Pros And Cons of GLP-1 Medications for Weight Loss

Author: Lisa Spriet Registered Dietitian (RD)

Online, in the news, and in our clinic, GLP-1 receptor agonist medications have quickly become part of the mainstream conversation around weight loss and metabolic health. For some people, they can be a helpful tool. For others, a food-first or lifestyle-based approach may be more appropriate, or like many of our clients, medications work best alongside nutrition support.
If you’re in the decision-making stage, this article walks through the pros and cons of GLP-1 medications, what they actually do, and how to think about them within a longer-term, sustainable health plan and why a food-first approach still matters. We’ll give you some of our top tips when deciding.

Table Of Contents

1. What Are Glp-1 Medications?
2. Pros of GLP-1 Medications
3. GLP-1 Cons And Limitations To Consider
4. Important Questions To Ask Before Starting GLP-1 Medications
5. Why A Food-First Approach To Weight Loss Still Matters

What Are Glp-1 Medications?

This class of medications, first created for blood sugar control, include name brand medications such as Ozempic and Wygovy. GLP-1 medications mimic a naturally occurring gut hormone (glucagon-like peptide-1) that plays a role in:

• Appetite regulation
• Blood sugar control
• Slowing stomach emptying
• Increasing feelings of fullness

By acting on these pathways, GLP-1 medications can reduce hunger and support weight loss, particularly in people with insulin resistance, type 2 diabetes, or obesity.
Currently all of the GLP-1s on the market in Canada come as an injectable medication, taken once per week. While each medication has its own dosage and titration schedule, typically clients are started on a low dose and increased every 4 weeks to a desired effective dose.

Pros of GLP-1 Medications

From a clinical perspective, GLP-1 medications offer several potential benefits:

Clinically Significant Weight Loss

Many people experience meaningful weight loss of 15% or more, particularly when medications are combined with nutrition and lifestyle support. Where we’ve seen the most success with these medications is in clients who have struggled with weight, as well as chronic conditions associated with weight, for years. Clinically significant weight loss can and does happen with nutrition and behaviour coaching alone, but for those predisposed to obesity or who have weight-related conditions, sometimes more help is needed.

Improved Blood Sugar Regulation

These medications were originally developed for diabetes management and can improve insulin sensitivity and glycemic control. In our practice, we see these medications working really well for those who are both overweight and have high A1c levels.

Appetite And Portion Control Support

Reduced appetite can help people break cycles of overeating or constant food noise, especially early on. We spend a lot of counselling time working on hunger and satiety cues and breaking emotional eating or problematic eating habits. While this counselling is still the cornerstone of creating new, lifelong habits, we have found that GLP-1s can help to ‘quiet food noise’ and allow clients to actually make use of the tips and behaviour change counselling.

Potential Cardiometabolic Benefits

Some GLP-1 medications have shown benefits for cardiovascular risk factors, such as LDL-cholesterol and triglyceride levels, for those at higher risk. This also includes those with MASLD (also known as fatty liver disease). While it’s hard to differentiate whether these improvements are due to weight loss and lifestyle changes or the medication, research supports that these medications can improve cardiometabolic markers.

GLP-1 Cons And Limitations To Consider

While GLP-1 medications can be effective, they are not without downsides. In clients considering taking medications, we often have several conversations weighing out the pros and cons, as we think it is really important to go in with as much knowledge as possible.

Common Side Effects

Nausea, vomiting, diarrhea, constipation, bloating, and fatigue are common, particularly during dose increases, which typically happen every 4 weeks for the first few months. We work with clients to reduce this, for example, with smaller meals, avoiding high-fat meals, including adequate fibre, and more. We also help clients navigate dose increases, and often communicate back to doctors or pharmacists when we feel a dose increase may not be needed due to balancing side effects and effectiveness.

Cost And Accessibility

These medications can be expensive, and insurance coverage varies widely. Current costs are anywhere from $5600-$10,600 CAD per year, depending on medication and dosage. While these prices should be decreasing in coming years, they will still have a significant monetary impact. However, when we weigh this against the costs of chronic disease, and potentially lower quality of life, it can be worth it for many. Many of those living with obesity have spent 10x these costs over their lifetime on fad diets, exercise programs, supplements, etc.

Muscle Loss Risk With GLP-1 Weight Loss Therapy

Rapid weight loss, with or without medications, in the absence of adequate protein intake and resistance training can lead to loss of lean muscle mass. We address this head on with clients and always align them with a higher protein diet and easily accessible weight resistance training. We work with those who have food aversions due to the medication to ensure they can still meet their protein needs.

Long-Term GLP-1 Medication Sustainability Questions

Many people regain weight if medication is stopped without a strong nutrition and behaviour foundation. In our initial conversations, we talk about what this looks like, both in terms of continuing the medication for life, or a plan of action for after medication.

Not A Stand-Alone Solution

GLP-1 medications do not, on their own, teach personalized, healthy eating skills based on individual goals and overall health needs, food literacy, or sustainable habits. Dietitians do that! These medications are a helpful tool, but not the only tool or a panacea.

Important Questions To Ask Before Starting GLP-1 Medications

Before deciding whether GLP-1 therapy is right for you, consider:

• What is my primary goal — weight loss, blood sugar control, overall health, or all three?
• Am I prepared to pair medication with nutrition and lifestyle changes?
  What is my plan for maintaining results long-term?
• Have I explored food-first approaches or worked with a dietitian before?

Why A Food-First Approach To Weight Loss Still Matters

At NutriProCan, we emphasize that nutrition is not optional, even when medications are involved. A food-first approach can:

• Reduce side effects
• Preserve muscle mass
• Improve nutrient adequacy
• Improve relationship with food
• Support long-term weight maintenance, with or without medications

For some individuals, food-first strategies alone are enough. For others, GLP-1 medications may complement nutrition care, but they should not replace it. A dietitian can help you navigate weight-loss strategies with science-based, unbiased perspectives. Start with a free online consultation with one of our team members.

Explore Our Weight Loss Services For A Natural, Food-First Approach

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Author:

Lisa Spriet, RD, BSc (Hons), MSc is a Registered Dietitian and Co Owner of NutriProCan, a national team of nutrition professionals. She studied biochemistry, genetics, nutraceutical sciences, and dietetics at Western University and the University of Guelph. Her career spans personal training, clinical practice, biotechnology, and teaching nutrition at the university level. She is passionate about advancing healthy eating initiatives and works with individuals, workplaces, and organizations to develop practical, evidence based nutrition programs.
She is dedicated to making healthy living achievable and impactful at every stage of life.