GLP-1 medications are everywhere right now. For some people, they’ve been life-changing. For others, they’ve raised more questions than answers. And for many, the conversation feels oddly polarized… they either hear “this is the miracle we’ve been waiting for” or “these drugs are dangerous and should be avoided at all costs.” Information about the true GLP-1 risks can be hard to decipher.

In a recent live webinar, I set out to do something different: step out of the extremes and walk through the actual science, the real trade-offs, and the decisions people deserve help making (but often aren’t supported through).

This post highlights the key themes we covered. If you’re considering a GLP-1, currently on one, or thinking about coming off, this will give you context. And if you want the full depth of the webinar, including the ability to see the slides jam-packed with information, you will find a link to the full recording at the end.

Why This Conversation Matters

Roughly three-quarters of U.S. adults are currently overweight or obese, and GLP-1 prescriptions have surged faster than most long-term data can keep up with. These medications were originally developed for diabetes management, but they’re now being widely used for weight loss, and they’re often prescribed with very little guidance beyond “let’s see how it goes.”

The problem isn’t that GLP-1s don’t work. For most people, they do lead to weight loss. The problem is that weight loss is being treated as synonymous with health, while critical questions about muscle, metabolism, nutrition, gut health, and long-term sustainability are often left unanswered.

What GLP-1s Actually Do (and What They Don’t)

GLP-1 is a naturally occurring gut hormone involved in appetite and blood sugar regulation. The medications amplify that signal far beyond normal physiology and for far longer than the body would naturally produce it.

They work by:

• Slowing gastric emptying
• Increasing satiety
• Reducing food reward and cravings through central nervous system signaling
• Improving short-term blood sugar control

What they don’t do is just as important:

• They don’t burn fat directly
• They don’t build or preserve muscle automatically
• They don’t repair metabolic dysfunction on their own
• They don’t teach sustainable eating patterns

They make it easier to eat less. What happens because you eat less depends entirely on what else is in place.

Who May Benefit (and Who Should Pause)

GLP-1s may be appropriate in specific situations, such as significant insulin resistance, diabetes, or repeated weight-loss failure despite genuine effort and support. In some cases, short-term use as a bridge (paired with nutrition, strength training, and a clear plan!) can make sense.

At the same time, caution is warranted for people with:

• A history of eating disorders or chronic under-fueling
• Heavy training loads or over-exercising
• Fragile digestion or motility issues
• Thyroid or gallbladder instability
• High stress and nervous system dysregulation

The same intervention can have very different consequences depending on the person.

What Many People Aren’t Told

One of the most important parts of the conversation is what often gets minimized.

Lean mass loss

Across research on rapid weight-loss, roughly 25–40% of weight lost is lean tissue, including muscle. GLP-1 trials show similar (or sometimes even higher) patterns when muscle preservation isn’t actively prioritized. Losing muscle changes resting metabolic rate, insulin sensitivity, and long-term weight maintenance.

Nutrient sufficiency

Eating significantly less doesn’t just affect the scale.  It can show up as fatigue, hair thinning, poor recovery, cold intolerance, sagging skin, and a general sense of malaise. For many people, the trade-off isn’t simply “thin vs. not thin” … it’s how they feel in their body once weight is lost.  This is where we have a LOT of people coming to us after losing the weight, but wondering why they feel terrible and how to reverse it.

GI and psychological effects

Nausea, reflux, constipation, food aversions, and changes in appetite signaling are common. For some, appetite suppression also alters their relationship with food and creates anxiety about eating normally again.

Why Weight Often Comes Back After Stopping

Weight regain after stopping GLP-1s is extremely common based on the physiology of stopping the medication.

After weight loss:

• Appetite hormones rebound
• The brain perceives an energy threat
• Resting metabolic rate often drops more than expected
• Muscle loss lowers the body’s metabolic “floor”

Without a transition strategy, the body does exactly what it’s designed to do: try to restore what was lost.

Doing This Better: A More Durable Framework

Whether someone is GLP-1 curious, currently on a medication, wondering about GLP-1 risks, or planning to come off, long-term success depends on more than appetite suppression.

In the webinar, I outlined three non-negotiable pillars:

1. Food as medicine – adequate protein, nutrient density, fiber, and eating enough to support metabolism
2. Physical activity as metabolic restoration – especially resistance training to preserve and rebuild muscle
3. Mindset and nervous system support – rebuilding trust with hunger cues and reducing fear-driven decision-making

Medication doesn’t replace these foundations. At best, it temporarily lowers the barrier to working on them.

Where Support Fits In

One of the biggest takeaways from the webinar was this: most people aren’t failing because they lack discipline; they’re struggling because they lack structure and support.

This is exactly why we created Refocus, and why we added a dedicated GLP-1 Track for those navigating these medications. The goal isn’t to push anyone toward or away from a drug. It’s to help people protect their health, preserve muscle and metabolism, and make decisions they won’t regret later.

Watch the Full Webinar Recording

This post only scratches the surface. In the full webinar, we go much deeper into the physiology, the data, and the practical decision-making frameworks for:

• People considering GLP-1s
• People currently using them
• People planning a strategic exit

👉 Watch the full webinar recording here to get the complete context and decide what path makes the most sense for you.

If you want personalized guidance, you can also book an initial consultation to talk through your situation and whether Refocus (or the GLP-1 Track) is the right fit.  Our team is here to help!