Ozempic, Wegovy, Saxenda — in recent years, GLP-1 receptor agonists have exploded in popularity, though not for their indicated use. Originally conceived as a treatment for diabetes, GLP-1 RAs have gained incredible traction as “miracle” weight-loss agents. But is their promise real, or a little too good to be true? Chenot’s research and development officer, Dr. Antonio Di Mauro helps separate fact from fiction, and explains how these drugs might fit into a sustainable, long-term health plan.
Although they’ve been on the market for 20 years, a particular class of diabetes drug has recently exploded in popularity — though not for its indicated use. Since approximately 2022, semaglutides Ozempic and Wegovy, liraglutide Saxenda, and other GLP-1 receptor agonists have gained incredible traction as “miracle” weight-loss drugs. Commit to just one routine injection, proponents swear, and the pounds melt away. It’s a big claim, and it certainly comes with strings attached: GLP-1 RAs can create grueling side effects, they can be expensive — as much as $1,000 per month in the United States — and thanks to their reapplication as weight-loss agents, they’re also in short supply. But just how effective are GLP-1 RAs? Dr. Antonio Di Mauro, Chenot’s research and development officer, helps separate fact from fiction, explaining how these drugs might fit into a sustainable health plan.
What are GLP-1 RAs and how do they work?
When you eat, your gut secretes GLP-1, a chemical that lowers blood sugar by triggering the production of insulin and inhibiting the production of glucagon, a hormone that raises blood-sugar levels. GLP-1 also slows digestion and gastric emptying, extending the absorption of sugars over longer periods of time. And by working on the parts of the brain that control appetite, it promotes the feeling of satiety.
An agonist, meanwhile, is a manufactured substance that mimics the molecules our bodies naturally produce, binding to the same cellular receptors to evoke the same response. Most of the time, GLP-1 RAs are taken as a subcutaneous injection into an area dense in fatty tissue, administered at home between once a day or once a week. (Semaglutides can also be taken daily in tablet form.) For diabetics, the result is better glucose control through regulated insulin secretion, but GLP-1 RAs also dampen the patient’s desire to eat and drink. If you don’t feel hungry, if a smaller portion of food makes you feel fuller for longer, or if meals begin to make you feel queasy — nausea being one of the drug’s most commonly reported side effects — then you’ll likely find yourself consuming less on a daily basis. And that, in turn, may mean weight loss.
What are the possible side effects?
In addition to nausea, GLP-1 RA use carries a risk of vomiting, diarrhea, constipation, and a generally upset stomach, in addition to headaches and dizziness. More serious complications are also possible: The development of pancreatitis or a potential association with thyroid cancer (though this has only been observed in rodent studies, not confirmed in humans). And because the GLP-1 RAs currently in use are relatively new additions to the pharmaceutical market, future research may pinpoint as-yet unknown consequences of extended use. Given that Ozempic (for example) was only approved for use in the European Union in 2018, it may simply be too soon to tell what other side effects GLP-1 RAs might create over time.
But despite those potential downsides, GLP-1 RAs also hold clear promise: The World Health Organization estimates that, globally, 830 million people are living with diabetes, which is now one of the top 10 causes of death and disability worldwide. And globally, more than a billion people qualify as obese, putting them at heightened risk for the development not only of type-2 diabetes, but also of certain types of cancers, fatty liver disease, stroke, heart attack, and more. For those patients, GLP-1 RA agonists appear to reduce the risk of cardiovascular death and disease, as well as the incidence of stroke. They may also help lower blood pressure, improve cholesterol levels and other lipid disorders, and mitigate liver and kidney disease.
Among patients who’ve struggled with obesity who’ve seen limited success with other measures, the ease and the speed with which GLP-1 RAs work may come as an immense relief. But given the recent spike in interest — between 2019 and 2023, the U.S. alone recorded a 700 percent increase in GLP-1 RA use among non-diabetic patients, according to one 2024 study — Di Mauro worries about supply and demand. The W.H.O. reports sudden and severe shortages in the medication thanks to the surge in weight-loss interest, a trend that may create dangerous scarcity for patients seeking to manage their diabetes. The popularity of GLP-1 RAs among people looking to drop a few pounds, Di Mauro says, “could raise ethical concerns because of the real need as compared with a diabetic with the medical indication.”
How can GLP-1RAs fit into a sustainable weight-loss plan?
If convenience is one of the GLP-1 RA’s major selling points, it can also be one of its prospective pitfalls, Di Mauro explains. He suspects that for some patients, leaning too heavily on medication to do the leg work in weight loss may make new routines seem less urgent. Maybe “they start realising, Oh, I’ll be on medication,” he explains. “I can keep up with bad habits — bad habits that include diet, poor sleep, poor physical activity, a sedentary lifestyle by means of primarily indoor living.” While diabetic patients may stay on GLP-1 RAs for life, those pursuing weight loss may not; Di Mauro worries what happens when they come off the drug and their appetites come back. Without a multi-pronged health plan already in place, GLP-1 RAs may simply create “weight loss that is artificial,” Di Mauro explains; something akin to yo-yo dieting.
“We really need to make a distinction between short-term, medium-term, and long-term,” Di Mauro says. For results that last beyond the medication course, each patient needs to have made and acclimated to lifestyle adjustments before ending their injections. “Diet is just one piece of the puzzle,” di Mauro notes. “Science tells us that motivation, engagement, empowerment are all crucial over the long-term. That’s really the very first distinction that differentiates motivation and discipline. Discipline includes physical activity. Discipline includes sticking to some food categories that we might not really adore.” Discipline includes prioritising sleep, staying regular with our schedules, and committing to concrete changes, even when they’re uncomfortable. Ideally, Di Mauro notes, a long-term health plan would be crafted in collaboration with a team of experts: An endocrinologist dispensing the medication, a nutritionist, a fitness coach, and even a mental health professional, all of whom can advise on the individual yet overlapping lifestyle factors that influence a person’s weight.
At Chenot, we take a holistic approach to each guest’s health, irrespective of the medication they may or may not take. We factor it into the treatment plans our facilities provide, tailoring the experience to the guest’s individual needs, but the real value comes from the way guests learn to empower themselves.
A week spent at Chenot means a week spent learning what your body needs, and building the kinds of habits that enable lasting vitality: daily movement, whole foods, a balanced sleep cycle. We don’t think about health as a number on a scale; rather, we think about health as a matter of enduring functionality. We aim to teach our guests how to keep themselves feeling as capable, as energetic, and as resilient as possible for as long as possible. “It depends very much on a person’s mindset,” Di Mauro says. It depends on their willingness to live a little differently every day. “What ease may pay immediately,” Di Mauro says, “discipline and consistency pay long-term.”
Ultimately, a person’s weight represents one thread in the tapestry of their full-body health. Neglect to weave in the others, and the whole thing unravels.
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