What are GLP-1 agonists?
These are medications that have been used for type 2 diabetes (Glucagon-like peptide-1). They work by mimicking the actions of the naturally occurring hormone GLP-1, which is released after eating. Trade names – e.g Wegovy, Ozempic, Mounjaro
How do GLP-1 agonists work?
- Blood sugar: they help the body produce more insulin, which lowers blood sugar.
- Appetite: they increase feelings of fullness, which reduces hunger and cravings.
- Digestion: they slow down digestion and reduce gastric emptying which also gives you the feeling of fullness.
The medication is usually injected via a small syringe and needle and has to be taken every day or every week depending on the type. As part of their function we have noticed that their use can result in weight loss. At this stage they are prescribed off label – this means that there has been limited research on the risks and long term outcome on patients that have no type 2 diabetes. You thus take the risk yourself.
The FDA currently approves the use of semaglutide and high-dose liraglutide to help treat obesity. You should have a body mass index (BMI) of 30 or higher.
Side effects (read each package insert, but the most common ones are)
- Allergic reactions
- Low blood sugar (hypoglycemia)
- Vomiting
- Diarrhea
- Constipation
- Pancreatitis
- Gastroparesis
- Bowel obstruction
- Gallstone attacks and bile duct blockage
Severe — but rare — side effects can include:
- Pancreatitis.
- Medullary thyroid cancer.
- Acute (sudden) kidney injury.
- Worsening diabetes-related retinopathy.
At this stage there have been no randomised controlled trials or studies that have looked at GLP-1 agonists in patients that have confirmed Lipoedema.
We have seen a few patients that have been on these medications with varying results.
It is important that you understand the risks and that there are potentially unknown long term risks.