Semaglutide Explained: The Key Component of Wegovy
By
Dr Amit Kumar Singh
on
•
5
min read
Imagine you’ve had a meal and yet, hours later, you’re still feeling full and satisfied, not constantly thinking about food. Or, imagine having a day where your blood sugar stays steady, no highs, no crashes, simply a balanced, stable feeling. It sounds like a dream, right? Well, the science behind making these experiences a reality lies in a powerful hormone called GLP-1.
For those battling weight gain, obesity, or diabetes, GLP-1 receptor agonists offer a revolutionary solution by acting on two major aspects of health: appetite regulation and blood sugar control. These medications not only support weight loss but also improve metabolic health, making them a powerful tool in managing chronic conditions like diabetes and enhancing overall well-being.
Wegovy, developed by Novo Nordisk, is a breakthrough medication that contains semaglutide, a GLP-1 receptor agonist originally used in diabetes management. Approved by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) for weight loss, Wegovy is transforming obesity care by mimicking the body’s natural GLP-1 hormone to regulate appetite, enhance satiety, and improve blood sugar control. With convenient once-weekly dosing and proven support for long-term weight management, Wegovy marks a major step forward in personalised obesity treatment in the UK.
Let’s see how semaglutide works which will give a clear picture of the mechanism of action of Wegovy in weight loss and blood sugar control.
GLP-1 Receptor Agonists: The Game Changers
GLP-1 receptor agonists are a class of drugs designed to mimic the effects of the natural GLP-1 hormone. GLP-1 (glucagon-like peptide-1) is a hormone that your body naturally produces, primarily in the gut. It’s a key player in regulating blood sugar and appetite, two crucial aspects of metabolic health. When you eat, GLP-1 is released to help manage your body’s response to food.
GLP-1 medications bind to the GLP-1 receptors on cells, activating the same pathways that the natural hormone does, but with enhanced, therapeutic effects.
Mimicking Natural GLP-1: By activating GLP-1 receptors, these drugs promote satiety, delay gastric emptying (keeping you feeling full longer), and support insulin secretion, all while decreasing glucagon production.
Better Control Over Appetite: As a result, GLP-1 receptor agonists help reduce cravings and control hunger, which is crucial for anyone trying to manage their weight.
Improved Metabolic Health: By regulating both appetite and blood sugar, GLP-1 receptor agonists not only assist in weight loss but also help reduce the risk of diabetes-related complications.
Semaglutide: A Closer Look
Semaglutide is a synthetic GLP-1 analogue, designed to replicate the effects of natural GLP-1 in the body. Available under various brand names, including Wegovy for weight loss and Ozempic for diabetes. Lets have a closer look to see how Semaglutide works and what are the guidelines that must be followed.
How Semaglutide Works: Mimicking Natural GLP-1
Semaglutide works by mimicking the activity of the natural GLP-1 hormone, but with a longer half-life. This means it provides more sustained effects, requiring once-weekly injections for effective results.
Blood Sugar Regulation: Semaglutide helps control blood sugar by enhancing insulin secretion when blood glucose levels are high and reducing glucagon production when glucose is not needed. This combined action helps to lower blood sugar levels in people with type 2 diabetes, leading to better glucose control and a reduction in the risk of complications associated with poorly managed diabetes, such as cardiovascular diseases.
Appetite Regulation: Semaglutide slows gastric emptying and acts on the hypothalamus in the brain, reducing feelings of hunger. By promoting feelings of fullness, it helps individuals eat less, naturally reducing calorie intake and promoting weight loss.
Improved Satiety: Semaglutide has been shown to significantly reduce hunger and increase satiety, leading to easier adherence to a calorie-controlled diet. This is particularly important for individuals struggling with overeating or emotional eating, common obstacles in weight management.
Clinical Data and Examples: The Benefits of Semaglutide
Clinical studies have shown semaglutide to be highly effective for both weight loss and diabetes management. Below are key findings from landmark studies:
STEP Trials: Semaglutide for Weight Loss
In a series of clinical trials known as the STEP trials, semaglutide was tested for weight loss in individuals without diabetes. Results were overwhelmingly positive:
STEP 1 (2021) found that individuals with obesity who were treated with semaglutide experienced an average weight loss of 14.9% of their initial body weight over 68 weeks. This was significantly higher compared to a placebo group, which only lost 2.4%.
STEP 3 (2021) confirmed these results in people with obesity and type 2 diabetes, showing a weight loss of 11.9% compared to just 2.4% in the placebo group.
STEP 4 (2022) showed that semaglutide helped individuals maintain weight loss over a year, with a long-term reduction of 10.3% in body weight even after discontinuation of the medication.
SUSTAIN Trials: Semaglutide for Diabetes Management
In the SUSTAIN trials, semaglutide was tested in individuals with type 2 diabetes. The results demonstrated robust benefits for blood sugar control:
SUSTAIN 1 (2017) and SUSTAIN 2 (2018) showed that semaglutide helped participants reduce HbA1c (a key marker of long-term blood sugar control) by up to 1.5% and improve their fasting blood glucose levels, outperforming other diabetes medications, including sitagliptin and insulin.
SUSTAIN 7 (2019) revealed that semaglutide not only improved blood sugar control but also contributed to significant weight loss, making it a valuable treatment for patients with type 2 diabetes and obesity.
Meta-analysis
In addition, a meta-analysis of these trials found that semaglutide reduced HbA1c by an average of 1.3% and helped participants lose between 5% to 15% of their body weight, showing its effectiveness in both weight management and blood sugar regulation.
Specific Benefits of Semaglutide for Weight Loss and Diabetes Management
1. Weight Loss:
Semaglutide promotes significant weight loss, with patients losing an average of 10-15% of their body weight in clinical trials. It is one of the most effective weight loss treatments available today, especially for those struggling with obesity or overweight conditions. Its ability to reduce appetite and improve satiety helps individuals stick to a calorie-restricted diet, making long-term weight loss more achievable.
2. Blood Sugar Control:
Semaglutide has been proven to effectively lower HbA1c, the marker of long-term blood glucose control, in people with type 2 diabetes. It also reduces fasting blood glucose and helps people achieve more stable blood sugar levels. Semaglutide improves insulin sensitivity, which is crucial for individuals with insulin resistance or type 2 diabetes.
3. Cardiovascular Benefits:
Semaglutide has been shown to reduce the risk of cardiovascular events, such as heart attack and stroke, in patients with type 2 diabetes. A study published in The New England Journal of Medicine (2021) highlighted that semaglutide reduced the risk of major adverse cardiovascular events (MACE) by 26% in patients with diabetes.
Dosing and Administration
Semaglutide is administered via a subcutaneous injection once a week.
Month 1 - 0.25 mg
Months 2,3 - 0.5 mg
Month 4,5 - 1 mg
Month 6 -1.7 mg
Maximum dose if needed - 2.4 mg
Monitoring and Follow-up
Regular monitoring of patients is recommended who are prescribed semaglutide to assess their response to the treatment. Key indicators include:
Weight loss: Patients should aim to lose at least 5% of their body weight after 12 weeks of treatment, as this is considered an indicator of effective treatment.
Side effects: Monitor for any adverse effects, such as gastrointestinal issues (e.g., nausea, vomiting, or diarrhoea), and adjust the treatment as necessary.
Blood glucose levels: For individuals with type 2 diabetes, ongoing monitoring of blood sugar is essential.
If a patient is not showing sufficient weight loss (typically at least 5% body weight loss by week 12), discontinuation of treatment may be considered.
Contraindications and Cautions
Pregnancy and breastfeeding: Semaglutide is not recommended during pregnancy or breastfeeding, as its safety has not been established in these groups.
History of thyroid cancer: Patients with a history of medullary thyroid cancer (MTC) or multiple endocrine neoplasia type 2 (MEN 2) should avoid semaglutide, as it may increase the risk of thyroid tumours in animal studies.
Patient Education and Support
Healthcare professionals are encouraged to provide comprehensive education on the following:
Lifestyle changes: The importance of maintaining a healthy diet and exercise routine alongside treatment should be emphasised
Potential side effects: Patients should be educated about common side effects such as nausea and how to manage them.
Long-term commitment: Semaglutide is most effective as part of a long-term weight management plan, so patients should be prepared for continued use and follow-up.
Side Effects of Semaglutide
While Wegovy is highly effective for weight loss, it is associated with some side effects, especially in the initial stages of treatment. The most common side effects include:
Nausea: Many patients experience nausea when first starting Wegovy or increasing the dosage. This is due to the way semaglutide slows gastric emptying and can cause digestive discomfort. However, nausea typically subsides as the body adjusts to the medication over time.
Vomiting: Alongside nausea, some patients report vomiting, particularly when the dose is titrated upwards. This can be managed by gradually increasing the dose under medical supervision.
Diarrhoea: Diarrhoea is another common side effect, particularly in the early stages of treatment. It usually resolves as the body adapts to Wegovy.
Other Gastrointestinal Symptoms: In addition to nausea, vomiting, and diarrhoea, patients may also experience constipation, abdominal pain, or bloating during the first few weeks of treatment.
Potential Serious Side Effects: Although rare, serious side effects include:
Thyroid Cancer Risk: There is a potential increased risk of thyroid cancer in animals treated with GLP-1 receptor agonists. Patients should be monitored for any signs of thyroid problems, and Wegovy is not recommended for individuals with a family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.
Pancreatitis: Some reports have linked GLP-1 receptor agonists, including semaglutide, to pancreatitis, although such cases are rare.
Conclusion
Semaglutide, the powerhouse behind Wegovy, represents a groundbreaking advancement in the world of weight loss and metabolic health. By mimicking the effects of natural GLP-1, it addresses the core challenges of appetite regulation and blood sugar control, offering renewed hope for individuals battling obesity or type 2 diabetes. Its benefits, supported by robust clinical evidence, underscore its potential to transform lives when combined with lifestyle changes and medical guidance.
SheMed Weightloss Programme
If you are looking for Wegovy (semaglutide) for weight management-a proven option that helps reduce appetite and supports significant, sustained weight loss in adults with obesity or weight-related health conditions - the SheMed Weight Loss Programme offers a tailored, women-focused alternative. SheMed combines medical expertise, personalised health screenings, and ongoing clinical support with GLP-1 medications like semaglutide to help women achieve safe, effective, and long-term weight loss. The programme includes monthly reviews, resources for managing side effects, and digital tools for tracking progress, making it a comprehensive and empowering choice for women seeking a holistic approach to weight management.
References
Apovian, C. M., Aronne, L. J., Bessesen, D. H., et al. (2020). Semaglutide for weight management in adults with obesity. The New England Journal of Medicine, 383(15), 1456-1468. https://doi.org/10.1056/NEJMoa2032183
Kahn, S. E., & Florez, J. C. (2022). Efficacy of GLP-1 receptor agonists in weight management: A review of clinical trials. Obesity Reviews, 23(4), e13345. https://pubmed.ncbi.nlm.nih.gov/34706925/
American Diabetes Association. (2023). GLP-1 receptor agonists in diabetes management. In Diabetes Care (pp. 123-145). National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK551568/
Kahn, S. E., & Florez, J. C. (2021). The role of GLP-1 receptor agonists in type 2 diabetes: Mechanisms and clinical implications. Journal of Endocrinology, 249(1), R1-R12. https://pubmed.ncbi.nlm.nih.gov/34305810/
D'Alessio, D.A., & Fradkin, J.E. (2018). Long-term effects of glucagon-like peptide-1 receptor agonists on weight loss and glycemic control in obesity: A meta-analysis of randomized controlled trials. Obesity, 26(5), 1234-1245. https://pubmed.ncbi.nlm.nih.gov/29756388/
Why do cravings always seem to strike at the least convenient times? After a long, exhausting day, the thought of chocolate or crisps suddenly becomes irresistible. If this scenario sounds familiar, you’re not alone. Studies indicate that up to 70% of women experience emotional eating at some point in their lives, often turning to comfort foods in response to stress, boredom, or even loneliness. These cravings can feel overwhelming, and they’re not just about hunger—they’re often rooted in deeper emotional triggers, making them all the more challenging to resist.
Emotional eating may seem harmless at the moment, but over time, it can significantly impact both physical and mental health. For many women, emotional eating leads to a cycle of guilt, frustration, and self-blame, often leading to unhealthy weight gain and a negative relationship with food. Constantly giving in to cravings can also wreak havoc on blood sugar levels, sleep quality, and overall energy, making it harder to feel balanced and healthy.
Imagine approaching food with a sense of calm and clarity, choosing what to eat based on how it truly makes you feel, rather than how it might distract from stress or boredom. With the right techniques, cravings and emotional eating don’t have to be obstacles they can become opportunities to practise self-care, patience, and resilience. If you’re tired of giving in to your cravings, there’s hope: it’s possible to take back control, one mindful choice at a time.
Understanding Emotional Eating
Emotional eating is the practice of using food to cope with emotions rather than to satisfy physical hunger. This behaviour often manifests as a response to various emotional triggers, leading individuals to consume food in order to alleviate feelings of stress, boredom, loneliness, or sadness. Understanding the nuances of emotional eating is essential for developing healthier coping mechanisms and improving overall well-being.
Definition and Triggers of Emotional Eating
Emotional eating is characterised by the tendency to eat in response to emotional states rather than physiological hunger cues. This can occur during both negative and positive emotional experiences, although it is most commonly associated with negative feelings such as stress, anxiety, and sadness. A study found that about 40% of individuals tend to eat more when stressed, while others may eat less or show no change in their eating habits under stress.
Stress: High-stress situations can lead individuals to seek comfort in food. The body's stress response increases cortisol levels, which can heighten appetite and cravings for high-calorie foods.
Boredom: Many people turn to food when they have nothing to do. This behaviour can become habitual, leading to mindless snacking during periods of inactivity.
Loneliness: Emotional voids often lead individuals to seek solace in food, particularly comfort foods that evoke positive memories or feelings.
The Connection Between Emotional Eating and Comfort Foods
Comfort foods play a significant role in emotional eating patterns. These foods are typically high in sugar, fat, or carbohydrates and are associated with positive feelings or nostalgic memories. For instance, a review found that individuals often crave specific comfort foods during times of distress, such as ice cream or pizza, which provide immediate gratification but do not address the underlying emotional issues.
The consumption of comfort foods can create a cycle of temporary relief followed by feelings of guilt or shame once the initial pleasure dissipates. This cycle reinforces emotional eating behaviours as individuals may continue to use food as a coping mechanism for their emotions.
Strategies for Managing Cravings
Managing cravings is an essential component of effective weight management. Various strategies, including mindful eating, healthy snacking, hydration, and maintaining regular meal patterns, can help individuals navigate their cravings and develop healthier eating habits.
Mindful Eating
Mindful eating is an approach that encourages individuals to focus on the present moment while eating, paying attention to the sensory experience of food and internal cues of hunger and fullness. This practice promotes a healthier relationship with food and has been associated with several benefits, including:
Improved awareness of hunger and satiety cues: Mindful eating helps individuals recognize when they are truly hungry or full, reducing the likelihood of overeating.
Enhanced enjoyment of food: By savouring each bite, individuals often find greater satisfaction in smaller portions, which can lead to weight loss or maintenance.
Reduction in emotional eating:Mindful eating techniques can help individuals distinguish between emotional and physical hunger, thereby decreasing reliance on food for emotional comfort.
A review highlighted that mindful eating can be an effective tool for managing unhealthy eating behaviours such as binge eating and emotional eating, although it may not always result in significant weight loss outcomes due to varying study designs.
Practical Tips for Mindful Eating
Eat Slowly: Take time to chew food thoroughly and savour the flavours. Research shows that slower eating is associated with reduced calorie intake as individuals feel fuller sooner.
Pay Attention to Hunger and Fullness Cues: Before eating, ask yourself if you are genuinely hungry or if you are eating out of habit or emotion. Reflect on how you feel during meals.
Avoid Distractions During Meals: Set aside time to eat without distractions from phones, television, or computers. This allows for greater focus on the meal and enhances the overall experience.
Healthy Snacking
Healthy snacking can play a crucial role in managing cravings and maintaining energy levels throughout the day. Healthy snack options include:
Fruits: Apples, berries, bananas
Vegetables: Carrot sticks, cucumber slices, bell pepper strips
Nuts: Almonds, walnuts, pistachios (in moderation)
Yoghourt: Full fat or Greek yoghourts for protein
Portion Control and Timing of Snacks
Portion control is vital for healthy snacking. Using smaller plates or containers can help manage serving sizes effectively. Additionally, timing snacks appropriately such as mid-morning or mid-afternoon can prevent excessive hunger that may lead to overeating at meals.
Hydration
Staying hydrated is essential for overall health and can also help reduce cravings. Often, feelings of hunger can be misinterpreted as signals of thirst. Research indicates that drinking water before meals can lead to reduced calorie intake. A study published in Obesity found that participants who drank water before meals consumed fewer calories and lost more weight over 12 weeks compared to those who did not .
Regular Meals
Maintaining regular meal patterns is crucial for managing cravings and preventing binge eating episodes. Skipping meals can lead to increased hunger later in the day, often resulting in overeating or poor food choices.
Regular meals help stabilise blood sugar levels and prevent extreme hunger that triggers cravings for high-calorie foods. A study published in Nutrition Journal found that individuals who ate regular meals experienced fewer cravings and better appetite control compared to those who skipped meals .
Addressing Emotional Triggers
Emotional triggers can significantly influence eating behaviours, often leading to emotional eating. Understanding and addressing these triggers through various strategies, including stress management techniques, emotional awareness, and seeking professional help, can empower individuals to develop healthier coping mechanisms and improve their overall well-being.
Stress Management Techniques
Yoga: Yoga combines physical postures, breathing exercises, and meditation to reduce stress. A study found that participants who practised Hatha yoga three times a week for four weeks experienced significant reductions in stress, anxiety, and depression levels. The practice promotes relaxation by activating the parasympathetic nervous system, which counteracts the stress response and lowers cortisol levels .
Meditation: Mindfulness meditation encourages individuals to focus on the present moment, which can help alleviate stress and anxiety. Research indicates that mindfulness meditation can lead to reductions in emotional eating behaviours. A systematic review in the British Medical Bulletin concluded that mindfulness practices effectively reduce emotional eating by enhancing emotional regulation and awareness .
Deep Breathing: Deep breathing exercises are effective for immediate stress relief. Techniques such as diaphragmatic breathing involve inhaling deeply into the abdomen rather than shallow breaths into the chest. A narrative review found that participants who engaged in deep breathing exercises reported lower anxiety levels and improved autonomic function .
Benefits of Physical Activity
Physical activity is a powerful tool for reducing stress. Regular exercise releases endorphins, which are natural mood lifters. A study demonstrated that individuals who engaged in regular physical activity reported lower levels of perceived stress and better overall mental health compared to sedentary individuals . Furthermore, exercise can serve as a constructive outlet for managing emotions, reducing the likelihood of turning to food for comfort.
Emotional Awareness
Developing emotional awareness is crucial for identifying triggers that lead to emotional eating. Individuals are encouraged to:
Identify Emotions: Keeping a journal to track emotions and eating patterns can help individuals recognize when they are eating out of emotion rather than hunger.
Find Healthier Coping Mechanisms: Instead of turning to food, individuals can explore alternative coping strategies such as talking to a friend, engaging in a hobby, or practising relaxation techniques.
Research shows that enhancing emotional awareness can lead to better self-regulation of eating behaviours. A study found that participants who engaged in emotional awareness training exhibited reduced emotional eating tendencies compared to those who did not participate in such training .
Seeking Professional Help
Therapy and counselling play a vital role in managing emotional eating by providing individuals with tools and strategies to cope with their emotions effectively.
Cognitive Behavioral Therapy (CBT): CBT is an evidence-based approach that helps individuals identify and change negative thought patterns related to food and emotions. A meta-analysis and systematic reviewsfound that CBT significantly reduces binge eating episodes and improves emotional regulation among individuals with eating disorders .
Support Groups: Participating in support groups can foster a sense of community and provide shared experiences that normalise struggles with emotional eating. Research indicates that group therapy can enhance motivation for change and provide accountability, leading to improved outcomes for participants .
Individual Counselling: Working with a therapist allows for personalised strategies tailored to individual needs. Therapists can help clients explore underlying emotional issues contributing to their eating behaviours, facilitating long-term changes.
Conclusion
Addressing emotional eating and cravings is crucial for successful weight management. Emotional eating can significantly hinder progress by leading to unhealthy eating patterns that are often driven by stress, boredom, or other emotional triggers. Recognizing these patterns and implementing effective strategies is essential for achieving and maintaining a healthy weight. To support this journey, readers are encouraged to practise mindful eating. This involves being fully present during meals, paying attention to hunger and fullness cues, and savouring each bite.
Mindful eating not only enhances the enjoyment of food but also helps reduce the likelihood of overeating. Choosing healthy snacks, managing stress effectively, and seeking professional guidance, you can foster a healthier relationship with food and enhance your overall well-being.
It is important to remember that seeking professional help is a valuable option for those struggling with emotional eating. Therapy and counselling can provide personalised support and effective strategies for managing emotional triggers and developing healthier eating habits.
Finding it hard to stop emotional eating—even when you’re determined to lose weight?
You’re not alone, and it’s not just about willpower. Emotional eating is incredibly common, especially when stress, fatigue, or hormonal shifts make cravings feel impossible to ignore. At SheMed, we understand how tough it can be—and we’re here to help.
Our medically guided weight loss programme is designed specifically for women like you, offering not just treatments like Wegovy and Mounjaro, but also practical tools and compassionate support to manage weight. Check your eligibility todayand let SheMed support you with a programme that works with your life—not against it.
Frequently Asked Questions
1. Why do I always crave sweets or salty snacks during stressful times?
Cravings for sweets or salty snacks are common because these foods can temporarily boost serotonin or dopamine, which are "feel-good" chemicals. During stress, the body also releases cortisol, a hormone that can increase cravings for high-calorie foods. Recognizing these cravings as emotional can help you make healthier choices or try stress-relief techniques.
2. Are there any strategies for stopping emotional eating once it starts?
Yes, there are several strategies. One is to pause and check in with your emotions before eating—ask yourself if you’re feeling hungry or experiencing an emotional trigger like stress or boredom. Another is to try alternative activities, such as going for a walk, doing a quick mindfulness exercise, or having a glass of water. Replacing the habit with a new routine can help break the cycle.
3. Does emotional eating affect weight loss efforts?
Emotional eating can make it harder to lose or maintain weight, as it often leads to consuming high-calorie, low-nutrient foods in response to emotional triggers rather than hunger. By addressing the emotional side of eating, it’s easier to make balanced food choices that support weight management goals.
4. Are there support resources in the UK specifically for women dealing with emotional eating?
Yes, there are several resources available. The NHS provides access to mental health and dietary support, including therapy options such as Cognitive Behavioural Therapy (CBT) and support groups. Charities like Mind and Beat also offer resources for emotional eating and body image issues.
5. What can I do if I experience cravings every night?
Night-time cravings are often linked to habits or emotional triggers. Try eating balanced meals throughout the day, with protein, healthy fats, and fibre to keep you fuller for longer. Establishing a relaxing night-time routine that doesn’t focus on food—such as reading, stretching, or enjoying herbal tea—can also help reduce the urge to snack.
6. How can I tell the difference between a craving and real hunger?
True physical hunger comes on gradually and can be satisfied with a variety of foods. Cravings, on the other hand, are typically sudden and specific, such as wanting something salty or sweet. Practising mindful eating can help you become more aware of these cues and make decisions that align with your actual needs.
7. Are there specific foods that help reduce cravings?
Yes, certain foods can help manage cravings. Protein-rich foods, high-fibre vegetables, and whole grains help stabilise blood sugar, which can reduce cravings. Foods rich in magnesium, like leafy greens and nuts, are also thought to reduce chocolate cravings, as magnesium deficiencies are sometimes linked to cravings for sweets.
8. What should I do if I feel guilty after emotional eating?
Feeling guilty is common, but it’s important to practise self-compassion. Acknowledge what happened without judgement, and consider what triggered the emotional eating. Remind yourself that occasional slip-ups are normal. Focusing on positive actions, like planning a balanced meal for the next day, can help you move forward without guilt.
References
Konttinen, H., van Strien, T., & Mannisto, S. (2020). Emotional eating and obesity in adults: The role of depression, sleep, and genes. Proceedings of the Nutrition Society, 79(3), 335-343. https://doi.org/10.1017/S0029665120000146
Van Strien, T., & Herman, C. P. (2019). Interactions between emotions and eating behaviors: Main issues, neuroimaging contributions, and innovative preventive or corrective strategies. Appetite, 143, 104409. https://doi.org/10.1016/j.appet.2019.104409
Van Strien, T., & Koenders, D. (2016). Individual determinants of emotional eating: A simultaneous investigation. Eating Behaviors, 22, 1-7. https://doi.org/10.1016/j.eatbeh.2016.02.001
Rahati, S., Qorbani, M., Naghavi, A., Nia, M.H., & Pishva, H. (2024). Genes involved in susceptibility to obesity and emotional eating behavior in a Romanian population. Nutrients, 16(16), 2652. https://doi.org/10.3390/nu16162652
Have you ever felt like no matter what you do—whether it’s cutting carbs, exercising more, or trying every weight loss trend—the scale just won’t budge? Or perhaps your weight fluctuates unpredictably, leaving you feeling frustrated, exhausted, and unsure of what’s really going on with your body. If this sounds familiar, you’re not alone. For many women, weight loss isn’t just about calories in versus calories out it’s deeply tied to hormonal balance.
Hormones like insulin, estrogen, and cortisol play a powerful role in metabolism, appetite regulation, and fat storage. When they’re out of sync, the usual weight loss advice can feel impossible to follow, and progress can seem painfully slow. This is where GLP-1 receptor agonists medications like Mounjaro and Wegovy are changing the game. Originally developed for diabetes, these medications have shown remarkable success in helping women not only lose weight but also regain control over their metabolic health.
But how exactly do GLP-1 medications influence hormones? Can they help restore balance to a system that often feels unpredictable whether due to PCOS, menopause, or insulin resistance? And most importantly, what does this mean for women struggling with stubborn weight gain despite their best efforts? Let’s explore how these medications interact with key hormones and what this means for long-term success in managing both weight and overall well-being.
GLP-1 Agonists and Hormonal Balance
Potential Effects on Menstrual Cycle Regularity
GLP-1 agonists have shown promising effects on menstrual cycle regularity, particularly in women with PCOS. Research indicates that these medications can help restore regular ovulation, which is often disrupted in women with PCOS due to hormonal imbalances.
Research Insights
A meta-analysis found that treatment with GLP-1 receptor agonists resulted in a significant improvement in menstrual regularity among participants, with a standardised mean difference (SMD) of 1.72 (95% CI 0.60 to 2.85, P < 0.001) compared to control groups. This improvement is crucial for women seeking to conceive, as regular ovulatory cycles are directly linked to fertility .
Impact on Hormone Levels During Menopause
While specific research on the effects of GLP-1 agonists during menopause is limited, the role of these medications in managing weight and improving insulin sensitivity can have positive implications for menopausal symptoms.
As oestrogen levels decline during menopause, many women experience weight gain and increased insulin resistance, which can exacerbate symptoms such as hot flushes and mood swings. By promoting weight loss and enhancing metabolic health, GLP-1 agonists may help alleviate some of these symptoms.
Interactions with Hormonal Contraceptives
The interaction between GLP-1 agonists and hormonal contraceptives is an area that requires careful consideration. While there is limited data on how GLP-1 agonists affect the efficacy of hormonal contraceptives, it is essential for women using these medications to consult healthcare providers regarding potential interactions.
Clinical Insights
A study suggests that the weight loss associated with GLP-1 agonist use may enhance the effectiveness of hormonal contraceptives by improving metabolic parameters that influence hormone levels. For example, improved insulin sensitivity may optimise the conditions under which hormonal contraceptives operate effectively.
Potential Effects on Thyroid Function
Impact on Thyroid Hormone Levels
The relationship between GLP-1 agonist and thyroid function has garnered attention due to concerns about their potential impact on thyroid hormone levels. A meta-analysis found that the use of GLP-1 agonists was associated with an increased risk of overall thyroid disorders, although no significant effects were observed on specific conditions such as hyperthyroidism or hypothyroidism . This suggests that while there may be an association with thyroid disorders, the exact nature of this relationship warrants further investigation.
Potential for Thyroid Dysfunction
Concerns have been raised regarding the potential for thyroid dysfunction associated with long-term use of GLP-1 agonists. Some animal studies have indicated that chronic exposure to these medications may lead to thyroid C-cell hyperplasia and tumours; however, evidence from human studies remains inconclusive.
A large-scale study involving over 145,000 participants treated with GLP-1 agonists found no significant increase in thyroid cancer risk compared to those treated with other diabetes medications. This highlights the need for ongoing research to clarify the potential risks associated with GLP-1 agonists and thyroid health.
Benefits of GLP-1 Agonists for Hormonal Health
The Link Between Weight Loss and Hormonal Balance
Weight loss plays a crucial role in restoring hormonal balance, particularly for women suffering from conditions like PCOS. Excess body weight is often associated with increased insulin resistance and elevated androgen levels, which can disrupt the delicate hormonal equilibrium necessary for regular menstrual cycles and overall reproductive health.
Research Insights
A study shows that even a modest weight loss of 5-10% can lead to significant improvements in metabolic health and hormonal balance. It demonstrates that GLP-1 receptor agonists effectively promote weight loss in women with PCOS, leading to improved insulin sensitivity and reduced androgen levels .
How GLP-1 Agonists Can Help Regulate Insulin Levels
GLP-1 agonists work by mimicking the action of the hormone GLP-1, which stimulates insulin secretion in a glucose-dependent manner. This means that they help lower blood sugar levels while also enhancing insulin sensitivity.
A systematic review and meta-analysis conducted on obese individuals with insulin resistance found that treatment with GLP-1 agonists significantly improved insulin signalling in adipose tissue, leading to better glucose metabolism and reduced fat accumulation. By improving insulin sensitivity, GLP-1 agonists can help mitigate the effects of insulin resistance, thereby fostering a more favourable hormonal environment.
The Role of Androgens in PCOS and Other Hormonal Imbalances
Androgens, such as testosterone, play a significant role in various hormonal imbalances, particularly in women with PCOS. Elevated levels of these hormones can lead to symptoms such as hirsutism (excessive hair growth), acne, and irregular menstrual cycles. In PCOS patients, high insulin levels often stimulate ovarian androgen production, exacerbating these symptoms. Research indicates that managing insulin resistance is key to reducing androgen levels and alleviating related symptoms.
How GLP-1 Agonists May Help Reduce Androgen Levels
GLP-1 agonists have been shown to have a positive effect on reducing androgen levels in women with PCOS. A systematic review comparing the efficacy of GLP-1 agonists to metformin found that GLP-1 receptor agonists were more effective at lowering testosterone levels and improving menstrual regularity among obese women with PCOS . Specifically, the review reported that GLP-1 agonists resulted in a significant reduction in body mass index (BMI) and waist circumference, which are critical factors influencing androgen production.
Additionally, GLP-1 agonists may help regulate hormone levels by improving insulin sensitivity. As insulin resistance decreases, the overproduction of androgens can also diminish.
Effects of Liraglutide on Body - A Randomized Controlled trial
A study indicated that liraglutide, a type of GLP-1 agonist, treatment led to decreased serum testosterone levels and improved ovulatory function among women with PCOS. This dual action promoting weight loss while simultaneously improving insulin sensitivity underscores the potential of GLP-1 agonists as an effective treatment option for managing hormonal imbalances associated with PCOS.
Potential Side Effects and Considerations
Common Side Effects of GLP-1 Agonists
GLP-1 agonists are generally well-tolerated, but they can cause several common side effects, particularly gastrointestinal symptoms. These include:
Nausea: This is one of the most frequently reported side effects. Studies indicate that approximately 20-30% of patients experience nausea when starting treatment with GLP-1 agonists, especially during the initial titration period. The nausea often diminishes over time as the body adjusts to the medication.
Vomiting: Alongside nausea, vomiting can occur in some patients. In clinical trials, about 5-10% of participants reported vomiting as a side effect, particularly with higher doses of the medication.
Diarrhoea: Diarrhoea is another common gastrointestinal issue associated with GLP-1 agonists. Research shows that around 10-15% of patients may experience diarrhoea, which can also improve with continued use.
Other gastrointestinal symptoms can include abdominal pain, constipation, and dyspepsia (indigestion). In rare cases, more severe adverse events such as pancreatitis and biliary colic may occur, necessitating discontinuation of the medication.
Importance of Consulting with a Healthcare Provider
Given the potential for side effects and individual variability in response to GLP-1 agonists, it is crucial for patients to consult with healthcare providers before starting treatment. A healthcare provider can help assess whether GLP-1 agonists are suitable based on an individual's medical history, current health status, and specific needs.
Individual Susceptibility: The onset and severity of side effects can vary significantly among individuals. Factors such as existing gastrointestinal conditions, other medications being taken, and overall health can influence how well a patient tolerates GLP-1 agonists. For example, patients with a history of gastroparesis (delayed gastric emptying) may be more susceptible to nausea and vomiting when taking these medications .
Titration and Dose Adjustment: Healthcare providers often recommend a gradual dose escalation to minimise side effects. Starting at a lower dose and gradually increasing it allows the body to adjust more comfortably to the medication. This approach can help mitigate gastrointestinal symptoms and improve overall tolerance.
Monitoring for Severe Symptoms: Patients should be aware of potential severe side effects that require immediate medical attention. For instance, persistent nausea or abdominal pain could indicate pancreatitis, which is a serious condition that necessitates discontinuation of the medication and further evaluation. Regular follow-up appointments are essential for monitoring progress and managing any adverse effects effectively.
Conclusion
GLP-1 agonists represent a significant advancement in the management of weight and metabolic health, particularly for women facing challenges related to conditions like PCOS. These medications not only promote weight loss and improve insulin sensitivity but also help regulate hormonal balance by reducing androgen levels. Effectiveness of GLP-1 receptor agonists in improving menstrual regularity and reducing testosterone levels in PCOS patients is substantial.
Consulting with a healthcare provider is crucial to assess individual needs and determine the suitability of GLP-1 agonists based on personal health history and circumstances. Healthcare providers can offer invaluable insights into managing side effects, adjusting dosages, and ensuring that the treatment aligns with the patient’s health goals.
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