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Glucagon-like peptide-1 medications (GLP-1s) were originally developed to treat diabetes. GLP-1s help the pancreas produce more insulin to counteract the insulin resistance common with diabetes.

But researchers were surprised to discover that people taking GLP-1s began losing weight and reporting feeling fuller. The benefits – and potential concerns – have continued to emerge. GLP-1s may have applications in treating heart disease, PCOS, menopause, and more. However, they may also contribute to bone or muscle loss, and potentially trigger or worsen eating disorders.

Charisse Fullwood, NP, a knowledgeable and experienced nurse practitioner, offers guidance on some of the most pressing questions about these powerful medications.

Who can get a prescription for a GLP-1?
In general, patients need to be diagnosed with diabetes or meet specific BMI criteria to qualify for GLP-1 medications like Ozempic, Mounjaro, Wegovy, Zepbound, or Saxenda.

“It’s typically someone with a BMI of 27 to 29.9 who also has a weight-related comorbidity – such as high blood pressure, high cholesterol, diabetes, or sleep apnea – or someone with a BMI of 30 or higher,” explains Charisse Fullwood, NP.

Do GLP-1s make you feel sick?

“GLP-1s impact satiety, so you feel fuller, faster,” says Charisse Fullwood, NP. “They also slow gastric emptying, which means your digestive process is slower. That’s part of what helps you feel full, but it can also lead to side effects like nausea, vomiting, diarrhea, constipation, and heartburn.”

Are you losing muscle on a GLP-1?

“Any time we lose weight, we’re losing more than just fat,” explains Charisse Fullwood, NP. “We also lose water and lean muscle mass. There’s concern about preserving muscle and maintaining bone density—especially in older adults.”

She recommends incorporating resistance or strength training to support muscle retention.

“We aim to preserve at least 30% of lean muscle mass, and strength training plays a big role in that.”

Can GLP-1 medications treat menopause symptoms?
These medications may offer relief for some menopausal symptoms, but the research is still ongoing.

“GLP-1s are promising, but they should be paired with holistic lifestyle changes,” says Charisse Fullwood, NP. “They’re not a standalone solution for menopause.”

Can a GLP-1 medication reverse PCOS?

“Some studies have shown that GLP-1 medications can improve ovulation and regulate menstrual cycles in people with PCOS,” says Charisse Fullwood, NP. “There’s even evidence that GLP-1 receptors exist in the ovaries and endometrium, which could help improve implantation and reduce inflammation.”

Still, more research is needed before making broad claims.

Do GLP-1s help with heart disease?
GLP-1 drugs may benefit the endothelial cells that line the blood vessels, and clinical trials suggest they may regulate blood pressure and lower mortality for patients with a history of cardiovascular events.

“It’s difficult to say whether the benefit is directly from the drug or the weight loss it promotes,” notes Charisse Fullwood, NP.

Can GLP-1 medications increase your heart rate?

“Yes. GLP-1s affect the parasympathetic nervous system and the vagus nerve, which can raise heart rate in some individuals,” explains Charisse Fullwood, NP.

Can GLP-1s help with COVID-19 outcomes?
In one study of 17,000 individuals, fewer people taking GLP-1s died from COVID-19 compared to those not on the medication. While the data is statistically significant, Charisse Fullwood, NP, cautions:

“We can’t attribute the difference solely to the medication. Obesity is a risk factor for severe COVID outcomes due to inflammation and poor cardiopulmonary function. GLP-1-related weight loss may have played a protective role.”

Can people with eating disorders take GLP-1s?
There is growing concern in the eating disorder treatment community regarding misuse of these drugs.

“We don’t want GLP-1s to be used inappropriately by people without clinical need or as a tool to worsen disordered eating behaviors,” says Charisse Fullwood, NP. “That said, in some cases, GLP-1s may reduce ‘food noise’—that constant mental chatter around eating—and help individuals make more intuitive food choices.”

GLP-1s may be particularly helpful for patients with binge eating disorder, especially if it overlaps with other conditions like PCOS, diabetes, or heart disease.

Do GLP-1s stop addiction?
Early research suggests GLP-1s might help reduce cravings—not just for food, but also for substances like alcohol. In fact, GLP & GIPS 1's are typically now used for patients with alcohol use disorder or binge eating disorder . 

“It's encouraging to see how these medications are helping people improve their health in multiple areas.”

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