GLP-1 Medications Beyond Weight Loss: The Science Behind Semaglutide and Long-Term Health Benefits

Can GLP-1 medications be used for health, not just weight loss? And is it possible to be anti-diet, critical of diet culture, and still consider a medication like semaglutide (Ozempic or Wegovy)? A year ago, I would have laughed at that question and said of course not. I was deeply skeptical of GLP-1 medications.

Content warning: This post discusses weight gain, weight loss, calories, dieting, and disordered eating. While it aims to tear down stigma in a health-focused framework, please feel free to skip or take care while reading.

Likely you’re hearing about it everywhere.

From Brian Johnson, the billionaire focused on reducing his biological age, to Serena Williams, one of the strongest most powerful athletes to ever live, we’re hearing about semaglutide everywhere.

Admittedly, the anti-diet part of me was immediately frustrated by all the rhetoric and incessant advertising. Then the SkinnyTok girlies and gymfluencer bros were “micro-dosing” along with nicotine (?!) and a host of other things that made my eyes roll. These are the same people who will troll with fat-phobia while using a medicine to optimize their own aesthetics. It really turned me off. I wasn’t open to looking into the actual science because of the fitspo harm it was causing.

Then Jessica Brown, Dr. Tommy Martin, Dr. Gregory Dodell, and others I respect started reminding me there is nuance in all of this. I discovered Dr. Salas Whalen‘s compassionate approach to education with weight bias. And I remembered two things can be true at the same time.

The same tool can be abused by diet culture and still be used thoughtfully for health.

If I’m being curious, as I want to be, I need to be open to listening and learning and actually looking at data. Which led me to the decision that shocked me as much as it’s going to shock you: I’ve started taking oral semaglutide (Wegovy), a glucagon-like peptide-1 receptor agonist. Because I’m all about transparency and research like it’s my religion, here’s why.

Are you an auditory learner? Listen to the podcast here:

PART 1:

PART 2:

Part 1 – My Personal Perspective

I think we all need to start reconsidering how we think about this medication that is having profound results. The science may not be what you think (it was shocking for me to learn, sincerely). If you’d like to skip my personal experience and jump to the research, start here.

A Little History

In 2010 I became one of the “pioneers” of the Paleo diet. I wrote three international bestselling books all sold in Costco, had two book tours, and thought I had it all figured out. Then, I realized I was a) using Paleo as a tool for disordered eating and had become so orthorexic, that 2) I’d given myself atypical anorexia and a myriad of health ailments. I justified this through intermittent fasting, which meant I couldn’t digest food properly that led to multiple health scares including a thyroid nodule. Furthermore, I had hair falling out in tumbleweeds and endless food intolerances from the gut microbiome I killed off in the process.

I only figured these things out because when I stopped breastfeeding, I began to gain weight and ignored all the other health red flags. That weight gain led me to CrossFit, then, ultimately, Strong Man.

Then I went on to become a competitive athlete.

I continued to use this as a way to obsess within diet culture. Tracking macros became a full time job. And while I was strong, my health was neglected, for example my hospitalization for dehydration. Even as a Nationals qualifier, training and working out relentlessly, I continued to gain weight, about 45 lbs.

When a debilitating back injury ripped away my sport, despite continuing my healthy habits, I gained more weight. It was so endlessly frustrating to be at war with my body. Which is what brought me to intuitive eating and body peace.

Finding body peace

For the last five years I’ve been on a journey to truly find harmony and acceptance in the skin I’m in. Is my body what I want? What society deems acceptable? Do I enjoy being mocked or made fun of? Does my weight reflected the amount of work and knowledge I have around health? No.

I am a passionate, curious, funny, and empathetic person. My weight doesn’t define me. In fact, it’s one of the least interesting things about me.

Coming to this conclusion, to be at peace in acceptance of my body as it is, was life changing for my mental well being. Of course I always want to strive to improve, but that doesn’t mean I cannot love myself today.

Set-Point

As I worked to ingrain these beliefs in myself, as is expected with intuitive eating, I gained even more weight. It was part of my journey to learn to let go of scarcity mindset around food. I had to learn to eat without the fear of eventual starvation. Eventually, my body settled at its pre-babies natural set-point (from my early 20’s).

The body set point is a theory suggesting your brain and body, particularly the hypothalamus, maintain a specific, natural weight range through regulating metabolism, hormones, and hunger, often resisting weight loss. The theory also suggests that a person’s weight set point is established early in life and remains relatively stable unless altered by specific conditions, explaining why weight loss is often difficult to maintain. [1]

My body’s set point, as with many of us, was influenced by genetics. My grandmother and great-grandmother were both obese from a young age. I was never a small child. And a traumatic event right around puberty caused my weight to start on the roller coaster I’ve been on ever since.

I tell more of that story in my Camp Shame podcasts (here and here).

Then at some point in my journey of acceptance and intuitive eating, my weight slowly reduced. By focusing on nutrient sufficiency, my HEALTH (not my weight), and on behavior practices that made a difference, I lost 20lbs. Without dieting.

It’s both exciting to know that what I’m doing is showing me a symptom that it’s working, and also it was incredible to not feel like my value was associated with that number.

Are intuitive eating and health habits wrong if they cause weight loss?

If gaining weight isn’t a moral failing, then losing weight doesn’t need to be either. I’d worked hard to develop true health habits. In late 2024 I wrote about how I was proud to have Great Health in a Larger Body.

This was not to say that people in larger bodies need to justify their existence to anyone. I, personally, was simply  proud of what scientific measurements could show me of what I knew to be true, beyond the scale.

Learning about GLP-1s beyond the scale

It has taken many years, but I now truly know weight gain or loss isn’t something to judge or value. I want to be healthy and want to feel good for as long as possible.

For years I’ve looked at GLP-1 medications and rolled my eyes, deep sighed, and even hosted podcasts that clearly shared what I thought. For me, the very real risks of muscle wasting, nutrient deficiency, and negative side effects did not seem worth pursuing weight loss alone.

But then the science kept progressing. They found semaglutide is doing a whole lot more than making all our celebrities emaciated. The second half of this post is dedicated exclusively to that research.

My personal experience with GLP-1s

As someone who was given rice cereal solids in my bottle as an infant, “because I was insatiable,” I yo-yo dieted during puberty and was sent to fat camp over multiple summers. I remember having a plastic surgeon consult at 15 years old about saggy breasts because my skin had lost elasticity from gaining and losing so much weight repeatedly.

Chronic weight cycling causes harm. [2] In fact, losing weight and gaining it back is worse for you than just staying at your current weight, because you’ll lose muscle but gain fat. [23] This reduces metabolic efficacy, harms your gut microbiome, and reduces the hormones needed for health: leptin, ghrelin, insulin, cortisol, thyroid, etc. [13]

I am the definition of the metabolically broken. Yet somehow I thought I could white knuckle my way through it?!

Ironically, Insurance Denied Me

I want to make sure that everyone knows, GLP-1s are NOT accessible. This is yet another reason for social determinants of health to create even more of a divide. Despite the entire world, including my primary care physician and gynecologist, identifying that this medication would be helpful for me, my insurance denied it.

When it was finally approved and I nervously took my script to the pharmacist, I learned it would be $500 a month. That is not feasible. I decided it was a sign and moved on, continuing to focus on mindset and behaviors. Months later, when the pill came out, I decided to go ahead and pay out of pocket because it is more affordable.

I say all this because I had no idea myself. We all have a lot of preconceived notions and judgements, but this medication is not accessible for most people. And, it takes a tremendous amount of thought to be successful with it.

My First Week

My first week was awful. I was “intuitively eating” and only eating when I felt hungry, but I felt so nauseous, light-headed and exhausted. I was in bed for most of the day several days in a row. Then something occurred to me: how much am I eating?

Women need to be eating at least 1200 calories a day for adequate organ and muscle function. When I tracked my calories, I’d been eating 500 calories a day. No wonder I felt awful, my body was screaming for help!

I cried

The second week of being on the medication, I learned to eat so that I was nourishing and fueling my body the way it needed: three (smaller) nourishing meals and two snacks a day.

I remember staring down at a portion of uneaten dinner. It was shocking how much less I needed to feel satiated. I started crying. Matt asked me what was wrong.

This is what it’s like for other people.

My whole life, literally even as an infant, it was incredibly difficult to be satiated. I lost my gallbladder in my early twenties, leading me to *pardon for the bluntness* literally shit my pants multiple times. Food quite often “runs through me.” Which means I often am not properly digesting and absorbing nutrients properly, which leads to more cravings.

Try as I might to white knuckle my body into submission, to try to find peace and acceptance (as I actually got fat shaming hate mail), my body was telling me something wasn’t right.

But I had internalized that as something I did wasn’t right. That it was my fault.

And now I had a medication that normalized a hormone for me (about 25% of us Americans have low GLP-1 levels [12]). I’m guessing they, too, have been in a metabolic war for a long time. And now it’s like getting that final puzzle piece to fit in just perfectly.

How I’m Approaching It

The original concerns I had about semaglutide medication still exist, so here’s how I’m handling each one.

Comments on My Body

First and foremost, I told the people closest to me (friends, family, coworkers) that I had started this medication for my health. I told them they would probably notice weight loss, though that wasn’t my goal and something I’ve struggled with my whole life. I asked them to please not comment on my weight.

It was a huge relief for me to know I’d be safe around them, and they all told me they appreciated my giving them that clarity.

Fueling Myself

Ultimately, I have to track my food to ensure I’m getting adequate calories as well as micro- and macro- nutrients. I am using Chronometer and focus on ensuring adequate energy (calories), adequate protein (my min is 100g/day), and micronutrients in my highlighted targets.

Women commonly face deficiencies in Vitamins A (37-50%), C (41-47%), D (>97%), E (86-92%), magnesium (44-62%), and Calcium (44-49%) [40], so achieving consistent surplus with a caloric deficit feels like a win.

I find that it’s easier to hit my other goals if I eat more carbs and fiber and less fat (since it doesn’t offer micronutrients with high calories). Which is the opposite of all the diet culture I’ve been “gifted” in my adult life.

The app gave me the minimum safe calories to not lose more than 2lbs per week.* I find shooting for a minimum, not obsessing over maximums, doesn’t trigger disordered eating for me. Especially with food noise removed. I do not worry about going over any of the goals, including calories, fat or carbs.

*Losing more than 2 pounds a week is considered unhealthy. This can lead to significant muscle loss, gallstones, nutrient deficiencies, electrolyte imbalances, and a slowed metabolism. It typically causes fatigue, hair loss, and is difficult to maintain long-term. [56]

Side effects can cause nausea or digestive upset.

I find the nauseous to be true, only when I don’t eat. It almost feels like morning sickness to me, like low blood sugar. The medicine is reducing your bodies cues to eat, but it doesn’t mean you don’t need to nourish yourself. If you are having side effects, including bloating or gas or digestive upset, work with someone like Jessica to help you figure out how to feel good.

Once I started eating intentionally, I felt SO much better. Not only was the food noise gone, but so were all the negative symptoms.

Sarcopenia or Muscle Wasting

While Sarcopenia is usually age-related, the loss of skeletal muscle mass, strength, and function is happening much more often and much younger because of GLP-1 medications. After about 6 weeks, once I felt confident in my energy levels and nourishment, I added strength training back into my routine. Over the last year I’d gotten back into the gym with a good routine of both cardio and lifting weights.

Combined with a minimum of 100g of protein a day, this should ensure any resulting weight loss is fat loss rather than losing muscle.

Nutrient Deficiency

Recently, an emerging link has surfaced between the use of GLP-1 receptor agonists like semaglutide and cases of scurvy, a severe vitamin C deficiency. The dramatic reduction in appetite and food intake can lead to severe malnutrition and nutrient deficiencies. [20]

Had I not realigned how I was nourishing myself after those first few days, I can see how this is very possible – if not inevitable. One cannot live on protein drinks and bars alone, friends.  Your skeletal muscle that runs your hormones need protein, absolutely. But they also need essential vitamins and minerals, too. After all, that’s why they’re essential.

It has been shockingly easy to get adequate nutrition with medication, because of tools I use. Without this multi-vitamin and Life Shake there is absolutely no way I could hit both my macro and micro nutrient minimums (let alone what I’d need to thrive) within the ~1500-1800 calories a day I’m consuming.

sign-up to be notified of my forthcoming e-book here

I’ll be sharing some of my favorite recipes and tools soon, but for now I have found these to be helpful tools to meet my goals:

Fiber

• Blackberries, raspberries and apples are my go-to fruits
• Popcorn and oats, I love having let go of the fear of carbs
• Peas, I microwave from frozen with salt and pepper
• Avocado, I add this to almost anything I can
• Legumes, which can be found in a lot of snack foods
• Seeds: I add chia, hemp, flax, pumpkin, or Zen Basil seeds to any and everything
• I love this protein drink that also has 5g of fiber
• Life Shake is a daily essential for me (has fiber, vitamins & protein)

Vitamins & Minerals

• Salads at least 1-2 a week, especially with kale, are considered the most nutrient-dense foods available
• Cherries, red bell peppers, & berries will help you hit your vitamin C and fiber goals for the day
• Season your foods with fresh lime or lemon, herbs and garlic for added boosts
• Edamame and soy add not only fiber and protein but also B vitamins, C, coQ10, and so much more
• Seaweed has become one of my go-tos, both dehydrated snack sheets and in fresh Asian-style salads
• Nutritional yeast, if you like the flavor is a great thing to add for B vitamins
• VitaLea Daily Essentials Multivitamin (I recommend this bundle to save money)
• I also add this Organic Greens Booster to my smoothies
• Life Shake is a daily essential for me (has fiber, vitamins & protein)

Protein

• Shrimp, specifically Costco’s cocktail shrimp platter is an easy and filling go-to
• Rotisserie Chicken, I like the cheap leftover bag from Costco with Kevin’s sauces and microwaved with the 90-second rice bags
• Egglife Eggwhite Wraps, I love mine with sliced turkey & avocado (fiber!) or tuna salad
• Go crazy with the parmesan cheese, add it to everything
• Greek yogurt and cottage cheese, yes…. I know, enough said but I wouldn’t eat it if I genuinely didn’t like it
• Life Shake is a daily essential for me (has fiber, vitamins & protein)
• Sparkling Protein

 

Best combo for it all: my Strawberry Chocolate Parfait

recipe in this (free) eBook

What I’m Not Doing

I’m not limiting the types of food I eat. Without food noise, I am finally able to actually think about what my body needs. And, for the first time since I can ever remember, I never become SO hungry that I then feel driven to overeat. I am in more control of the choices I make.

I don’t worry about calories going “too high”. There were a few days where my body was more hungry than usual. It was odd, and I worried the medication was become less effective. Then, I got my period. It was such a wonderful moment to realize my body knew it needed more fuel for menstruation and gave me even more confidence in trusting the process.

I still experience food joy! Quite often I enjoy popcorn after dinner. I enjoy pizza almost every Friday night with the family. Occasionally I’ll have sweets. I love that it’s easier to feel satiated when I do choose to enjoy them.

My Digestion is SO much better

A lot of people talk about the disappearance of food noise, and, yes, that has been amazing. But I’ve got one even better for you: my digestion has been better than ever. Truly, the slowing of the gastric emptying is something I hope more doctors come to suggest for anyone without a gallbladder.

It’s given my body a chance to digest and absorb nutrients with ease.

For those who struggle in the aftermath of cholecystectomy, or maybe you have Crohn’s, diverticulitis or other inflammatory digestive or bowel disease or issues, I highly recommend you discuss with your doctor if a GLP-1 could be right for you.

If your medical professional isn’t open to discussing new research or your concerns, it may be worth seeking a second opinion. There are so many professionals who can work with you online through detailed bloodwork and beyond. Don’t settle for someone who isn’t as invested in your wellbeing as you are.

Once I started reading the research, I realized the story around GLP-1 medications is much bigger than weight loss.

Part 2: GLP-1 Medications Beyond Weight Loss

The landscape of pharmacological interventions in combating obesity has long struggled with the challenge of balancing efficacy and safety. Sadly, many folks have often sacrificed their health for weight loss only for the weight to come back.

GLP-1 receptor agonists are different. Extensive long-term studies have evaluated both safety and efficacy. Unlike other solutions, like restrictive dieting or medication that cannot be used long-term, it can be continued for a lifetime. It is more similar to a statin. It is truly a breakthrough, because it delivers a lot more than just a weight-loss tool.

Some of the research that helped me change my mind

Semaglutide has been FDA-approved for managing type 2 diabetes (T2D) since 2017, so I won’t include that science. First and foremost, one must understand the main mechanism of how and why this is and how new scientific research is proving a multitude of other health benefits that come from GLP1s.

Note: all of the research and benefits come from the FDA approved medications. Off-brand compounds can be dangerous and are not included in these data. [55]

Earlier concerns regarding semaglutide and potential links to the development of certain cancers, particularly thyroid and pancreatic cancer, and associations with suicidal ideation, have now subsided. Recent data show no increased risk of developing any type of cancer and no association with suicidal ideation. In fact, there is even a suggestion of a reduced risk of suicidal ideation in individuals undergoing semaglutide treatment. [3]

Anti-inflammatory

SUMMARY: The emerging research suggests that GLP-1 medications like semaglutide may help reduce systemic inflammation, a key driver behind many chronic diseases including heart disease, metabolic disorders, and some autoimmune conditions. By calming inflammatory pathways throughout the body, these medications may support broader health improvements beyond blood sugar or weight alone.

Overall, Semaglutide has shown promise in managing a variety of inflammation-based causes:

• reduced cardiovascular and COVID-19 death [16, 17, 19]
• improved PCOS-related symptoms,
• reduced insulin resistance,
• demonstrated renoprotective effects in diabetics and chronic kidney disease (CKD),
• improves liver enzyme levels, steatosis, and stiffness,
• aids in managing Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis,
• reduces major adverse cardiovascular events,
• improved heart failure symptoms,
• reduced physical limitations in diabetics,
• benefits in cognitive disorders, including Alzheimer’s disease, Parkinson’s disease, and vascular dementia
• decrease risk of hypothyroidism
• are safe and effective for Multiple Sclerosis (MS, an autoimmune disease) [14] [31][26]
• promise neuroprotection in MS [15]
• increase Vitamin D values [14]
• exerted protective effects against the risk of various types of cancer (ongoing human studies)

How? Through anti-inflammatory pathways

Inflammation contributes to many chronic conditions and is the result of autoimmune diseases. It is often associated with circulating pro-inflammatory cytokines and immune cells. GLP-1 levels often correlate. Its anti-inflammatory properties have been recognized only recently. GLP-1 also protects cells of the cardiovascular and nervous systems by reducing inflammation and apoptosis. [48]

Consistent evidences suggest that GLP-1RAs have anti-inflammatory properties that may modulate the immune-system. Notably, such anti-inflammatory effects target different pathways in different tissues, underling the broad spectrum of GLP-1RAs actions. [47] And, leads to dampened systemic inflammation that may be relevant in autoimmune and chronic inflammatory diseases.[47][47][48][49]

GLP-1 RA act as multi-faceted anti-inflammatory agents, suggesting they may delay or attenuate inflammation-driven tissue damage.[48][49]

GLP-1 receptor agonists very often dampen immune responses. [24][25][26][28]

“GLP-1RAs represent a promising avenue for treating autoimmune and autoinflammatory diseases.” [27]

Trials are also underway for numerous new solutions. For example, Zepbound is being tested as a Long Covid Treatment in a trial that began in Nov 2025 (60-90% saw symptoms improve so far!) [18]

Gut Health

SUMMARY: Despite the digestive side effects some people experience early on, GLP-1 may actually support gut health by reducing intestinal inflammation, improving gut barrier function, and helping rebalance the gut microbiome. Because gut inflammation is linked to many chronic diseases, this may be one of the mechanisms behind the broader health benefits researchers are seeing.

Despite so many of the side effect warnings surrounding digestion, the mechanistic work shows that GLP-1R activation can reduce intestinal inflammation and lower pro-inflammatory cytokines. That concomitant gut-dysbiosis (microbial imbalance alongside another condition that drives chronic inflammation) being addressed in the gut then helps reduce overall inflammation. [41][47]

Semaglutide therapies have actually been shown to restore gut barrier function [24]

Autoimmune Diseases

SUMMARY: Because GLP-1 medications appear to influence immune cell signaling and inflammation, early evidence suggests they may help reduce disease activity or improve metabolic health in people living with autoimmune conditions.

We do know that the immune system has many different “types” of immune cells, and GLP-1 drugs may shift how they act. Semaglutide medications may affect autoimmune diseases because they can change how the immune system’s cells function and interact. [30] They create significant immunomodulatory and metabolic effects that may translate into clinical benefits across multiple autoimmune diseases. [31]

A large study found that GLP-1 RA use was associated with lower risk of developing immune-mediated inflammatory diseases in patients with type 2 diabetes or obesity, suggesting a potential protective
effect in some cohorts.[42]

What the science is showing is potential for improvements:

• GLP-1RAs reduce blunt activation in fibroblast-like synoviocytes and improve joint inflammation and metabolic parameters in rheumatoid arthritis models and small human cohorts.[26][29][25] [31]
• Early clinical studies and case series in RA patients (especially those with coexisting type 2 diabetes or obesity) reported reduced disease activity scores (DAS28), lower C-reactive protein and erythrocyte sedimentation rate levels, fewer swollen joints, and diminished morning stiffness during GLP-1RA treatment, along with the expected weight reduction and improved insulin sensitivity.[31]
• Psoriasis showed improved PASI scores and quality-of-life metrics in patients with T2DM and psoriasis, alongside reductions in lesional skin and peripheral TNF-producing monocytes.[26] Case series show meaningful skin improvement.[26]
• In psoriasis and psoriatic arthritis, GLP-1RA therapy has been associated with improvements in inflammatory markers and disease severity indices.
• In type 1 diabetes mellitus, which involves autoimmune β-cell destruction, adjunctive therapy with GLP-1RA has shown promise in patients with residual β-cell function. These agents consistently reduced exogenous insulin requirements and facilitated modest improvements in glycemic control and even enabled temporary insulin independence in a few cases.
• They reduce systemic inflammation, improve adipokine balance, and restore gut barrier function [24]
• Better pain and physical-function outcomes in osteoarthritis, and reduced flares in patients with rheumatoid arthritis on DMARDs, pointing to dual cardiometabolic and anti-inflammatory benefits.[28][42]

“Overall, the integration of GLP-1RA into the treatment of autoimmune diseases has yielded partial improvements in disease control and significant benefits in managing metabolic comorbidities.” This does not remove the requirement for standard immunotherapies; rather, they function as complementary agents that address an often overlooked metabolic component of autoimmunity. [31]

It is important to note that some autoimmune conditions have been flagged as potential hazards for several autoimmune conditions, such as ulcerative colitis and thyroiditis. [32] [33] [44] Which is another reason to work with a medical professional using only FDA approved medication to ensure health and safety.

It also has been associated with reduced mortality, when looking at patients with inflammatory arthritis and type 2 diabetes. Lower risk of death with more favorable cardiovascular outcomes in the autoimmune-inflammatory population. [43]

Cardiovascular

SUMMARY: One of the strongest areas of evidence for GLP-1 medications is cardiovascular health. Large clinical trials show that semaglutide can significantly reduce the risk of heart attack, stroke, and cardiovascular death in certain populations. These benefits extend beyond weight loss and may result from improvements in inflammation, blood vessel health, and metabolic function.

Part of why there is a lower risk of death and more favorable cardiovascular outcomes is because, beyond weight reduction, semaglutide alleviates heart failure symptoms and reduces the risk of heart attack and stroke in individuals with obesity. This presents a promising intervention in the complex landscape of obesity pharmacotherapy.[3]

Semaglutide improved cardiometabolic risk factors and reduced antihypertensive/lipid‐lowering medication in a study of 1961 participants with overweight/obesity without diabetes. These potential benefits were not maintained after treatment discontinuation. [4]

A major double-blind study (17,604 participants) showed semaglutide (Wegovy) reduces major adverse cardiovascular events by 20% in adults with overweight/obesity and established cardiovascular disease, but without diabetes. It demonstrates that semaglutide reduces risks of nonfatal heart attacks, strokes, and cardiovascular death. [7]

Note: the adverse events (side effects) are often talked about with GLP1s, but in this huge study only 8% discontinued use more than the placebo group (16.6% v 8.2%).

Blood Pressure

The Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP), a series of trials demonstrated benefits for heart failure (HFpEF) and blood pressure control. [9]

It shows promise for HFpEF and cardiovascular protection, reducing inflammation, and improving heart and vascular health. [6]

In patients with heart failure treatment led to larger reductions in symptoms and physical limitations and greater improvements in exercise function. [10]

Kidney & Liver

SUMMARY: Research suggests semaglutide may help protect kidney function and improve markers of liver health, particularly in people with metabolic disease. 

Semaglutide protect kidney functions and kidney- related risks, with rare but manageable side effects.

A landmark, randomized, double-blind renal health study:

• reduces the risk of major kidney disease events by 24%,
• 50% greater decline in eGFR or death from renal/CV causes
• reduces cardiovascular (CV) events by 18%, and
• 20% reduction in all-cause mortality in patients with type 2 diabetes and chronic kidney disease.

The trial was stopped early due to clear evidence of renal protection, in order to give the placebo group access to the potentially life saving medication. [8]

It also improves liver conditions and potentially preventing fibrosis progression.

Brain & Neuro

SUMMARY: GLP-1 receptors exist in the brain as well as the body, and early research suggests these medications may help protect neurons, reduce neuroinflammation, and improve brain insulin signaling. They also appear to interact with the brain’s reward system, which may help reduce cravings for substances like alcohol, nicotine, and opioids. Because of this, scientists are exploring GLP-1 medications as potential therapies for neurological conditions such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and addictions.

GLP-1 shows neuroprotective potential by improving brain insulin sensitivity, reducing oxidation stress, and promoting neuronal survival. [6]

It can attenuate neuroinflammation and promote neuroprotection in multiple sclerosis, inhibit microglial activation, and may enhance remyelination processes, thereby potentially decreasing relapse rates and neurological damage.

New Research [21] that will be presented at the American Academy of Neurology in April links semaglutide to lower risk of severe migraine pain [21]

However, a study in neuromyelitis optica spectrum disorder (NMOSD) found that elevated GLP-1 and GLP-1R levels in cerebrospinal fluid and blood were associated with more severe brain-stem inflammation and acute-phase-reaction-like symptoms (APS). This is why working with a medical professional is extremely important, depending on your bio-individual needs. [44][48]

Addiction

GLP-1s are showing significant promise in treating addiction, with studies indicating they reduce cravings for alcohol, nicotine, cannabis, and opioids by modulating brain reward systems. Research suggests these drugs lower the risk of developing substance use disorders and decrease addiction-related emergencies, hospitalizations, and deaths. [50] [51]

It shows potential in smoking cessation by reducing cravings and modulating dopamine pathways [6]

Metabolic, Fertility & Weight

SUMMARY: While weight loss is the most widely discussed effect of GLP-1 medications, the research suggests it is only one piece of a larger metabolic picture. Because GLP-1 medications improve insulin sensitivity and metabolic signaling, they may also help regulate hormones and reproductive function. 

The evidence for metabolic improvement with GLP-1 medications is substantial. Improvements in insulin sensitivity and inflammation appear to influence many other health outcomes, including hormonal regulation, fertility, and long-term disease risk.

Fertility

GLP-1s are highly effective for women with PCOS, helping regulate menstrual cycles and encourage ovulation. [53] Benefits PCOS by enhancing insulin sensitivity and hormonal balance. [6] The GLP-1 RAs improve their metabolic functions. [52]

Clinical trials shown that GLP-1 receptor agonists improve menstrual regularity, decrease body weight and central adiposity, increase sex hormone-binding globulin levels, and lower free testosterone in overweight and obese women with PCOS. Beyond weight loss, GLP-1 receptors exist in the ovaries and brain, potentially reducing PCOS-related hyperinsulinemia and supporting ovulation. [52]

Studies show GLP-1 receptor agonists can help manage reproductive hormone imbalances. [53]

Preliminary clinical data indicate improved reproductive function in PCOS, as seen by increased pregnancy rates in both natural and IVF cycles. [52]

Endometrial cancer in benign uterine disease 66% lower with GLP-1 agonist and progestins. [22]

Male Fertility: Early data suggest GLP-1s might improve sperm parameters and increase testosterone in obese males.[53]

Note: GLP1-s can reduce the efficacy of oral contraceptives due to altered gastric emptying, resulting in accidental “Ozempic babies”.

Weight Management

If you are also wanting to lose weight, you’re not alone. And the studies are obviously very positive for results – as long as you maintain the medication for a lifetime, which is required to sustain just like the other health improvements. [11]

A systematic review and meta-analysis found that, using randomized controlled trials, that semaglutide is efficacious for sustained weight loss in patients with overweight/obesity and without diabetes. [5]

Specifically, it reduces not just body weight but importantly waist circumference. High waist circumference specifically has been linked to numerous health risks:

• Hypertension (high systolic blood pressure)
• Diabetes mellitus (high blood glucose levels)
• Hypercholesterolemia (high triglycerides)
• Joint and low back pains
• Hyperuricemia (high uric acid levels)
• Obstructive Sleep Apnea Syndrome

In Summary

A year ago I believed GLP-1 medications were simply another tool of diet culture. What the science and my own experience have shown me is something far more nuanced.

GLP-1 medications like semaglutide are not a moral decision, a shortcut, or a failure of willpower. They are a medical tool that can improve metabolic health, reduce inflammation, and support long-term wellbeing for many people.

Like any medical intervention, they require thoughtful use, adequate nutrition, strength training, and guidance from a qualified healthcare professional. But dismissing them outright ignores a growing body of research showing benefits far beyond weight loss.

I’m still anti-diet culture. I still believe health cannot be judged by body size. But I also believe in staying curious, following the science, and being willing to change my mind when the evidence demands it.

Visual & Auditory References, for continued education:

• BBC News: Studies reveal new effects of semaglutide, Mar 2025
• WION Podcast: Semaglutide Cuts Heart Risk Beyond Weight Loss: Study, Apr 2025
• Chicago Arthritis and Regenerative Medicine: using GLP-1 with biologics in autoimmune conditions, Jan 2025
• The Whole View, Ep 499: Genetics, Epigenetics & Social Determinants of Health, Mar 2022

References

1. Obesity and Set-Point Theory, NIH Apr 2023
2. The metabolic consequences of ‘yo-yo’ dieting are markedly influenced by genetic diversity, PMID: 38961153, NIH July 2024
3. Semaglutide and beyond: a turning point in obesity pharmacotherapy, PMID: 38362559, NIH Feb 2024
4. Semaglutide improves cardiometabolic risk factors in adults with overweight or obesity: STEP 1 and 4 exploratory analyses, PMID: 36200477, NIH Oct 2022
5. Long-Term Efficacy and Safety of Once-Weekly Semaglutide for Weight Loss in Patients Without Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, PMID 38679221, NIH July 2024
6. The multifaceted effects of semaglutide: exploring its broad therapeutic applications, Taylor & Francis Online, Sept 2025
7. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes, The New England Journal of Medicine, Nov 2023
8. FLOW trial stopped early due to evidence of renal protection with semaglutide, Oxford Academic European Heart Journal Cardiovascular Pharmacotherapy, Jan 2024
9. Once-Weekly Semaglutide in Adults with Overweight or Obesity, The New England Journal of Medicine, Feb 2021
10. Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity, The New England Journal of Medicine, Feb 2021
11. Efficacy and Safety of Semaglutide for Weight Loss in Obesity Without Diabetes: A Systematic Review and Meta-Analysis, PMID: 3657889, NIH Aug 2022
12. Gut Microbes Triggering Akkermansia with dietary polyphenols: a new weapon to combat the metabolic syndrome? PMID 26900906 Feb 2016 low glp-1 producers study
    and Jessica Brown’s Video on it here
13. 10 Solid Reasons Why Yo-Yo Dieting is Bad for You, Healthline, May 2017
14. Glucagon-like peptide-1 agonist safety and efficacy in a multiple sclerosis cohort, PMID: 39693702, Dec 2024
15. Glucagon‑like peptide‑1 receptor agonists in multiple sclerosis: therapeutic promise, challenges, and future directions, PMID: 41196232
16. Brigham-Led Study Finds Weight Loss Drug Semaglutide Reduced COVID-19 Related Deaths During the Pandemic, Mass General Brigham, Sept 2024
17. Semaglutide Reduces Cardiovascular and COVID Death, Mass General Brigham, Dec 2024
18. RECOVER-TLC Zepbound Gets New Test: Long Covid Treatment Trial Begins, Foundations for the National Institutes of Health
19. Semaglutide Reduces COVID-19 Related Deaths in Patients with Obesity and CVD, American College of Cardiology, Aug 2024
20. Yes, weight-loss drugs work but nutrition needs attention, Hunter Medical Research Institute, Feb 2026
21. GLP-1 Receptor Agonists and Chronic Migraine: A Real-World Cohort Study of Healthcare
    Utilization and Preventive Escalation, AAN, Mar 2026
22. More Good News for GLP-1 Agonists and Cancer Risk, Med Page Today, Feb 2026
23. Weight Cycling and Its Cardiometabolic Impact, PMID: 31089525, Dec 2017
24. The Thyroid Twist: How GLP-1 Agonists Are Influencing Autoimmune Thyroid Care, PMID: 41479489, Nov 2025
25. Glucagon-like peptide and its receptor agonists for the treatment of rheumatic diseases, PMID: 41523775, Sep 2025
26. The potential role of GLP-1 receptor agonists in the management of psoriatic disease: a scoping review, PMID: 41266905, Nov 2025
27. Roles of glucagon-like peptide 1 receptor agonists in immune cell biology and autoimmune/ autoinflammatory diseases, PMID: 41074143
28. The immunomodulatory effects of GLP-1 receptor agonists in neurogenerative diseases and ischemic stroke treatment, PMID: 40134421
29. GLP-1 Receptor Agonists Show Promise in Rheumatic Disease, MedCentral, Nov 2025
30. Evaluating the causal effect of using glucagon-like peptide-1 receptor agonists on the risk of autoimmune diseases, Science Direct, Jan 2025
31. The Potential of GLP-1 in the Treatment of Autoimmune Diseases: A Review of Mechanisms and Clinical Data, International Journal of Innovative Technologies in Social Science, Vol 3 No 3 2025
32. Study Flags Autoimmune Concerns with GLP-1 Use, American Medical Journal, Jun 2025
33. Association between autoimmune diseases and glucagon-like peptide-1 receptor agonists: A real-world evidence study, Science Direct, July 2025
34.  GLP-1RA Therapy Linked to Lower Incidence of Rheumatic Diseases, Endocrinology Advisor, Oct 2025
35. The immunomodulatory effects of GLP-1 receptor agonists in neurogenerative diseases and ischemic stroke treatment, Frontiers, Mar 2025
36. Glucagon-like peptide 1 receptor is a T cell-negative costimulatory molecule, Science Direct, Jun 2024
37. Obesity-Mediated Immune Modulation: One Step Forward, (Th)2 Steps Back, Frontiers, Jun 2022
38. GLP-1R agonist therapy and vaccine response, Science Direct, Aug 2024
39. Using GLP-1 Agonists with Biologics in Autoimmune Conditions, Chicago Arthritis and Regenerative Medicine, Jan 2025
40. Total estimated usual nutrient intake and nutrient status biomarkers in women of childbearing age and women of menopausal age, ScienceDirect, Apr 2021
41. Anti-inflammatory role of glucagon-like peptide 1 receptor agonists and its clinical implications, PMID: 38288136, Jan 2024
42. New Research at ACR Convergence 2025 Highlights Potential of GLP-1 Therapies in Rheumatic Disease Management, American College of Rheumatology, Oct 2025
43. GLP-1 receptor agonists cut risk of death in inflammatory disease patients, Clinical Trials Arena, Aug 2024
44. GLP-1 Levels Linked to Brain Inflammation in Autoimmune Disorder, Managed Healthcare, Sept 2025
45. Use of GLP-1 Receptor Agonists and Occurrence of Thyroid Disorders: a Meta-Analysis of Randomized Controlled Trials, Frontiers, Jul 2022
46. Benefit-Risk Assessment of GLP-1 Receptor Agonists: Implications for Dermatologists and Plastic Surgeons, PMID: 40924351, Sept 2025
47. The anti-inflammatory and immunological properties of GLP-1 Receptor Agonists, Science Direct, Aug 2022
48. Glucagon-like peptide-1: a multi-faceted anti-inflammatory agent, Frontiers, May 2023
49. Antiinflammatory actions of glucagon-like peptide-1–based therapies beyond metabolic benefits, The Journal of Clinical Investigation, Nov 2025
50. Five things to know about GLP-1s and addiction, Stanford Medicine, Apr 2025
51. The role of glucagon‐like peptide 1 (GLP‐1) in addictive disorders, PMID: 34532853, Feb 2022
52. A Systematic Review on GLP-1 Receptor Agonists in Reproductive Health: Integrating IVF Data, Ovarian Physiology and Molecular Mechanisms, PMID: 41596408, Jan 2026
53. The dual impact of GLP-1 receptor agonists on metabolic and reproductive health in polycystic ovary syndrome: insights from human and animal trial, PMID: 41069706, Oct 2025
54. Relevance of GLP-1 Agonists for Infertility Practice, Science Direct, Nov 2024
55. FDA Intends to Take Action Against Non-FDA-Approved GLP-1 Drugs, FDA, Feb 2026
56. Is It Bad to Lose Weight Too Quickly, Healthline, Sept 2025

Thank you to Jessica Brown, author of Beyond the Shot, for her help with this research and joining me for this incredibly vulnerable and detailed podcast. I don’t know that I’d be willing to have listened and learned enough to help myself if not for her own vulnerability in sharing science that her (our) community will have a hard time processing.

 

Keep up each week on Instagram and our newsletters:

Never want to miss an educational article, podcast, recipe, resource or general tip? Get our Real Everything newsletter, here.

Never want to miss a better beauty post, sale, or deal? Join my Healthy Inside & Out email list for more info on non-toxic living and safer skincare!