GLP-1 Medications: the buzz, the hype, & the hormone

You’ve probably heard the buzz. Maybe a friend mentioned Ozempic at a dinner party. Maybe you’ve seen the before-and-after photos on social media. Or maybe you’ve just noticed that suddenly everyone seems to be talking about a class of medications called GLP-1s. So, what actually are they, and should you know more about them? Let’s dig in.

What Is GLP-1, Actually?

Before we talk about the medications, meet the hormone they’re named after. GLP-1, short for glucagon-like peptide-1, is produced naturally by your gut every time you eat. ^[1] Its job is to nudge your pancreas into releasing insulin, tell your liver to stop tipping extra sugar into your bloodstream, slow down how quickly food leaves your stomach, and eventually send a message to your brain along the lines of “alright, that’s enough, put the fork down.” ^[1,2] In other words, GLP-1 is your body’s in-house appetite manager, quietly doing its job in the background so you don’t eat an entire packet of Tim Tams in one sitting. In people with prediabetes, type 2 diabetes, or obesity though, this system can become a bit hard of hearing. The signal gets fainter, the fullness cue arrives late to the party, and blood sugar control starts to slip. Which is where the medications come in.

So What Are GLP-1 Medications?

GLP-1 receptor agonists are prescription medications built to copy your natural GLP-1 hormone, then turn the volume up considerably and make it last far longer than your gut ever could on its own. ^[1,2] The names you’ve almost certainly heard by now include:

• Semaglutide — Ozempic for diabetes, Wegovy for weight management ^[1]
• Liraglutide — Victoza for diabetes, Saxenda for weight management ^[1]
• Dulaglutide — Trulicity ^[1]
• Tirzepatide — Mounjaro, a newer dual-acting medication that targets both

GLP-1 and a second hormone called GIP ^[1,2] Semaglutide, dulaglutide, and tirzepatide are given as once-weekly injections under the skin. ^[1] Liraglutide is the exception, dosed once daily instead. ^[1] They were originally developed for type 2 diabetes, but the weight loss side effect turned out to be so dramatic that the medications went on to earn their own approval for weight management. ^[1] They have been called, without much exaggeration, the most significant development in obesity medicine in decades. Which is either very exciting or very confronting, depending on where you sit.

In New Zealand, dulaglutide and liraglutide are available on prescription, with funded access under Special Authority criteria for eligible people with type 2 diabetes. ^[5] Prediabetes isn’t currently covered by that funding, so anyone in that earlier stage would be looking at private prescription costs if a GLP-1 medication is being considered at all.

What Do They Actually Do in the Body?

Think of these medications as turning up the volume on signals your body was already trying to send, just with the microphone finally working properly. ^[1,2]

They Boost Insulin, Selectively

Unlike some older diabetes medications, GLP-1 drugs only ramp up insulin release when blood sugar is actually elevated, which keeps the risk of dangerously low blood sugar fairly low. Your pancreas responds to the situation rather than firing blindly.

They Quieten Glucagon

Glucagon is the hormone that tells your liver to release stored sugar into the bloodstream - useful in a fasting state, but problematic when blood sugar is already high. GLP-1 medications suppress glucagon when it’s not needed, helping blood sugar stay stable.

They Slow Things Down in the Stomach

Food moves more gradually from stomach to small intestine, so blood sugar rises more gently after meals and fullness sticks around longer. Your stomach essentially, stops rushing through its to-do list.

They Act on the Brain

This is where it gets fascinating. GLP-1 receptors exist in the brain - particularly in the areas that regulate appetite, reward, and cravings. ^[2] GLP-1 medications reduce hunger, lower cravings for high-fat and energy-dense foods, and change the way food feels rewarding. Some patients report that the joy of their Friday night chips simply disappears. Many describe this as a relief. Others find it mildly unsettling.

The Results

Clinical evidence puts average weight loss with semaglutide somewhere in the range of the mid-teens to low twenties as a percentage of body weight, with tirzepatide performing at least as well in some trials. ^[3] On top of the weight change, these medications have also been associated with meaningful cardiovascular benefit, including a reduction in major cardiac events such as heart attack and stroke in people with existing cardiovascular disease. ^[4]

What Are the Side Effects?

Let’s be honest, no medication this powerful comes without a catch. The good news is that for most people, side effects are manageable. The less good news is that your digestive system may have some strong opinions in the early weeks.

Very Common, Especially Early On

• Nausea, the most frequently reported side effect, generally settling down over the first couple of months ^[6]
• Vomiting
• Diarrhoea or constipation, sometimes both, as though the gut can’t quite decide on a direction. ^[6] Doses are increased gradually for exactly this reason, and going slowly genuinely does reduce how rough this part feels.

Less Common, But Worth Knowing About

• Gastroparesis, where the stomach empties very slowly or, rarely, barely at all. Worth mentioning to your surgeon or anaesthetist before surgery ^[7]
• Pancreatitis, a known but uncommon risk, with severe abdominal pain as the warning sign to act on ^[7]
• Muscle loss, since some of the weight lost on these medications comes from lean muscle rather than fat alone, which is exactly why protein intake and resistance exercise matter while taking them ^[8]
• Nutritional gaps, because appetite drops so significantly that it becomes genuinely possible to under-eat and miss key nutrients if food quality isn’t front of mind ^[7]

The Long-Term Questions Worth Asking

This is the part of the conversation that tends to get skipped in the glossy headlines, and it deserves more airtime than it gets.

They Work While You’re On Them, Not After

GLP-1 medications don’t permanently rewire your metabolism or your underlying appetite biology. Stop taking them, and those systems switch back on, loudly.

Weight Regain Is the Norm, Not the Exception

In the STEP 1 trial extension, people who stopped semaglutide regained roughly two- thirds of their lost weight within a year. ^[9] A larger 2026 meta-analysis of 37 studies found that people coming off semaglutide or tirzepatide regained weight at a rate that would return them to their starting point in around a year and a half. ^[10] Biology, it turns out, remembers exactly where it left off.

The Metabolic Benefits Can Reverse Too

It isn’t only weight that comes back. A 2026 study following adults with type 2 diabetes after they stopped GLP-1 treatment found a resurgence in inflammation, blood pressure, and cholesterol, alongside a rise in cardiovascular risk compared with people who stayed on the medication. ^[11] Researchers have taken to calling this “metabolic whiplash,” which is a fairly accurate description of how unwelcome it feels.

What This Means Practically

GLP-1 medications are increasingly being understood as a long-term treatment for a chronic condition, in the same category as blood pressure or cholesterol medication rather than a short course you finish and move on from. The common reasons people stop, cost, side effects, and supply shortages, are all genuine issues here in New Zealand.

This is exactly where having a solid metabolic health strategy alongside medication, or instead of it, starts to matter enormously.

Where Metabolic Balance® Fits In

The same underlying issues that push people toward GLP-1 medications in the first place, insulin resistance, chronic inflammation, disrupted hunger hormones, stubborn weight, can also be meaningfully addressed through targeted, personalised nutrition.

That’s the whole premise behind the Metabolic Balance® programme. Metabolic Balance® works from your own blood values to build a nutrition plan matched specifically to your body’s biochemistry. ^[12] No generic meal plans, no guesswork, just a plan built from what your blood is actually telling us.

For People Currently Taking a GLP-1

If you’re already on one of these medications, personalised nutrition arguably matters even more, not less. It helps protect muscle mass while appetite is suppressed, closes the nutritional gaps that reduced eating can open up, and builds the underlying metabolic foundation that determines what happens if you and your doctor ever decide to come off the medication. ^[8]

For People Considering a GLP-1

If you’re earlier in the process, particularly in the earlier stages of metabolic dysfunction, or keen to address root causes rather than manage symptoms indefinitely, Metabolic Balance® may be exactly the kind of comprehensive approach worth trying first. It’s built on the same principle driving the whole conversation around GLP-1s in the first place: insulin regulation. ^[13] The programme is specifically designed to stabilise blood sugar and reduce insulin levels through personalised whole-food choices and meal timing. ^[12,13] When insulin comes down, the body can start burning fat again, and the pull toward sugar and refined carbohydrates tends to ease. It’s the same problem GLP-1 medications are trying to solve, just approached from the food side of the equation rather than the pharmacy side.

Inflammation, hormonal balance, and sustainable weight loss without the rebound all sit inside this same framework, and personalised whole-food nutrition has repeatedly been shown to be one of the more effective tools available for calming systemic inflammation and supporting lasting metabolic change. ^[14]

So Which Is Right for You?

Before getting into that, it’s worth being honest about something these medications don’t advertise well: they don’t work equally for everyone, even among people who take them exactly as prescribed. Research estimates that somewhere between roughly one in ten, may have a genetic predisposition to a reduced result, and it isn’t about willpower or doing it wrong. ^[15,16] Genetics appears to play a real role, along with differences in how someone’s hunger and fullness signals are wired in the first place, and people with type 2 diabetes tend to see a smaller response than people without it. ^[15,16] One obesity specialist at Yale put it well: he avoids calling this “failure,” since the causes are biological rather than personal. ^[15] It’s a good reminder that no single approach, medication or otherwise, is going to be the right fit for every body, which is exactly why understanding your own biochemistry matters as much as picking a treatment off a shelf.

Honestly, it depends on where you’re starting from. For some people, particularly those managing type 2 diabetes, or those carrying significant cardiovascular risk alongside excess weight, or whose weight has reached a point where lifestyle changes alone haven’t been enough, GLP-1 medications are a legitimate and genuinely useful tool. There is no shame whatsoever in using them.

For others, especially anyone earlier in the piece, including people with prediabetes, or wanting to address the root cause rather than manage symptoms long-term, a comprehensive nutrition-based approach like Metabolic Balance® may be exactly what’s needed, either on its own or running alongside medication.

Think of it this way: GLP-1 medications can open the door. Metabolic Balance® is what helps you walk through it and actually stay there. If you’d like to talk through whether Metabolic Balance® is right for you, whether you’re considering a GLP-1 medication, already taking one, or simply want to get your metabolic health sorted from the ground up, I’d love to chat. Book a consultation and let’s figure out your next step together.

References

1. Latif W, Lambrinos KJ, Patel P, Rodriguez R. Compare and Contrast the Glucagon-Like Peptide-1 Receptor Agonists (GLP1RAs). StatPearls, National Library of Medicine, 2024. https://www.ncbi.nlm.nih.gov/books/NBK572151/
2. Liu QK. Mechanisms of action and therapeutic applications of GLP-1 and dual GIP/GLP-1 receptor agonists. Frontiers in Endocrinology, 2024. https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1431292 /full
3. Institute for Clinical and Economic Review (ICER). Semaglutide and Tirzepatide for Obesity: Effectiveness and Value, Draft Evidence Report, September 2025. https://icer.org/wp- content/uploads/2025/09/ICER_Obesity_Draft-Report_For-Publication_090925.pdf
4. Lincoff AM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (the SELECT trial). New England Journal of Medicine, 2023. https://www.nejm.org/doi/full/10.1056/NEJMoa2307563
5. Pharmac. Decision to enable new people to start treatment with dulaglutide and liraglutide for type 2 diabetes, 2025. https://www.pharmac.govt.nz/news-and- resources/consultations-and-decisions/2025-06-decision-to-enable-new-people-to-start- treatment-with-dulaglutide-for-type-2-diabetes
6. Bettge K, Kahle M, Abd El Aziz MS, Meier JJ, Nauck MA. Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists. Diabetes, Obesity and Metabolism, 2017. https://dom- pubs.onlinelibrary.wiley.com/doi/abs/10.1111/dom.12824
7. GoodRx. 10 GLP-1 Side Effects You Should Know About. https://www.goodrx.com/classes/glp-1-agonists/glp-1-side-effects
8. Neeland IJ, et al. Changes in lean body mass with glucagon-like peptide-1-based therapies and mitigation strategies. Diabetes, Obesity and Metabolism, 2024. https://dom- pubs.onlinelibrary.wiley.com/doi/10.1111/dom.15728
9. Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension. Diabetes, Obesity and Metabolism, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9542252
10. West S, Scragg J, Aveyard P, et al. Weight regain after cessation of medication for weight management: systematic review and meta-analysis. The BMJ, 2026. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12776922/
11. Xie Y, Choi T, Al-Aly Z. GLP-1RA discontinuation and risks of major adverse cardiovascular events in adults with type 2 diabetes: a target trial emulation. BMJ Medicine, 2026. https://doi.org/10.1136/bmjmed-2025-002150
12. Metabolic Balance. Discover the Metabolic Balance® Program. https://www.metabolic- balance.com/en-us/metabolic-program
13. Metabolic Balance. Nutrition Principles & The 4 Phases. https://www.metabolic- balance.com/en-us/our-nutrition-principles
14. Castro-Barquero S, Ruiz-León AM, Sierra-Pérez M, Estruch R, Casas R. Dietary Strategies for Metabolic Syndrome: A Comprehensive Review. Nutrients, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7600579/
15. Are You a GLP-1 Nonresponder? Yale Medicine, 2026. https://www.yalemedicine.org/news/are-you-a-glp-1-nonresponder
16. The New Weight-Loss Drugs Don’t Work for Everyone. Genetics May Explain Why. Scientific American, 2026. https://www.scientificamerican.com/article/why-ozempic-and- wegovy-dont-cause-weight-loss-for-everyone/