Diabetes and GLP-1: The Real Story Behind Ozempic, Wegovy, and Mounjaro (Part 1)

“The shocking part? Up to 40% of the weight you lose can be lean mass.”

Welcome to The Diabetes Podcast blog. We’re Richie and Amber, and today we’re breaking down the buzz around GLP-1 medications like Ozempic, Wegovy, and Mounjaro. Are they miracle drugs? Are they worth the cost? Why do some people gain all the weight back? In this part-one guide, we’ll share the real story: how these meds work, who they help, what side effects to expect, and what the data actually shows. We’ll also set you up for part two, where we’ll cover food, exercise, and a glp1 diet plan to boost your body’s own GLP-1—naturally.

What Is GLP-1—and Why It Matters

Think of your digestive system as a smart messaging network. When you eat, it sends signals to your brain, stomach, and pancreas. One of the most important signals is GLP-1 (glucagon-like peptide-1).

GLP-1 helps:

• Your pancreas: release insulin when glucose is present (glucose-dependent insulin release)

• Your liver: reduce extra glucose production

• Your gut: slow stomach emptying so you feel full longer

• Your brain: turn down hunger and tame “food noise”

• Your hormones: decrease excess glucagon

In type 2 diabetes, several systems are out of balance. GLP-1 drugs can touch 5 or more of the “core defects” at once. That’s a big reason they help with both blood sugar and weight.

Why Ultra-Processed Foods Break This System

Most GLP-1 is made in the far end of your intestines. When you eat fast-digesting foods (like donuts), sugar and fat get absorbed too early, and the GLP-1 “fullness signal” barely fires. You don’t feel satisfied, so you keep eating. That’s one reason modern food environments make appetite control so hard.

How GLP-1 Medications Work Today

Older versions were based on a compound found in Gila monster saliva. Today’s meds are fully synthetic:

• Semaglutide: Ozempic (diabetes), Wegovy (weight loss)

• Tirzepatide: Mounjaro (diabetes), Zepbound (weight loss; dual GLP-1/GIP)

They mimic your GLP-1 signal for longer. Many people say it feels like a hunger switch is turned down. Food noise gets quieter. Pizza and donuts lose their pull. Blood sugars improve.

What It’s Like To Start

• Weeks 1–4: Low starting dose, then slow increase. Common: mild nausea as your body adjusts.

• Weeks 5–12: Dose increases. Appetite drops. Many people lose 2–3 pounds per week. A1C often falls 1–2 points.

• Months 3–6: Peak weight loss period.

• Months 6–12: Weight loss slows and often plateaus. Your body adapts (homeostasis). Appetite signals start pushing back.

The Data, In Plain Language

• Average weight loss on high-dose semaglutide (Wegovy): about 15% of body weight

• On tirzepatide (Zepbound): up to ~20% for many

• In studies where the average starting weight was ~230 lbs, that’s roughly 14–35 lbs lost

• Most participants started obese and often remained in the obese category after weight loss

The Catch: Stop the Med, Weight Often Returns

Experts like Dr. Robert Kushner (a lead investigator in major GLP-1 trials) say it clearly: stop the medication, and the weight usually returns. For many people, this is a long-term therapy—like blood pressure meds or statins. Obesity behaves like a chronic disease that needs ongoing management.

Benefits Beyond Weight

• A1C reduction: roughly 0.8–2.0 percentage points (higher starting A1C usually means bigger drops)

• Every 1% A1C reduction is linked to ~21% lower risk of diabetes complications

• In people with existing heart disease, GLP-1 meds can reduce risk of heart attack and stroke by about 20%

Common Side Effects (Real-World View)

• Nausea: ~44%

• Diarrhea: ~30%

• Vomiting: ~24%

• Constipation: ~24%

• Appetite suppression: can make meals with family less enjoyable for some

• “Ozempic face”: rapid fat and muscle loss can change facial fullness. Rapid loss plus lean mass loss can make skin look looser.

The Most Concerning Side Effect: Muscle Loss

Up to 40% of weight lost can be lean mass. Less muscle means a slower metabolism. For example:

• Before: you burn ~2000 calories/day

• After lean mass loss: you may burn ~1700–1800/day
  This can make weight regain more likely if you stop the medication—or even while on it if habits don’t change. It’s especially important for older adults and women in perimenopause/menopause to protect muscle.

Costs and Coverage

• With type 2 diabetes, many insurance plans cover GLP-1s

• Typical monthly out-of-pocket: $25–$200 (co-pay cards can help, but not for Medicare/Tricare)

• Medicare usually does not cover GLP-1s for obesity alone

• Annual out-of-pocket can be ~$1,300–$1,400 even with coverage

• Shortages have led some to compounded versions—these are not FDA-approved, and the FDA has warned about dosing, labeling, and sterility problems

Compounded GLP-1 Caution

Some compounders use unapproved salt forms or inconsistent dosing. There have been reports of overdoses and hypoglycemia. If you consider a compounded product, talk to your doctor and pharmacist and understand the risks.

Why Plateaus Happen

Your body loves balance (homeostasis). Lose weight fast, and your body fights back:

• Hunger signals increase

• Metabolism slows due to lean mass loss

• Food noise can roar back if you stop the med
  This is why long-term success needs more than a shot. It needs a plan for food quality, strength training, sleep, and stress.

A Note on Hunger and “Food Noise”

It’s not “weakness” to feel hungry. Ultra-processed foods, high stress, and learned patterns can drown out your body’s natural fullness cues. GLP-1 meds can quiet the noise. But building skills to recognize real hunger and fullness is key for lasting change—on or off medication.

Who Might Benefit Most

• People with type 2 diabetes needing better blood sugar control

• Those with obesity and weight-related complications

• People with established cardiovascular disease (some GLP-1s show heart-protective effects)

Who Should Be Cautious

• Anyone unable to tolerate GI side effects

• Those at high risk for muscle loss who won’t or can’t do resistance training

• People considering non-FDA-approved compounded products

What’s Next: Part 2—The Natural “glp1 diet plan”

In part two, we’ll show you how to raise your own GLP-1 with food and movement. You’ll get:

• A practical glp1 diet plan with foods that may boost GLP-1 (some by 40%+ in studies)

• A simple strength and movement plan to protect muscle and metabolism

• Tips to reduce food noise and improve fullness signals

• How to talk with your doctor about starting, pausing, or stopping a GLP-1

• Big questions we all need to face: GLP-1s in kids, equity and access, and the risks of medicalizing obesity

Takeaway

GLP-1 medications can help a lot with blood sugar and weight, and they can lower heart risk for some. But they have costs and trade-offs: nausea, muscle loss, plateaus, and often weight regain when you stop. The best results come when medication is paired with a strong plan for food quality, resistance training, sleep, and stress.

If you’re on a GLP-1 or considering one, stay tuned. In part two, we’ll give you a step-by-step glp1 diet plan and lifestyle guide so you can quiet food noise, protect muscle, and build habits that last—whether you use medication or not.

Join Us Next Week

• Foods that boost GLP-1 naturally

• Exercise that supports appetite control

• A multi-week plan you can follow at home

You can do this—and we can help. If you need additional help or resources, contact us at [email protected].

Disclaimer

The information in this blog post and podcast is for educational and informational purposes only. It is not medical advice, diagnosis, or treatment, and it does not replace a one-on-one relationship with your physician or qualified healthcare professional. Always talk with your doctor, pharmacist, or care team before starting, stopping, or changing any medication, supplement, exercise plan, or nutrition plan—especially if you have diabetes, prediabetes, heart, liver, or kidney conditions, or take prescription drugs like metformin or insulin.

Results vary from person to person. Examples, statistics, or studies are shared to educate, not to promise outcomes. Any discussion of medications, dosing, or side effects is general in nature and may not be appropriate for your specific situation. Do not ignore professional medical advice or delay seeking it because of something you read or heard here. If you think you are experiencing an emergency or severe side effects (such as persistent vomiting, severe diarrhea, signs of dehydration, allergic reaction, or symptoms of lactic acidosis), call your local emergency number or seek urgent care right away.

We strive for accuracy, but health information changes over time. We make no guarantees regarding completeness, timeliness, or suitability of the content and assume no liability for actions taken or not taken based on this material. Use of this content is at your own risk.

Links or references to third-party resources are provided for convenience and do not constitute endorsement. By reading, listening, or using this information, you agree to these terms and understand that you are responsible for your own health decisions in partnership with your licensed healthcare provider.