GLP-1 agonists
Definition
Glucagon-like peptide-1 (GLP-1) agonists are a class of medicines used to treat
Alternative Names
GLP-1 receptor agonists; GLP-1 analogs; Incretin mimetics; GLP-1 RAs; Glucagon-like peptide-1 agonists
Information
HOW GLP-1 AGONISTS WORK
Glucagon-like peptide-1 (GLP-1) is a natural hormone that is released by your gut after a meal. The hormone GLP-1:
- Signals to your brain that you are full
- Tells your pancreas to release insulin, which helps regulate blood sugar
- Slows down how quickly your stomach empties
GLP-1 agonists are man-made (synthetic) hormones that cause many of the same actions as natural hormones. They enhance these natural processes within the body. The higher the dose, the more the effect.
GLP-1 agonists were first developed to help people with type 2 diabetes control their blood sugar. These medicines also lead to weight loss because they:
- Reduce your appetite
- Reduce food cravings
- Slow digestion so you feel fuller for longer
GLP-1 agonists alone cannot treat diabetes or obesity. They work best when used along with lifestyle changes such as a
Many people using GLP-1 agonists will regain lost weight if they stop taking the medicine.
GLP-1 agonists also may help reduce the risk of serious heart problems such as
TYPES OF GLP-1 AGONISTS
GLP-1 agonists are most often given as an injection either daily or weekly. One type is taken as a pill. GLP-1 agonists approved for the treatment of type 2 diabetes include:
- Dulaglutide (Trulicity): Injection; once a week
- Exenatide (Byetta): Injection; twice a day
- Liraglutide (Victoza): Injection; once a day
- Lixisenatide (Adlyxin): Injection; once a day
- Semaglutide (Ozempic): Injection; once a week
- Tirzepatide (Mounjaro): Injection; once a week
- Semaglutide (Rybelsus): Pill; daily
Dulaglutide and liraglutide are also approved for treatment in people with type 2 diabetes and heart problems to reduce the risk of serious cardiac events.
GLP-1 agonists approved for the treatment of obesity include:
- Semaglutide (Wegovy): Injection (once a week), or pill (once a day)
- Tirzepatide (Zepbound): Injection; once a week
POSSIBLE SIDE EFFECTS
GLP-1 agonists can have some side effects. Most of the side effects occur with a higher dose, and get better with time as the body adjusts to treatment.
Side effects may include:
- Nausea
- Vomiting
- Diarrhea
Abdominal pain - Loss of appetite
- Constipation
- Headache
Low blood sugar (higher risk if taken along with insulin or sulfonylureas)- Reduced muscle mass
- Injection site reactions, such as rash or itching
- Pancreatitis (rare)
- Gallbladder disease (rare)
Contact your health care provider if any side effect bothers you.
GLP-1 agonists are not recommended for:
- Pregnant women
- People with a history of
medullary thyroid cancer - People with a family history of
multiple endocrine neoplasia, type II (MEN II)
WHEN TO CONTACT A MEDICAL PROFESSIONAL
Call 911 or the local emergency number if you experience:
- Severe allergy (
anaphylaxis ) symptoms such as breathing or swallowing difficulty, chest tightness, orhives . - Low blood sugar symptoms such as dizziness, trembling, extreme tiredness, and fast heart rate.
References
Ahmann AJ, Riddle MC. Therapeutics of type 2 diabetes mellitus. In: Melmed S, Auchus, RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 34.
Dhatariyan KK, Umpierrez GE, Crandall JP. Diabetes mellitus. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 210.
Jensen MD, Bessesen DH. Obesity. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 201.
Moiz A, Filion KB, Tsoukas MA, Yu OH, Peters TM, Eisenberg MJ. Mechanisms of GLP-1 receptor agonist-induced weight loss: a review of central and peripheral pathways in appetite and energy regulation. Am J Med. 2025 Jun;138(6):934-940. Epub 2025 Jan 31. PMID: 39892489.
Moiz A, Filion KB, Tsoukas MA, Yu OHY, Peters TM, Eisenberg MJ. The expanding role of GLP-1 receptor agonists: a narrative review of current evidence and future directions. EClinicalMedicine. 2025 Jul 17;86:103363. PMID: 40727007; PMCID: PMC12303005.
Orandi BJ, Aronne LJ. Obesity. In: Chung RT, Rubin DT, Wilcox CM, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 12th ed. Philadelphia, PA: Elsevier; 2026:chap 8.
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