Everything you need to know about GLP1-a: Ozempic, semiglutide, and Wegovy

Hello there, I’m Dr. Fauntleroy—your wholistic diabetes expert. I’ve noticed a lot of buzz—and a fair share of questions—about GLP‑1 receptor agonists. Whether you’ve heard the names Ozempic, semaglutide, or Wegovy, they all refer to the same basic medication; a GLP‑1 receptor agonist. As a diabetes doctor, I get a lot of questions about this class of medications, and recently, a lot of skepticism. “Is it effective?” “Is it safe?”  “What about natural alternatives and do they work?” “Can it decrease muscle mass, or might I regain the weight once I stop taking it?” Today, I’d like to share clear, research-backed information based on my expert clinical experience to help you navigate these questions with confidence and clarity.

Why Are GLP‑1 RAs So Popular for Diabetes?

Since GLP‑1 receptor agonists (GLP‑1 RAs) are currently such a new craze, you might be surprised to know they have been an option for managing type 2 diabetes for nearly 20 years. According to the American Diabetes Association (ADA), they are a preferred medication for treating type 2 diabetes. Here’s why they’re often recommended:

• Weight Loss: Yes, one of the big perks is weight loss—a benefit that’s especially important for many people with type 2 diabetes. One of the ways these drugs work is by helping you feel full, so you naturally consume fewer calories. Some other medications like Glypizide or insulin are known to cause weight gain instead.

• Effective Glycemic Control: These medications help lower blood sugar levels effectively, and unlike some other diabetes treatments, they don’t carry the risk of causing dangerously low blood sugar (hypoglycemia) like Glypizide or insulin.  This often means this medication is a safer choice for people who struggle with regular meals or consistency with medications – like so many of us with very busy lives or professional careers.

• Cardiovascular Benefits: Another benefit, less commonly known, is cardiovascular protection. Studies have shown that GLP‑1s can significantly reduce the risk of major cardiovascular events like heart attacks and strokes, offering protection for your heart while managing your blood sugar. This protection is significant enough that recent studies have begun to investigate the potential of GLP-1 RAs to improve cardiovascular outcomes in non-diabetic populations. I’ll keep you posted when we learn the results!

So overall, GLP-1 RAs are effective, less risky than other meds, and have the added benefits of reducing weight and protecting the cardiovascular system. It makes logical sense in this regard why this medication has become a top recommendation. But what are the side effects, and how risky is this medication?

Understanding the Side Effects

Just because a medication is effective doesn’t always mean it’s safe. Take morphine, for example—it’s an excellent pain reliever, but the risks can be severe and often outweigh the benefits for use. So, are GLP-1 receptor agonists safe? What are the side effects, and who should or shouldn’t use them?

I know the internet can be full of conflicting messages—some sources claim these medications are completely safe, while others warn of severe side effects. Here’s what a combination of current research combined with my extensive and practical medical experience provides:

Common Side Effects

• Gastrointestinal Discomfort:

  
  

  Many patients experience nausea, vomiting, diarrhea, constipation, or abdominal pain, especially when starting treatment. These side effects are often due to slower gastric emptying, meaning food stays in the stomach longer before moving to the small intestine. While this effect helps with satiety—making it easier to manage weight and blood sugar—it can also cause discomfort. Patients often describe it as feeling “Thanksgiving full” all the time.

• The good news? These symptoms usually improve over a short time. The bad news? In some cases, they persist for weeks and become too significant for certain patients. While this isn’t particular common, I have seen it happen in practice. If the side effects are severe and long-lasting, this medication may not be the right fit. Thankfully, most people who take it experience only mild, temporary symptoms that go away with time. To help minimize these effects, I always start patients on a low dose and gradually increase it over a few weeks, so the body has time to adjust.

• Full disclosure: A small number of patients have reported serious conditions like gastroparesis (delayed stomach emptying), leading to lawsuits claiming manufacturers didn’t adequately disclose these risks. As with any medication, risks exist, and my job is to ensure you are fully informed before making any decisions about your treatment. It is vital that you inform your doctor of any side effects so we can assist you in determining the safety profile for you individually.

  
  

Less Common, But More Serious Concerns

• Pancreatitis:

  
  

  The risk of developing acute pancreatitis while using GLP-1 RAs is considered low overall, though studies show mixed results. Some research suggests slightly increased risk, particularly in those with a history of pancreatitis, gallbladder disease, or high triglycerides. However, large-scale studies, including a 2020 meta-analysis, found no significant increase in risk among GLP-1 RA users. A more recent study reported that while the relative risk may be doubled, the absolute risk remains very low. Don’t worry if you don’t know what that means; the simple version is that while the medication may slightly increase the chance of pancreatitis, the overall likelihood is still rare.

Gallbladder Issues

·         Some people taking GLP-1 medications may have a higher chance of gallbladder problems, like gallstones or inflammation. This might be partly because these medications can lead to fast weight loss, which can raise the risk of gallstones.

·         If you’ve ever had gallstones or had your gallbladder removed, please let me know. It doesn’t necessarily mean you can’t use a GLP-1, but we’ll want to keep a closer eye on things or consider other options to keep you safe.

Thyroid Cancer Considerations

·         In studies done on rats, some GLP-1 medications were linked to a rare type of thyroid cancer. The same hasn’t been shown clearly in humans, but we still like to be cautious — especially if you or someone in your family has had thyroid cancer in the past.

·         Before starting treatment, I usually check a few basic thyroid labs and will keep monitoring them if there’s any concern. It’s just one of the ways we make sure your treatment is right for you.

Natural Alternatives to Enhance GLP-1

As a Naturopath, I’m often asked whether there are natural ways to boost GLP-1 levels. Remember GLP-1 is something our own body produces on its own. While medication can be highly effective, there are a few strategies worth considering: 

Dietary Choices:Eating foods rich in fiber—such as whole grains, fruits, vegetables, and lean proteins—can naturally encourage GLP-1 secretion. These choices not only help with satiety but also support balanced blood sugar control. Although a good diet and regular physical activity (I say “physical activity” rather than “exercise” because it encompasses everyday movement) may not produce results as quickly as medication, they address the root causes of weight gain. This is a huge part of what I discuss with every diabetic or weight-loss patient, whether they are using a GLP-1 medication or not.

Herbal Supplements: Berberine

Berberine is a natural plant compound that’s been getting attention as a possible alternative to GLP-1 medications. While it works differently in the body, some research shows that it can help lower blood sugar, support weight loss, and even improve cholesterol.

That said, it’s not the same as a GLP-1. For example, berberine doesn’t make you feel full the way GLP-1 medications often do, and the results tend to take longer to show up.

When we look at numbers from research:

• Semaglutide (a common GLP-1) can lower A1c by about 1.0% to 1.8%

• Berberine can lower A1c by around 0.9% to 1.1%

(These aren’t direct head-to-head studies, but they give us a ballpark sense of how each might perform.)

While GLP-1 medications tend to give stronger results over time, I still really like berberine for many patients — especially because it can support blood sugar, weight, and cholesterol all at once. If you’re thinking about trying berberine, let’s chat first to make sure it fits into your care plan.

Compounded GLP-1 Medications

When there was a national shortage of GLP-1 medications like Ozempic and Wegovy in 2022 and 2023, compounding pharmacies were allowed to step in and make versions of these drugs using the same active ingredients. This helped many people continue treatment when the brand-name versions weren’t available.

But as of spring 2025, the FDA has officially declared the shortage over. That means compounding pharmacies are no longer allowed to make these medications. Specifically, the cut-off was April 22 for regular compounding pharmacies and May 22 for larger outsourcing facilities. After those dates, only the FDA-approved versions are legally permitted.

If you’ve been using a compounded GLP-1, don’t worry — we’ll figure out the next step together. Whether that means switching to a brand-name version or exploring other options, I’m here to help you find a safe, sustainable plan moving forward.

Muscle Loss and Weight Regain: What to Expect with GLP-1 Medications

If you're taking GLP-1 RAs for weight management, you may be wondering about two common concerns: muscle loss during treatment and weight regain after stopping. Let’s explore both.

Muscle Loss

·         It’s true that most forms of weight loss—whether from diet, medication, or surgery—can result in some loss of lean muscle mass. GLP-1 medications are no exception, but research shows that the degree of muscle loss is similar to that seen with traditional methods like calorie restriction.  That’s why I strongly recommend a protein-rich diet and resistance training while using these medications. These strategies help preserve muscle mass and support overall health. Because GLP-1 RAs often reduce appetite, it becomes even more important to choose nutrient-dense foods and make every bite count.

Weight Regain

·         Yes, stopping GLP-1 therapy can lead to some weight regain over time. For example, one study found that about a year after stopping semaglutide, patients regained roughly two-thirds of the weight they had lost.

·         But there is good news: not everyone regains weight, and some even continue to lose. The difference often comes down to lifestyle habits. Sustainable nutrition, consistent physical activity, and behavioral support can make a major impact on long-term outcomes.

·         Think of GLP-1 medications as a powerful tool—a way to jump-start your journey, not a quick fix. The goal is to use that momentum to build long term habits that support lasting change.

Who Is a Good Candidate?

In my experience, there isn’t a one‐size‐fits-all answer when it comes to GLP‑1 receptor agonists. Whether you’re managing type 2 diabetes or simply curious about a medication that can also help with weight control as a beneficial side effect, the decision is very personal. I take the time to consider your full medical history, lifestyle, and unique goals to determine if this approach might be safe and effective for you. If you have questions about whether a GLP‑1 RA fits into your health plan, I’m here to discuss your specific situation—no judgment, just honest answers and education.

What to Expect When Starting Treatment

Starting a new medication can feel overwhelming, so let me explain what typically happens when you begin a GLP‑1 RA. We usually start at a low dose and gradually increase it. This gradual approach helps your body adjust, minimizing any initial gastrointestinal side effects, such as mild nausea or that extra “full” feeling. I’ll be with you every step of the way—tracking your progress, reviewing lab tests, and answering any questions you have. My goal is to ensure you feel safe, well-informed, and supported as we work together on your health journey.

Conclusion

GLP‑1 receptor agonists have changed the management of type 2 diabetes by offering effective blood sugar control, supporting weight loss, and providing cardiovascular protection. While these medications have a favorable safety profile compared to some other diabetes treatments, it’s natural to have questions and concerns. I’m here to help clarify the facts, answer your questions, and discuss any concerns you might have—because your health is personal, and you deserve care that’s both expert and compassionate.

If you’re curious to learn more or need further guidance, please don’t hesitate to reach out. I’m here to support you every step of the way.

Stay curious and take care,

Dr. Jason FauntLeRoy, ND FauntLeRoy Naturopathic Medicine - Sweet Science. Real Medicine.

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