In 1986, GLP-1 was identified (Mojsov et al., 1986). In 2005, the FDA approved a compound similar to GLP-1 (exenatide) for diabetes. It took nearly three decades of technological advancement in genetic research, tissue culturing (Saccharomyces cerevisiae), genetic sequencing, purification, and stabilization of the product for GLP-1 to become commercially available.

GLP-1 is a potent stimulator of insulin release (lowers blood sugar) while decreasing Glucagon secretion (think of it as anti-insulin). GLP-1 also slows GI motility and stomach emptying. It reduces the appetite at the brain level. GLP-1 medication stimulates insulin release from the Beta cell, which produces insulin in the pancreas. GLP-1 intercepts signals in the Vagus nerve to slow gastric emptying.

There are built-in safety mechanisms to prevent the human body from self-destructive, runaway chemical imbalances. For example, osteoclasts and osteoblasts are cells that break down and build bones, as we read in this blog. This balance is closely regulated against outside interferences to prevent osteoporosis or bone thickening (low vitamin D, menopause, or growth hormone injections).

When a patient takes thyroid medication, the TSH goes down because it senses enough thyroid in the bloodstream to stop ordering thyroid gland from secreting (even though none was being secreted as to why the thyroid medication was started)

These are all examples of where I am going with this:  What is not adequately explained and discussed is that other chemical pathways are being affected in ways that we do not recognize. We already know it can cause pancreatitis because GLP-1 can overstimulate the beta cells. We also know that it can cause certain rare types of thyroid cancer.

Yes, I am a surgeon, but I could help my patients. I would have started prescribing these medications long ago before we started seeing a patient who is now coming to have surgery after trying GLP-1 medications and gaining weight back after they stopped because they had significant complications and side effects, or they could not afford it. The complication profile and the side effects cause significant portion of the medication discontinuation.

I have already stated before that GLP-1 medications offer no off-ramp for the patients. Once you start it, you must stay on it for a long time. The published data provides dismal long-term outcomes for patients who stop the medication.