Myth Busting Common GLP-1 Misconceptions

The era of GLP-1 medications has arrived, and more people than ever are on track to hit their goal weight assisted by these medications. But despite their popularity, there are still some common misconceptions and myths floating around the subject. From the misleading notion that GLP-1s make you “feel” fuller to the belief that these medications are all you need to lose weight, there are a few GLP-1 myths we want to clear up, ahead.

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Myth: GLP-1s Make You Feel Fuller Longer

Fact: GLP-1s cause delayed gastric emptying, slowing digestion.

When it comes to weight loss, the phrase “feel fuller longer” is a common promise of dietary supplements and diet pills. But when we’re talking about GLP-1s, that’s only part of the story.

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Sure, you’re going to feel fuller for longer. That’s because you are fuller for longer taking a GLP-1. “Even when you’re hungry, it takes much less food to make you feel full,” explains Newton, MA plastic surgeon Joseph Russo, MD. “This is because gastric emptying is delayed. It slows down the ability of your stomach to push food into the intestine, and it slows down the whole length of your intestine. One of the things that isn’t recognized is that constipation is a significant complication of these medications. Therefore, when you do start taking them, you have to be sure to keep your bowel moving; otherwise, you can have significant trouble with constipation.”

This slowed digestion has a big impact on how medical providers perform surgery. In 2023, the American Society of Anesthesiologists developed guidance to better manage patients on these medications. The guidance requires patients to stop their medication before any surgery to reduce the “risk of regurgitation and pulmonary aspiration of gastric contents during general anesthesia and deep sedation.”

“These shots slow your gastric emptying and make you feel full, which is how they achieve weight loss,” explains Louisville, KY plastic surgeon Chet Mays, MD. “But on the other side, if you’re going to have general anesthesia, you do not want a full stomach prior to surgery. So, stopping these medications and letting the G.I. system wake up before surgery is critical.”

Myth: GLP-1s Are All You Need to Lose Weight

Fact: GLP-1s should be part of a weight loss management plan including exercise and dietary changes under the direction of a healthcare practitioner.

“Staying hydrated, eating protein and working to build muscle mass are all crucial when you’re on these weight loss medications,” Dr. Mays says.

This is especially true if you are considering any kind of cosmetic surgery. “If you are considering cosmetic surgery while on these medications, you need to prepare for surgery with your nutrition,” Dr. Mays adds. “Getting supplemental protein packets a few weeks before your surgery is critical to your recovery process. We give patients in our practice a two-week supply of Juven Wound Care Nutrition before their cosmetic procedure if they are on the weight loss shots.”

Additionally, the changes GLP-1 causes to your digestion can impact your level of protein absorption, which can result in malnutrition. This can impact your health and cause delays in any potential treatments or surgeries you’re looking for. “I had a patient who had a gastric sleeve and was taking these medications to lose additional weight,” notes New York plastic surgeon Mokhtar Asaadi, MD. “We had to reschedule her cosmetic surgery because she was experiencing swelling in her arms and legs. This was a result of poor protein absorption, essentially malnutrition. So that had to be addressed and she had to have a lot of protein before it is safe to operate. That just goes to show that these medications require medical supervision.”

Myth: GLP-1s Work Like Any Diet Pill

Fact: Weight loss on GLP-1s can happen much more rapidly than with other weight loss medications.

GLP-1 myths like this mostly come from a lack of understanding of how these medications work. By slowing digestion and increasing feelings of fullness, patients can expect to lose an average of 5-10 percent of their body weight in one year. As a result of rapid weight loss, plastic surgeons around the country have seen a marked increase in patients seeking to address loose skin.

“We are certainly seeing an increase in patients with a lot of loose skin as a result of rapid weight loss,” Dr. Asaadi says. “These medications cause weight loss at a fast rate, resulting in loose skin not just in the face but all over the body. Depending on the patient’s skin quality and their age, it could be more or less extreme.”

“We are now seeing the effects of weight loss from head to toe,” Dr. Mays adds.

Myth: You Should Stop Taking GLP-1s After Meeting Your Weight Loss Goal

Fact: GLP-1s are designed for long-term weight management.

In terms of GLP-1 myths, this is a pretty big concern. New data shows that withdrawing from these medications most often leads to weight regain.

“Most of the GLP-1 medications are intended for long-term use with people who have diabetes or pre-diabetes,” explains Dr. Russo. “Once you reach your weight loss goal, you can go to a maintenance level. But like anything else, once you stop the diet or stop the medications and start eating like you did before, you’re going to gain weight again.”

“It helps to think of these medications like a blood pressure medication,” Dr. Asaadi explains. “As long as you take it, your blood pressure is under control. But if you were to stop, all that progress you made would be undone, and your blood pressure would be a health issue again. In terms of these medications, stopping them after losing the weight won’t have a lasting impact on your body. You will gain weight back, maybe even more than you lost.”

And for a plastic surgeon, that’s concerning. “We don’t want to treat your loose skin just for that weight to be gained back,” Dr. Asaadi says. The result won’t be the same.”