9 GLP-1 myths, debunked by doctors

From your group chat to the ads on your favorite podcast, everyone’s (still) talking about GLP-1s for weight loss. And even though they've been around for decades at this point, they remain the hot topic in health that keeps the rumor mill running. The biggest GLP-1 myths cover the spectrum, from if they’re even safe to take (yes) to whether you can get effective stuff without a prescription (steer clear!). Here, we asked board-certified doctors to clear up some of the most stubborn misconceptions out there.

Key takeaways

• GLP-1s have decades of research to back up their efficacy — but even so, there’s a ton of misinformation around how they work and what they do.

• They’re not a “cheat code” for weight loss, since obesity is a chronic medical condition that can require medication to treat.

• GLP-1s are FDA-approved treatments for diabetes and weight management, meaning they’ve gone through rigorous safety and efficacy trials.

• Weight regain after stopping GLP-1s can happen, but certain habits can help you sustain your results.

• Like other medications, GLP-1s come with side effects and aren’t for everyone, which is why it’s important to work closely with your clinician.
  
  

Taking a GLP-1 is in no way “cheating” when it comes to weight loss. After all, obesity is a chronic disease, and like other chronic diseases, medication can help. “No one tells a patient with diabetes that insulin is the easy way out,” says Dr. Gitanjali Srivastava, M.D., medical director for obesity medicine at Vanderbilt University Medical Center. “Obesity is driven by genetics, hormones, environment, and a body that actively defends its highest weight.” GLP-1s can give motivation a needed assist by addressing that biology behind obesity. 

Patients also don’t just take their medication, sit back, and watch the pounds melt off. They become active participants in the whole process. “They manage side effects, overhaul their eating, start strength training, and navigate cost and stigma,” says Srivastava. That might sound overwhelming, but there are programs out there that can help. With the Weight Watchers Med+ program, for instance, you get both access to GLP-1 medications (if you qualify) and the accompanying lifestyle program, GLP-1 Success, which has macro trackers, virtual Workshops, coaches, and on-demand workout videos to make that extra effort feel seamless and sustainable.

It’s true that weight regain is possible when you stop taking a GLP-1. In a 2022 study, people who stopped taking a GLP-1 regained two-thirds of the weight they'd lost. Not only that, but the latest research discovered that people who quit GLP-1s regain weight faster than their counterparts who lost weight via other methods, like diet. It makes sense: “When patients stop treatment, the biology that drove weight gain comes back, and studies show most people regain a substantial portion of what they lost within a year,” says Srivastava. 

That said, nothing is set in stone, and there are ways to minimize the amount of weight you regain. “The habits you build while on treatment are the ones that support you over the long haul,” says Srivastava. “Think of the medication as the tailwind, not the boat.” In one study, people who started an exercise program while they were on a GLP-1 — and continued working out after stopping the drug — maintained their weight loss better than people who weren't physically active while on a GLP-1. That’s why, if you have an end date in sight, it’s important to use your last 30 days on a GLP-1 to set yourself up for long-term success and firm up your lifestyle strategies for maintaining weight loss. 

It’s true that GLP-1s got their start as medications for diabetes, with the FDA approving Victoza (liraglutide) in 2010 followed by Trulicity (dulaglutide) in 2014, Ozempic (semaglutide) in 2017, and Mounjaro (tirzepatide) in 2022.

But ever since 2014, when the FDA approved Saxenda (liraglutide), there have been GLP-1s approved specifically for chronic weight management. More recent additions include Wegovy (semaglutide), Zepbound (tirzepatide), and Foundayo (orforglipron).

And GLP-1s may have uses in addition to diabetes treatment and weight management. Wegovy, for instance, has FDA approval to reduce the risk of major cardiovascular events (like heart attack and stroke) in adults with overweight and obesity plus heart disease. And Zepbound is approved for the treatment of moderate to severe obstructive sleep apnea in adults with obesity. “These medications have shown health benefits well beyond the scale, including reduced cardiovascular events in high-risk patients, and they're being studied across a range of obesity-related conditions,” says Srivastava. “Weight is one outcome; health is the goal.”

GLP-1s have been prescribed for more than 20 years, so this class of medications has “a well-established safety profile backed by large clinical trials and years of real-world use,” says Srivastava.

They do come with side effects, but these tend to be manageable and include nausea, constipation, diarrhea, and vomiting. These are more likely to occur as you’re increasing your dose, according to Srivastava.

While there are more serious risks, such as gallbladder issues and pancreatitis, these tend to be rare. And some people are likely not good candidates for them. GLP-1s “aren't appropriate for people with a personal or family history of medullary thyroid cancer or MEN2,” Srivastava says. “That's why screening matters.”

While the medication lowers your appetite and turns down the food noise, it works best when paired with healthy lifestyle habits. This includes prioritizing nutrient-dense foods — “If you're eating less, every bite has to work harder nutritionally,” says Srivastava — and doing muscle-building activities like weight-lifting. “Eating protein and doing strength exercises are really important to preserve your muscle while you are on a GLP-1, because you don't want to lose muscle — you want to lose the fat,” says Dr. Sonal Mittal, M.D., a dual board-certified internal and obesity medicine physician with WeightWatchers Clinic.

Moreover, tweaking your diet can also influence your side effects. So you might experience more nausea after you eat a rich or high-fat meal, for instance. “For the medicine to work properly, you need to eat the right way,” Mittal says. That’s why Weight Watchers offers the GLP-1 Success Program, which helps you optimize your diet and exercise (and make other lifestyle shifts) and make the most of the medication.

While it’s true that some foods, including fiber-rich foods like oats, beans, lentils, and apples, naturally stimulate your body’s own GLP-1, it doesn’t have the same impact as the prescription version. “Your natural GLP-1 lasts about two minutes in the bloodstream,” says Srivastava. “Prescription GLP-1 medications are engineered to last days, at levels far beyond what food can produce.” You should still eat fiber because it’s good for you, can help you feel full longer, and helps keep you regular — but not because it can replicate the effects of GLP-1 medications in any meaningful way.

Similarly, there are no FDA-approved over-the-counter Ozempic, Wegovy, or other GLP-1s. While some supplements, like berberine, are billed to be “nature’s Ozempic” and might have a small effect in boosting the body’s GLP-1 release, they are supplements that have not been shown in clinical trials to produce the weight-loss outcomes of prescription GLP-1s. “They aren't regulated like medications, and can interact with other drugs,” Srivastava says. Always discuss any supplements with your prescribing clinician.

It feels like GLP-1s can unlock dramatic weight loss, but that's not the case for everyone. For one, the amount that people can lose varies. While you may hear that the average person loses 15% of their weight, for example, one person may lose 18% while another may lose 7%. Not only that, but some people don't respond at all: In a large trial, more than 13% of people taking 2.4 mg semaglutide, which is the standard maintenance dose, lost less than 5% of their body weight. 

You also may lose some weight, then grind to a halt. Know that if you’ve stopped losing weight on a GLP-1, you’re not alone. “Every weight-loss treatment has a plateau,” says Mittal. “Even a GLP-1 with lifestyle changes.” That doesn’t mean the medication failed or that you messed up. It just means that the treatment can only do so much for you, she says. 

Keep in mind that you don’t need to lose a fifth of your weight to get the health benefits of a GLP-1. “Even if you are able to lose 10% of your starting total body weight, you decrease your risk of having a lot of metabolic diseases, and your overall physical and mental wellbeing is improved,” Mittal explains. 

One thing that can help support your progress on a GLP-1: the Weight Watchers GLP-1 Success Program, available to all Med+ members. At six months, those who engaged regularly with the lifestyle program lost 36.4% more body weight, on average, than those who did not.*

You might have heard about Ozempic face, or the loose, sagging facial skin that some people experience when taking a GLP-1. But while that can happen, it’s not because the drug is aging you for some mysterious reason. Rather, research has found that it’s the work of rapid fat loss, which can create loose skin anywhere on the body — the face included.

Ozempic face isn’t necessarily preventable, but losing weight more gradually may give your skin more time to adjust to the loss of volume. Getting adequate nutrition with enough protein is also important for tissue repair in the body (although there aren’t any hard studies to link this to better skin in particular).

This is one of those myths that has some basis in fact. While there’s no magic amount of time to be on a GLP-1, they are intended to be an ongoing medication. After all, “you're trying to manage this chronic disease,” Mittal says. And it needs to be treated like any other chronic condition. “We don't stop blood pressure medication once blood pressure normalizes, and this is no different,” says Srivastava. 

But reality can get in the way: For instance, your insurance might drop its coverage, or you might not like the side effects. If that’s the case, you may need to stop — which can potentially come with some weight regain for some people. That’s because GLP-1s work by increasing feelings of satiety and reducing cravings.. “When you take away that GLP-1, some patients might get that [increased] desire to eat back because their hunger hormones are rising again,” Mittal explains.

If you’re planning to stop your GLP-1, you can do some things to minimize your risk of regaining weight. This includes discussing with your prescribing clinician possibly tapering your dose, or slowly going down over a period of weeks to months. In 2024, data presented at the European Congress on Obesity found that people who tapered their dose over nine weeks were able to maintain a stable body weight for the first 26 weeks after stopping their dose. Your clinician will be able to guide you on the best way to go about it and talk with you about the importance of maintaining your healthy habits even if you’re no longer taking the medication.

GLP-1s are among the most powerful weight-loss medications out there and have decades of research to back up their safety and efficacy. And while they’re not right for everyone — which is why a consultation with a clinician is so important before and while taking a GLP-1 — and some people experience side effects, they can be a meaningful tool in getting and staying healthy. They don’t work alone, either: Pairing them with other lifestyle changes, like tweaking your nutrition and ramping up your exercise, can help you make the most of the medication.