced rates of heart attack, stroke, and cardiovascular death (SUSTAIN-6, SURPASS-CVOT)
- Kidney protection in type 2 diabetes (FLOW trial, semaglutide)
The side effects no one warns you about
Common (and usually temporary): nausea, constipation, diarrhea, reflux, fatigue, "Ozempic burps." Most resolve over 4–8 weeks as the dose escalates.
Less talked about but real:
- Muscle loss, up to 40% of total weight lost can be lean mass without resistance training
- "Ozempic face", rapid fat loss makes facial volume drop visibly
- Gallbladder issues, slightly elevated risk of gallstones
- Hypoglycemia when combined with insulin or sulfonylureas
- Mood changes, emerging reports of anhedonia and apathy in a minority of users
Who should not use them
- Personal/family history of medullary thyroid carcinoma or MEN-2
- Pancreatitis history (relative contraindication)
- Pregnancy or planning pregnancy in the next 2 months
- Severe gastroparesis
What to do alongside the medication
- Resistance train 2–3x per week to protect muscle
- Eat 1.2–1.6 g protein per kg of body weight daily
- Hydrate aggressively, dehydration amplifies side effects
- Track time-in-range in GLUCORAiQ to see real glycemic impact
- Plan an off-ramp, most people regain 2/3 of lost weight within a year of stopping
The bottom line
GLP-1s are the most effective pharmacologic tool we have ever had for type 2 diabetes and obesity. They are not magic, they are not free of trade-offs, and they work best when paired with the lifestyle work the marketing pretends you can skip.
Log every dose, every meal, and every glucose reading in GLUCORAiQ. Bring the report to your next appointment. The medicine plus the data is what changes outcomes.