Can GLP1 Drugs replace diet and exercise?

Can GLP1 Drugs replace diet and exercise?
Photo by Anupam Mahapatra / Unsplash

tl;dr - No, unless you have infinite money and an infinite appetite for side effects, and are fine with possibly losing too much muscle mass.

GLP1 Receptor Agonists (Semaglutide, Liraglutide, Exenatide, etc) are not miracle drugs. Whether pursuing weight loss goals or trying to manage a case of type 2 diabetes, GLP1 RAs work best with changes to your lifestyle which include diet and exercise.

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Unfortunately, the research is a bit thinner on this subject than for general efficacy (we know more about whether the drugs work rather than what goes best with them), it's worth discussing this topic.

Weight training stays valuable: Muscle loss may occur while on GLP1 Receptor Agonists

person standing beside black weights
Photo by Victor Freitas / Unsplash

The research has pointed to a loss of "lean mass" (i.e. non-fat mass, including muscle) which was around 1/3rd of the total fat that was lost.

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This has lead many medical professionals to suggest that it's better to pair usage of GLP1 drugs (Ozempic, Mounjaro, Wegovy, Zepbound, etc) with a weight training (or resistance training) regimen.

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Tweaking your diet is still a good idea

poached egg with vegetables and tomatoes on blue plate
Photo by Brooke Lark / Unsplash

Along with the research, anecdotal data abounds on sites like Reddit regarding the reduction in food cravings:

Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes
To evaluate the effect of oral semaglutide on energy intake and appetite in subjects with type 2 diabetes (T2D).In this randomized, double‐blind, placebo‐controlled, two‐period cross‐over trial, 15 subjects with T2D received…
Weird elimination of cravings/urges
by u/LuckyGirl1003 in Semaglutide

Reddit thread about elimination of cravings

When does “Food Noise” go away?
by u/beepboopbeep2016 in Semaglutide

Reddit thread about food noise not going away

It's important to note that not everyone sees the same reduction in food cravings, some people actually see higher food cravings:

craving for sweets but repulsion to other food?
by u/tomeq_ in Semaglutide

Reddit thread about cravings while on Semaglutide

Though, food cravings going up should be relatively rare, given the research and the current scientific knowledge on how GLP1 Receptor Agonists work.

It's always important to contact your doctor to figure out how any treatment you might take will affect you, but as has been common sense for centuries, a healthy diet is a fantastic weight management tool.

Note that "healthy diet" does not mean "diet you do for 3 weeks" – changing your diet requires changing what you purchase and keep in your house to eat, forever.

Taking Semaglutide/Tirzepatide/Liraglutide/etc is a great time to change what you buy at the store and get in a habit of avoiding purchasing foods that has poor nutritional content/keeps you hungry.

GLP1 Drugs cost less every year, but they are still expensive

While the price of GLP1 drugs is sure to continue to decrease, they are still quite expensive.

From our article on Zepbound, we have the following table:

DrugManufacturerFDA approvalList price ($)
Wegovy (semaglutide)Novo Nordisk for chronic weight management1,349
Saxenda (liraglutide)Novo Nordisk for chronic weight management1,349
Zepbound (tirzepatide)Eli Lillyfor chronic weight management1,060
Mounjaro (tirzepatide)Eli Lillyfor Type 2 Diabetes1,023
Rybelsus (semaglutide)Novo Nordisk for Type 2 Diabetes936
Ozempic (semaglutide)Novo Nordisk for Type 2 Diabetes936

Obviously, avoiding this per-person cost for the rest of your life is ideal, but of course this is weighed against the negative effects of being overweight or type 2 diabetes (heart disease, hyperglycemia, etc).

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