GLP-1

What Your Doctor Didn’t Tell You About GLP-1 Drugs

by

Will You Get Scurvy If You Use A GLP-1 Drug?

Author: Dr. Stephen Chaney

GLP-1 drugs have revolutionized the weight loss industry. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years.

Currently, there are around 33 million Americans (12% of the adult population) on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drug they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. I have covered these in a previous issue of “Health Tips From the Professor”.

In that article I emphasized two side effects that I thought had not received sufficient attention:

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors because they struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

However, since I wrote that article these side effects have received more attention. Your doctor may have warned you about them.

But there is another concern about GLP-1 drug use that your doctor has probably not told you about.

What Your Doctor Didn’t Tell You About GLP-1 Drugs

Closeup portrait clueless senior health care professional doctor with stethoscope, has no answer, doesn’t know right diagnosis standing in hospital hallway isolated clinic office windows background.

The miracle of GLP-1 drugs is that they suppress appetite, which makes it much easier to lose weight.

  • Snacks are no longer appealing.
  • Large portion sizes leave you feeling bloated.
  • It’s tempting to skip meals because you just aren’t hungry.

You no longer have to struggle to eat less. It just comes naturally. But this miracle is also a snare. The issue becomes not how much you eat, but what you eat. The issue becomes not how many calories you eat, but how many nutrients you eat. And your doctor probably hasn’t talked to you about that.

Weight loss diets often result in nutritional insufficiencies. However, GLP-1-aided weight loss is worse.

That’s because GLP-1 is a drug, not a diet plan. It’s dispensed like any other drug.

  • Your doctor gives you a GLP-1 prescription. If you are lucky, they may give you a “one-size-fits-all” handout on how to lose weight while you are using it. For example, in a recent study:
    • Only 51% of patients received information from their doctor on how to manage side effects of GLP-1.
    • Only 20% were referred to a dietitian. The other 80% received no information on how to change their diet and lifestyle.
  • When you pick up the drug from the pharmacy, you get a package insert listing the side effects but no information on how to change your diet.

The results are predictable:

  • As I discussed in a recent issue of “Health Tips From the Professor”, a recent study found that the diets of the GLP-1 users were deficient in fiber, healthy fats, 10 essential vitamins and minerals and did not contain enough protein to prevent loss of muscle mass.

It’s All About Nutrient Density

healthy foodsYears ago, when I was researching the adequacy of the American diet I was surprised to discover that the USDA statistics showed that the diets of teenage women were suboptimal for many nutrients, while the diets of teenage boys were suboptimal for only a few.

You might ask, “What was the difference?”

  • It wasn’t that teenage boys ate a better diet.
  • If you have raised a teenage boy, you probably already know the answer. They have bigger appetites.

The message is clear, even with a lousy diet you can meet the recommended intake of most nutrients if you eat enough calories.

So, the analogy I will use is that going on GLP-1 drugs is like going from the caloric intake of a teenage boy to that of a teenage girl. Your diet will become nutritionally insufficient unless you change it.

This is where the concept of nutrient density comes in. You need to change your focus from how many calories there are in each serving of food you eat to how many nutrients there are in each serving of food you eat. You need to make every bite count.

And, just in case you were wondering where to find high nutrient density, low calorie foods:

  • Whole, unprocessed foods with no added fat or sugar are high in nutrient density and low in calories.
  • On the other hand, highly processed foods are low in nutrient density and high in calories.

The problem is that highly processed foods account for 60-70% of the calories in the typical American diet. So, if you are like most Americans GLP-1 use will result in nutritional insufficiencies unless you change your diets to focus on nutrient dense foods.

And the bonus is that that same focus on nutrient dense foods will help you keep the weight off once you quit the GLP-1 drug.

But your doctor probably hasn’t told you this.

Will You Get Scurvy If You Use A GLP-1 Drug?

Question MarkThe short answer is, “No”. It’s highly unlikely that you will ever develop scurvy while on GLP-1 drugs. You would need to have a truly horrible diet and never take multivitamins to develop a nutritional deficiency disease like scurvy.

Headlines like that are simply meant to draw you in, so you will read the article. But there are real concerns about the long-term effects of nutritional insufficiencies. For example:

  • Long term inadequacies of calcium, magnesium, and vitamin D increase the risk of osteoporosis.
  • Long term inadequacies of healthy fats, magnesium, vitamin D, and antioxidants may increase the risk of heart disease.
  • Long term inadequacies of antioxidants and phytonutrients can accelerate cellular aging.
  • Long term muscle loss due to inadequate protein intake leads to frailty and metabolic diseases as we age.

You get the point. GLP-1 drugs are not a panacea for weight loss. Unless you switch to a whole food, nutrient dense diet you may end up leaner and sicker – not healthier.

What Does This Mean For You?

The take-home message is clear. GLP-1 drugs may seem like a weight loss miracle. Your appetite decreases. You eat less. And the pounds just melt away. But the health benefits of losing weight with GLP-1 drugs may be a mirage rather than a miracle.

That is because what you eat is critical. If you just eat less of what you were eating before, you may end up leaner and sicker.

Forget calories. Instead, focus on the nutrient density of the foods you are eating. And that means eating whole, unprocessed foods that are low in fat and added sugar.

But the ads don’t tell you that. The drug labels won’t tell you that. And chances are that your doctor won’t tell you that either.

The Bottom Line

GLP-1 drugs may seem like a weight loss miracle. Your appetite decreases. You eat less. And the pounds just melt away. But the health benefits of losing weight with GLP-1 drugs may be a mirage rather than a miracle.

That’s because what you eat while you are on GLP-1 drugs may be critical to your long-term health. And your doctor probably didn’t tell you about that when they were prescribing GLP-1.

For more details about the dangers of GLP-1 drugs, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

 

Can Protein Supplements Increase GLP-1?

by

What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drugs they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

Let me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach to reduce the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine to reduce gut motility, which increases transit time through the small intestine. This also prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain to turn down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Can Protein Supplements Increase GLP-1? 

Questioning WomanYou may be wondering, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

When you eat a meal, GLP-1 levels rise within 10 minutes and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

And protein appears to play an important role in this process. High-protein meals result in higher and more prolonged GLP-1 levels than high-fat or high-carbohydrate meals. That’s because protein is digested to amino acids in the intestine. And some of those amino acids bind to receptors in intestinal L-cells and stimulate GLP-1 release.

You may be wondering what this has to do with protein supplements. Theoretically, protein supplements should offer the same benefit as a high-protein meal with fewer calories.

This hypothesis has been tested with a few protein supplements, and they have been shown to increase GLP-1 levels naturally. And, based on the limited data available, it appears that the increase in GLP-1 is proportional to the protein content of the supplement.

So, it appears that the answer I posed at the beginning of this article is,

  • Yes, it appears that protein supplements can increase protein levels naturally.
  • And it appears that the higher the protein content of the supplement, the greater the increase in GLP-1 levels.

However, there are many variations in the formulation of protein supplements, and we don’t know how these variations influence the effect of protein supplements on GLP-1 levels. Therefore,

  • We can’t yet say that all protein supplements increase GLP-1 levels equally.
  • When choosing a protein supplement, you should ask for clinical studies with their product showing it increases GLP-1 levels.

What Does This Mean For You?

If you can raise your GLP-1 levels naturally with high-protein meals and protein supplements, you might be asking, “What makes the GLP-1 drugs different?” To understand the answer to that question, you first need to know what GLP-1 drugs are.

  • GLP-1 drugs mimic the natural GLP-1 peptide.
  • However, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

And let’s remember that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. The effect may not be as strong as with the GLP-1 drugs, but it may help you suppress your appetite enough to successfully implement your lifestyle changes. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • That’s where protein supplements come in.
  • And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Can protein supplements increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How protein supplements can raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Increasing GLP-1 Levels Naturally

by

What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drug they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

ProfessorLet me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels. It does this by:

  • Increasing glucose uptake by our cells. In the fed state almost all our cells use glucose as an energy source.
  • Converting any glucose in excess of immediate energy needs to storage forms.
    • In the muscle and liver, it is converted to a glucose polymer called glycogen. Our ability to create glycogen stores is limited.
    • In muscle it is also converted to amino acids, and it stimulates the use of those amino acids to make new protein. Our ability to increase muscle stores is also limited, but it can be increased by exercise.
    • In adipose tissue, it is converted to fat. As you may have noticed, our ability to create fat stores is unlimited. Even worse, when we become obese, fat starts accumulating in muscle and liver, which has severe health consequences.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

Most tissues in our bodies switch to fat as an energy source in the fasting state. However, our red blood cells, kidney medulla, and brain continue to require glucose [Note: The brain can adapt to ketone bodies as an energy source after several days of glucose deprivation, but that’s another discussion for another time.] Glucagon supports our tissues by:

  • Signaling the liver to break down its glycogen stores and release glucose into the bloodstream. These stores are limited, but they can supply enough glucose to keep blood sugar levels constant for a few hours.
  • However, the brain uses lots of glucose, so the glycogen stores are rapidly depleted. When this happens, glucagon signals our muscles to break down muscle protein and convert the amino acids to glucose. We have enough muscle tissue to supply our brain with glucose for weeks. But we are using that muscle protein for other important things.
  • Finally, glucagon signals adipose tissue to break down its fat stores and release fat into the bloodstream to feed all our tissues that no longer depend on glucose.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach and reduces the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine and reduces gut motility, which increases transit time through the small intestine. This prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain and turns down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Increasing GLP-1 Levels Naturally 

At the beginning of this article, I asked the question, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

GLP-1 levels rise within 10 minutes after consuming a meal and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

“What makes the GLP-1 drugs different?”, you might ask.

  • In the first place significantly higher doses of GLP-1 are used.
  • More importantly, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

What Does This Mean For You?

Questioning WomanLet’s start by remembering that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • The macronutrients fat, carbohydrate, and protein all increase GLP-1 levels.
    • But if you are trying to lose weight, you want the greatest increase in GLP-1 with the fewest calories. That leaves out fatty foods.
    • You could try high carbohydrate meals, but there are lots of reasons why that’s not a good choice.
    • That leaves protein. And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Is it possible to increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How to raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are GLP-1 Users Getting Enough Nutrients?

by

What Does This Mean For Your Future Health?

Author: Dr. Stephen Chaney

Most people want to lose weight so they can get trimmer and healthier. I don’t know of anyone who wants to be leaner and less healthy. But if they are not getting the essential nutrients their body needs while they are losing weight, they may well end up both lean and unhealthy.

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

GLP-1 drugs do work. They target the intestine and the brain, increasing satiety (feeling of fullness) and decreasing appetite.

However, like any other drug, they have side effects. The most frequent are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

In a previous issue of “Health Tips From the Professor” I discussed a serious side effect that is often overlooked, namely increased risk of depression, anxiety, and suicidal thoughts. My recommendations were:

  • If you suffer from depression, anxiety, or suicidal thoughts, GLP-1 drugs may not be the best choice for you. At the very least you should discuss the risks and benefits with your doctor before using them.
  • If you are using GLP-1 drugs and experience an increase in depression, anxiety, or suicidal tendencies, you should discontinue the drug immediately and report your side effects to your doctor.

Another question that has not been addressed previously is whether people using GLP-1 drugs are getting the essential nutrients their bodies need for optimal health. Today’s study (B Johnson et al, Frontiers in Nutrition, published online in April 2025) was designed to measure the nutritional adequacy of GLP-1 user’s diets.

How Was This Study Done? 

clinical studyThe investigators enrolled 69 people who had been using a GLP-1 drug for at least a month in their study using an online research platform through the University of Turin in Italy.

The characteristics of the study participants were:

  • Weight:
    • 5% normal weight
    • 27% overweight
    • 18% Obese Class I
    • 20% Obese Class II
    • 30% Morbidly Obese
  • Age = 49.6 ± 12.3
  • Ethnicity:
    • 82% Caucasian
    • 6% Hispanic
    • 8% African American
    • 1% Asian
    • This is similar to the ethnic distribution of GLP-1 users in this region.
  • Length of GLP-1 use:
    • 7% <3 months
    • 29% 4-6 months
    • 25% 7-12 months
    • 39% >1 year

The participants were trained on how to use an online dietary recall instrument and then recorded their dietary intake for 3 consecutive days.

Are GLP-1 Users Getting Enough Nutrients?

Question MarkThe results of the 3-day dietary recalls from the GLP-1 users were:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.
  • Their diets were low in fiber (14 grams). This is half the recommended intake of fiber.
  • Their diets were sufficient for B-vitamins, copper, phosphorous, selenium, and zinc.
  • Their diets were deficient for calcium, iron, magnesium, potassium, choline, vitamin A, vitamin C, vitamin K, vitamin D, vitamin E, and fiber. For example:
    • 99% of participants were not getting enough Vitamins D and K from their diet.
    • 94% weren’t getting enough choline.
    • 90% weren’t getting enough magnesium.
    • 88% weren’t getting enough iron.

The study did not report the intake of omega-3 fats, but the participants were likely deficient in that as well.

The study participants averaged 0.8 gm/kg of protein, which is the recommended intake for sedentary adults who are not on a weight loss diet. However, 0.8 gm/kg of protein is not sufficient for maintaining muscle mass on weight loss diets, especially weight loss diets aided by GLP-1 drugs. Most experts recommend 1.2gm/kg to 1.6 gm/kg to prevent loss of muscle mass, with a few recommending as high as 2 gm/kg.

Most of the participants in this study did not meet the increased protein recommendations for weight loss.

  • Only 43% consumed at least 1.2 gm/kg of protein.
  • Only 10% consumed at least 1.6 gm/kg of protein.
  • Only 5% consumed at least 2.0 gm/kg of protein.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [daily recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

What Does This Mean For Your Future Health?

QuestionsThe results of this study are both appalling and expected. Weight loss diets often result in nutritional insufficiencies. However, GLP-1-aided weight loss is worse.

That’s because GLP-1 is a drug, not a diet plan. It’s dispensed like any other drug.

  • Your doctor gives you a GLP-1 prescription. If you are lucky, they may give you a “one-size-fits-all” handout on how to lose weight while you are using it. For example, in this study:
    • Only 51% of participants received information from their doctor on how to manage side effects of GLP-1.
    • Only 20% were referred to a dietitian. The other 80% received no information on how to change their diet and lifestyle.
  • When you pick up the drug from the pharmacy, you get a package insert listing the side effects but no information on how to change your diet.

The results were predictable:

From a medical point of view the results were a big success:

  • The participants in the study reduced their caloric intake by 20%.
  • Most of the participants in the study felt the GLP-1 drug was helping them lose weight.

But from a nutritional point of view the study raises a red flag. Most of the participants were not told to change their diet or lifestyle, and they didn’t. Their diet was still:

  • High in total fat and saturated fat and probably low in healthy fats, although that was not assessed.
  • Low in fruits, vegetables, grain, dairy, and fiber.

The typical American diet is bad enough as it is. But when you eat the same diet and decrease calories, the nutritional inadequacies of the American diet are magnified. That is why the diets of the GLP-1 users were deficient in fiber plus 10 essential vitamins and minerals and did not contain enough protein to prevent loss of muscle mass.

Most (52%) of the participants were planning to be on GLP-1 drugs for a short period of time – just long enough to reach their weight loss goals. But the reality is far different.

Studies show that when people lose weight on GLP-1 drugs without changing their diet and lifestyle, the weight comes roaring back as soon as they get off the drugs. The reality is that those people will need to stay on GLP-1 drugs for a lifetime if they want to keep the weight off.

That’s when the nutritional inadequacies shown in this study start to have real health consequences. For example,

  • Long term inadequacies of calcium, magnesium, and vitamin D increase the risk of osteoporosis.
  • Long term muscle loss due to inadequate protein intake leads to frailty and metabolic diseases as we age.

I could go on, but you get the point. GLP-1 drugs are not a panacea. Without diet and lifestyle change, they are just a temporary and expensive solution to weight loss.

The Bottom Line

A recent study looked at the nutritional intake of GLP-1 users. It found:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.They were deficient in fiber plus 10 essential vitamins and minerals.

 

  • They were not getting enough protein to prevent the loss of muscle mass associated with GLP-1 use for weight loss.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

For details about the study and the health consequences of these nutrient deficiencies, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Do GLP-1 Drugs Increase Suicide Risk?

by

The Pros and Cons Of GLP-1 Drugs 

Author: Dr. Stephen Chaney 

MagicYou’ve seen the ads. You just inject these “miracle” drugs into your thigh once a week, and your excess weight magically disappears. They look like the simple solution for weight loss everyone has been looking for.

More about that in a minute. Let’s first talk about what these drugs are how they work.

What GLP-1 Drugs Are: These drugs are commonly referred to as GLP-1 drugs. But their full name is GLP-1-like receptor agonists. That’s a mouthful, so let me break it down for you.

GLP-1 stands for glucagon-like peptide-1. Glucagon-like peptide-1 is produced by the stomach whenever we eat a meal. It is a hormone that binds to receptors in key organs and reduces appetite and lowers blood sugar (more about this in a minute).

GLP-1-like drugs are peptides designed to resemble the portion of the glucagon-like peptide that binds to GLP-1 receptor. The term agonist means that these drugs have the same effect as the naturally occurring GLP-1 peptide.

The difference is that the naturally occurring GLP-1 peptide hormone is rapidly degraded, so it stays in the bloodstream for a very short time after each meal. In contrast, the GLP-1-like receptor agonist drugs are designed to be much more stable, remaining in the bloodstream for a week or more. That’s why these drugs only need to be injected on a weekly basis.

How GLP-1 Drugs Work: GLP-1 drugs:

  • Bind to GLP-1 receptors on the pancreas and stimulate insulin release. This can help type 2 diabetics control their blood sugar levels.
  • Bind to GLP-1 receptors on the stomach and reduce the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Bind to GLP-1 receptors on the small intestine and reduce gut motility, which increases transit time through the small intestine. This also prolongs the feeling of fullness. But it can also lead to gastrointestinal side effects.
  • Bind to GLP-1 receptors on the brain and turn down your “appestat”. This reduces feelings of hunger between meals.

A Brief History Of GLP-1 Drugs

ProfessorGLP-1 drugs have been around since 2005.But the newest and most successful class of GLP-1 drugs (e.g., Ozempic) was developed in 2017 by a Danish pharmaceutical company called Novo Nordisk to help type 2 diabetics control their blood sugar levels.

However, once it became apparent that patients on Ozempic achieved significant weight loss, doctors started prescribing it for weight loss even though it had only been approved for controlling blood sugar. This is a practice described as “off label” use. It became so popular for weight loss that diabetics started to have trouble getting their prescriptions filled.

Novo Nordisk ramped up their production of Ozempic and introduced a second, higher potency drug, Wegovy, that is marketed primarily for weight loss. And, of course, where there is money to be made other companies have introduced their own GLP-1-like receptor agonists for both controlling blood sugar and weight loss.

The popularity of these drugs can only be described as a tsunami. To help you put it into perspective:

  • Novo Nordisk’s market value is currently over $500 billion. That is larger than the GDP of Denmark where it is located.
  • One in eight adults in the United States are either taking or have taken a GLP-1 drug.
  • GLP-1 drugs have had 1.2 billion Tik Tok views since 2021.

The Pros And Cons Of GLP-1 Drugs

pros and consLet me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drugs they are overprescribed.

The reality is that unless people on the drugs make healthy lifestyle changes, the weight comes back as soon as they quit using the drugs. So, for most people these drugs are not a short-term weight loss solution. They are a long-term necessity if they want to keep the weight off.

And whenever we are thinking about long-term drug use, we need to ask whether they are safe for long-term use.

That brings me to a story. When I was still teaching medical students, the co-director of the first-year course we ran was a medical geneticist. In his introductory lecture to the medical students he made the comment, “The only safe drug is a new drug”. After a dramatic pause he completed the statement with, “That’s because they haven’t discovered all the side effects yet.”

Let me elaborate. Before a drug can be approved by the FDA it must be proven safe and effective in a series of clinical trials. But those clinical trials have their drawbacks. They are relatively short and include a relatively small group of patients.

Sometimes it is only after a drug has been used by millions of patients for several years that we know of some of their most dangerous side-effects. For that reason, the FDA and regulatory agencies in other countries have a monitoring system for detecting “adverse drug reactions” (side-effects) after the drug has been approved.

Simply put, doctors report adverse drug reactions to a central agency. When enough adverse events of a particular type have been detected, clinical studies are initiated to determine how significant that side effect is.

Medical history is littered with drugs that passed the initial company-run clinical studies with flying colors and were introduced to the general public with great fanfare – only to be withdrawn a few years later once serious side-effects had been discovered. One might ask whether GLP-1 drugs may be in the same category.

When you look at the official Ozempic and Wegovy websites they say that the most common adverse reactions, reported in ≥5% of patients in their clinical trials, were nausea, vomiting, diarrhea, abdominal pain, and constipation. These side effects are fully predictable for drugs that inhibit gastric emptying and reduce gut motility. They are also easy to detect in short term clinical studies.

More recently, several reports have suggested that these drugs reduce muscle mass. This is not life-threatening, but it is concerning for older patients trying to maintain muscle mass and for anyone trying to lose weight.

That’s because your muscles are among the most metabolically active tissues in your body. When muscle mass decreases, basal metabolic rate (the rate at which you burn calories 24 hours per day) also decreases. With that in mind, you don’t need to be a genius to understand why loss of muscle mass is a concern for anyone trying to lose weight.

However, more troubling reports have recently surfaced about increases in suicidal behavior in people using GLP-1 drugs. During the company-run clinical trials only 0.27% of drug users reported an increase in suicidal thoughts or behavior, so the drug companies are saying, “Nothing to see here”. However, those clinical trials excluded patients with suicidal tendencies from their analysis, while no such exclusion is recommended for prescribing these drugs.

The authors of the study (G Schoretsanitis et al, JAMA Network Open, 7(8):e2423385, 2024) I will describe today decided to take a closer look at the association of suicidal behavior with GLP-1 drug use.

How Was This Study Done?

clinical studyThe authors obtained their data from the WHO Individual Case Safety Reports database. It is the largest database of its kind in the world, with over 28 million reports of suspected adverse drug reports from 140 member countries.

From this database they identified 107 reports of suicidal and/or self-injurious adverse drug reactions associated with the class of GLP-1 drugs that include Ozempic and Wegovy between July 2011 and August 2023. Key characteristics from these 107 reports were:

  • Median age = 48 years.
  • Percentage of female patients = 55%.
  • Length of GLP-1 use before symptoms were reported = 80 days.
  • Other medications used were primarily medications for diabetes (15.9%), depression (13.1%), and anxiety (4.7%).
  • The suicide was successful in 6.5% of the reports.
  • Suicidal thoughts and/or behaviors disappeared in 62% of the cases after discontinuing the drug.

The authors performed a statistical method known as a disproportionality analysis of suicidal thoughts and behaviors in this group of GLP-1 users. Simply put, they asked whether the frequency of suicidal thoughts or behaviors was disproportionally high for patients using GLP-1 drugs compared to all other drugs in the database for which suicidal tendencies have been reported.

In case you are thinking this is a strange comparison, let me explain why it was chosen.

  • The WHO Individual Case Safety Reports database (and similar databases maintained by the FDA and other national health organizations) only contains reports of adverse drug reactions. There is no way of comparing the number of adverse drug reactions with the number of people taking the drug. So, you cannot use the database to estimate the percentage of people using GLP-1 drugs who develop suicidal thoughts or behaviors.
  • Even if it were possible to estimate the percentage of GLP-1 users who develop suicidal tendencies, databases like this significantly undercount the percentage of adverse drug reactions. That’s because if the symptoms are mild, patients often do not report them to their doctors. And busy doctors don’t always report them to the FDA or WHO. It is primarily the cases that result in hospitalization that get reported.

Do GLP-1 Drugs Increase Suicide Risk?

For simplicity, I am restricting myself to the data in this paper related to the Ozempic and Wegovy class of GLP-1 drugs. The results with other classes of GLP-1 drugs were not as clear.

The authors reported:

  • The Ozemic/Wegovy class of GLP-1 drugs were associated with a disproportionately higher risk of suicidal thoughts and behaviors compared with other drugs in the WHO database.
  • The disproportionately higher risk remained significant when the authors looked at patients who were using the GLP-1 drugs with either antidepressants or anxiety medications.
    • The authors interpreted this as suggesting that people with anxiety or depression may be at higher risk of suicidal thoughts and behaviors when taking this class of GLP-1 drugs.

The authors concluded, “This study using the WHO database found a signal of semaglutide [the class of GLP-1 drugs that includes Ozempic and Wegovy] associated suicidal ideation [suicidal thoughts and behaviors], which requires urgent clarification.”

What Does This Study Mean For You?

Question MarkI don’t want to overemphasize the significance of this study.

  • It does not prove an association of this class of GLP-1 drugs with suicidal thoughts and behaviors.
  • It does not provide definitive information about other classes of GLP-1 drugs. There appeared to be an increased risk, but the data were not statistically significant.
  • However, it is the first study to show there might be an association with GLP-1 drugs and suicidal behavior.
    • Suicide is not a trivial side-effect, which is why the authors said it “requires urgent clarification” by future clinical studies designed specifically to address this possibility. For example, the premarketing clinical trials by the drug companies excluded patients with depression, anxiety, or suicidal tendencies. Since these are likely to be the most vulnerable group, future clinical studies should perhaps focus on this group.

As I said at the beginning of this article, we often don’t know about the most serious side effects of new drugs until they have been on the market for a few years. And it is studies like this one that are often the first indication of serious side effects.

So, here are my recommendations for you:

  • We don’t yet know for sure whether suicidal tendencies are a side-effect of GLP-1 drugs, but you need to be aware that this is a possibility.
  • If you suffer from depression, anxiety, or suicidal thoughts GLP-1 drugs may not be the best choice for you. At the very least you should discuss the risks and benefits with your doctor before using them.
  • If you are using GLP-1 drugs and experience an increase in depression, anxiety, or suicidal tendencies you should discontinue the drug immediately and report your side effects with your doctor.

My most important recommendation is that unless you are dangerously obese, you should consider healthier, drug-free approaches to losing weight. Simple changes in diet and lifestyle can give you gradual weight loss. More importantly, diet and lifestyle change can lead to permanent weight loss. And you will experience side benefits rather than side effects

The Bottom Line

GLP-1 drugs have become immensely popular for weight loss. If you believe the ads, all you need to do is to inject yourself with the drug and those excess pounds will magically appear.

However, we often don’t know about the most serious side effects of new drugs until they have been on the market for a few years. And there have been reports of increased suicide risk associated with the use of GLP-1 drugs.

A recent study looked the increased risk of suicidal thoughts and behaviors associated with the use of GLP-1 drugs. If found:

  • GLP-1 drugs were associated with a disproportionately higher risk of suicidal thoughts and behaviors compared with other drugs.
  • The disproportionately higher risk remained significant when the authors looked at patients who were using the GLP-1 drugs along with either antidepressants or anxiety medications.
    • The authors interpreted this as suggesting that people with anxiety or depression may be at higher risk of suicidal thoughts and behaviors when taking GLP-1 drugs.

For more details on this study and what it means for you read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Health Tips From The Professor