Hello beautiful Monster,
“What do you think about GLP 1s?”, “I am thinking about using GLP1”, “Should I use GLP1?” Those are questions I get often in check-ins, and I understand why… It is a hot topic! Although I give an answer in my feedback, I think that topic deserves more depth.
Let’s start with what they are.
GLP 1 medications, such as semaglutide and tirzepatide, are not just another influencer trend. They were developed for type 2 diabetes and are now also used for obesity and weight management. For some people, especially those living with obesity, insulin resistance, type 2 diabetes, severe hunger, food preoccupation, or a long history of dieting without enough medical support, they can be powerful tools!
How do they work?
They mimic hormones the gut naturally releases after eating. They help the body regulate blood sugar, they slow digestion so food stays in the stomach longer, and they send signals of fullness to the brain. That is part of why people often describe less hunger, less urgency around food, and less “food noise.”
The results can be meaningful! In clinical trials, people using these medications alongside lifestyle support have lost significant amounts of weight. Semaglutide has also been shown to reduce major cardiovascular events, such as heart attack and stroke, in people with established cardiovascular disease and overweight or obesity.
There is also interesting research happening around the brain. Some large real-world studies have found that people with type 2 diabetes using semaglutide had lower rates of a first Alzheimer’s diagnosis compared with people using certain other diabetes medications. But this is where we need to be careful with what we see on social media… Those studies show an association, not proof that semaglutide prevents dementia, and newer randomized trials in people who already had early Alzheimer’s disease did not show that semaglutide slowed cognitive decline.
So yes, there are reasons to be excited about these medications, but not to turn them into a miracle drug that can solve every health problem, because one thing is getting results, and another thing is understanding what those results mean for your body, your strength, your relationship with food, and your future, because the scale moving down does not automatically mean every part of the plan is moving in the right direction.
Let’s go back to “food noise.” Food noise does not happen in isolation. Sometimes it is physiological: blood sugar instability, insulin resistance, poor sleep, chronic dieting, hormonal changes, medications, or simply being underfed for too long. Sometimes it is psychological: stress, emotional overload, using food to self-soothe, trauma, boredom, or trying to find relief at the end of a difficult day. Sometimes it is social: growing up around food scarcity, living in a house where food is connection, celebrating every event through food, or living in an environment designed to keep highly rewarding food in front of us all the time.
Food has never been only food for many people. So when a medication quiets that pull, it can feel incredibly freeing, but it can also reveal things that were already there. A person may finally feel less pulled toward food, then realize that they do not know how to rest without eating, celebrate without eating, soothe themselves without eating, or sit with discomfort when food is no longer doing part of that work for them. That is not a failure, it is information about the role food had been playing in their life, and where they may need more support.
GLP 1 medications do not only work in the stomach. GLP 1 receptors are also found in areas of the brain involved in appetite, reward, and food-related decision making. Human studies suggest that GLP 1 receptor activation can change brain responses to anticipating highly desirable foods, which helps explain why cravings may feel quieter for some people. Scientists are also studying these medications in relation to alcohol use and other reward-driven behaviors. Now, that does not mean GLP 1s “destroy motivation,” and I do not think that is an accurate or responsible claim. In fact, despite what social media claims, the FDA completed a large review and found no increased risk of suicidal thoughts, depression, anxiety, irritability, or psychosis connected to GLP 1 medications. But it does mean we should understand that these medications can change more than appetite. They can change how rewarding food feels, how social eating feels, how routines feel, and sometimes how a person experiences pleasure or stress regulation.
Now, going back to the original question, should you use them? Maybe.
That decision should be made between the person and a qualified medical professional who understands their health history, medications, goals, risks, and reasons for considering treatment.
But there is one part of this conversation that I do not think gets enough attention, muscle.
When people lose weight, they do not lose only fat. They also lose lean mass. Lean mass includes water, glycogen, organs, connective tissue, and muscle, so we should not automatically assume every pound of lean mass lost is pure muscle. But muscle loss can still be part of the picture, especially when someone is barely hungry, has difficulty eating protein, stops resistance training, or is losing weight too quickly.
In the STEP 1 semaglutide body-composition analysis, participants lost much more fat mass than lean mass, but absolute lean mass still decreased. Similar findings have appeared with tirzepatide, where fat loss was greater, but lean mass also went down.
That is important because muscle is not just something we build to look a certain way. Muscle helps with glucose disposal, strength, mobility, bone support, balance, recovery, and the ability to stay capable as we age. It gives the body more capacity!
I wouldn’t automatically think that the medication is working if the person is under-eating… I would ask: are they eating enough protein? Are they resistance training? Is their strength stable? Are they recovering? Are they getting enough nutrients? Are they losing weight at a rate their body can actually tolerate? Someone can lose weight quickly, feel proud of the scale, and still end up under-eating in a way that does not support muscle retention or overall health and longevity.
Then the question becomes: what will happen when the medication stops?
In the STEP 1 extension, people who stopped semaglutide after 68 weeks regained about two-thirds of the weight they had lost within one year. Their cardiometabolic improvements also moved back toward baseline. That shows that obesity, hunger, and weight regulation are chronic biological issues, not something solved by one period of appetite suppression.
But if a person loses weight without building any structure around that process, without learning how to eat enough protein, train, manage stress, create regular meals, understand hunger, build coping skills, and protect their muscle, they may be left in a difficult position when appetite starts returning. They may have less muscle, less physical capacity, less confidence in what to eat, and the same stressors and environments that made food feel difficult in the first place.
We live in a culture that makes people desperate to become smaller, then acts surprised when they become afraid of food, obsessed with the scale, disconnected from hunger, or willing to lose muscle in the process.
We praise weight loss before we ask whether someone is getting stronger. We celebrate a smaller pant size before we ask whether they can carry groceries, get up from the floor, train with confidence, sleep well, recover from a workout, manage stress, or feel present in their own life.
This is Not Personal, Structural.
I am not here to tell anyone what to do with their body, but I do want people to be informed.
There are companies and influencers making a lot of money from this conversation, and your health deserves more than a sales pitch or a before and after photo.
If you decide to use a GLP 1 medication, work with qualified professionals who can help you protect muscle, structure your nutrition, monitor your strength and recovery, and build habits that still support your health when the medication is reduced or stopped. Use the help, but do not let the medication become the whole plan.
Build a body that is not only smaller, but stronger, better nourished, more capable, and supported by habits you can actually live with for a long time!!!
We have conversations like this inside my private women’s group, where we can talk openly about hormones, fat loss, food noise, stress, muscle, body changes, and all the life that is shaping our health.
It is free to join, and it is a space to learn, ask questions, and hear from other women who may be navigating similar struggles without judgment or shame. Come join us. Link below...💖
I’m glad you’re here.
With love,
Fran
