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GLP-1 Agonists: The Weight Loss Wonder Drug or Just Hype?

Written by: Dr Andrew Viljoen
Dr Viljoen explains weight loss drugs

What are GLP-1 Agonists?

GLP-1 stands for glucagon-like peptide-1, a naturally occurring hormone produced in the intestines that helps to regulate blood sugar, appetite and digestion. GLP-1 agonists are medications that mimic this hormone, triggering similar effects in the body – most notably, reducing appetite, increasing feelings of fullness and slowing down stomach emptying.

Originally developed to manage type 2 diabetes, these medications now have a growing role in obesity treatment. Well-known brand names include Ozempic, Wegovy, Mounjaro and Saxenda.

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The Good, The Bad & The Ugly

The Good: Benefits Beyond Weight Loss

· Effective weight loss: Clinical trials show that users can lose 10% – 20% of their body weight over time.

· Improved blood sugar control: Originally designed for diabetes, these drugs help reduce blood glucose levels and may even delay progression to type 2 diabetes.

· Heart health benefits: Some GLP-1 agonists have been shown to lower the risk of heart attacks and strokes in people with existing cardiovascular disease.

· Reduced appetite and cravings: People often report feeling fuller faster and experiencing fewer food cravings, especially for high-calorie, high-sugar foods.

The Bad: Side Effects and Downsides

· Gastrointestinal issues: Nausea, vomiting, diarrhea and constipation are the most common complaints – especially when starting the medication or when increasing the dosage.

· Cost and access: These drugs can be expensive and aren’t always covered by medical aid (unless prescribed for diabetes or medically qualifying obesity).

· Long-term commitment: Weight often returns if the medication is stopped, suggesting a need for lifelong use in many cases.

· Not for everyone: People with a history of certain thyroid cancers or pancreatitis may be advised against using it.

The Ugly: Ozempic Face, Hype & Misinformation

· Medication shortages: High demand has made it harder for diabetic patients to access their necessary medications.

· Unregulated use: Many people are obtaining these drugs without proper medical guidance, risking side effects and complications.

· Social pressure and body image issues: The popularity of these medications has fueled unrealistic body standards and led to a new form of appearance anxiety.

The rise of GLP-1 medications has also brought unexpected cosmetic side effects and social controversies.

‘Ozempic face’ – a term coined by a cosmetic dermatologist and widely circulated online – refers to the gaunt or aged appearance some people experience after rapid and significant weight loss while on GLP-1 medications. Why does it happen? Well, when you lose weight – especially quickly – fat and lean muscle are lost all over the body, including the face. This facial volume loss can lead to sagging skin, hollow cheeks and a more tired or older appearance. It’s not unique to GLP-1 drugs, but the speed and visibility of the weight loss associated with these medications can make the change more dramatic and jarring.

For many, this is a cosmetic concern rather than a health issue. Solutions like dermal fillers or skin-tightening treatments can restore lost volume, but it’s something to consider before starting treatment, especially if aesthetics is a high priority.

Dr Viljoen explains weight loss drugs

GLP-1 agonists are a powerful new tool in the fight against type 2 diabetes and obesity, offering hope where many traditional methods have failed. But, like all medications, they come with trade-offs – including physical, emotional and social effects.

If you’re considering one of these medications, it’s important to talk to a qualified healthcare provider to fully understand the risks and benefits. The best proven long-term outcomes are achieved with a change in lifestyle habits, a tailored eating plan and an exercise program.  

GLP-1 agonists are not a silver bullet. However, they’re an important piece of the puzzle.

Images: Tegan Smith

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