The world seems to be divided over the GLP-1 drugs. Some consider this Anti-Obesity Medication to be a game changing shift in the treatment of obesity. At the same time you hear other people say it is “the easy way out,” or even go as far as to say it’s “cheating.” As with most polarizing topics, both sides attempt to present convincing evidence as to why their perspective is correct. This ultimately leaves the consumer in a very confused state. Is this a breakthrough of modern medicine or a “cheat code” that allows someone to take the “easy way out?” Let’s explore further and see if we can find out.
A Unique Perspective on GLP-1 Drugs
I’m going to come at this from a unique perspective that will use two different lenses to filter this topic through. My first perspective is as an exercise physiologist who has over 20 years experience in the field working with people who have struggled with managing their weight. My second perspective is probably even more important to this discussion. That’s the perspective born out of being an obese teenager, who lost a bunch of weight, and then gained it all back in my early thirties to be an obese adult. While I’m now at a much healthier body weight than my early thirties, the psychological and emotional lessons I learned from those periods in my life strongly affect my perspective to this very day.
Saying all of that, I am not an obesity medicine physician or researcher. As an exercise physiologist it is out of my scope of practice to tell you if the GLP-1 drugs are right for you. If you’re wondering if they are, check out our weight loss drug resource page to learn more. What I do feel very qualified to talk about are the struggles people face to lose weight. First and foremost, because I’ve had my own very real struggles and secondly because I’ve helped hundreds (if not thousands) of people attempt to lose weight over my career. I can give you honest firsthand experience and observations. Those, coupled with the current scientific evidence on GLP-1 drugs can at least provide us with the moral answer (aka…is this “cheating”).
Level-Setting: GLP-1 Drugs
A couple of important items to get out of the way first. I’m using the term GLP-1 drugs, because that is how they are commonly known in the general public. You may have even ended up on this page because you Googled “GLP-1 Drugs.” Although this is a commonly used term, it is not the correct term.
By definition GLP-1 drugs are one type of a class of drugs referred to as Anti-Obesity Medications (AOMs). The most widely used GLP-1 AOM is semaglutide. It is sold as Wegovy for weight management and Ozempic for diabetes management. It’s the same drug, just a different dose. Another prominent AOM on the market is tirzepatide. It is sold as Zepbound for weight management and Mounjaro for diabetes management. Based on current research tirzepatide seems to result in more weight loss than semaglutide. For the rest of this article, I’ll refer to these medications as AOMs for accuracy’s sake.
Next I think it’s important to point out that AOMs (especially the GLP-1 drugs) have been around for some time. Semaglutide was approved in 2017 for the treatment of diabetes, and in 2021 for weight management. Other GLP-1 drugs have been around much longer. As an example, Dulaglutide (Trulicity) was approved for diabetes treatment in 2014. Liraglutide (Victoza) was approved for diabetes treatment in 2010.
So these drugs have been in the clinical pipeline for more than a decade. When people talk about the unknowns with the GLP-1 drugs they certainly can’t point to them being brand new. That being said, it’s also clear there is much to learn about AOMs more broadly and even the GLP-1 drugs. Rest assured more research will be conducted over the years, but right now, GLP-1 drugs are not nearly as unknown of an entity as what people will lead you to believe.
If you’re looking to learn a little more about AOMs (GLP-1 drugs and the others) as well as the importance of exercise when you’re taking an AOM, check out this article I wrote: Best Exercises to Do While Taking Ozempic, Wegovy, or Semaglutide.
My “Fat Kid” Perspective on AOMs (GLP-1 Drugs)
There is still a part of me deep down inside that sees himself as a fat kid. Maybe it’s because my nickname in high school was Fat Stack. My last name is Stack, Fat is not my first name, although it felt like it was throughout certain portions of my life.
Now please don’t feel bad for me, I’ve reconciled and made peace with the past. In fact, I’m grateful to have that experience in high school, because it sent me on the professional path I’m on today. It also taught me something – being overweight or obese is HARD! Yes, it’s physically hard, but it’s psychologically and emotionally even harder.
If you would have told me in high school there was a medication I could have taken that would have taken away the constant cravings and thoughts about food, I would have been excited. If you then told me it would make me just be Mike Stack (rather than Fat Stack) I would have literally done anything to get it. Alas, there wasn’t that kind of medication back then, so I learned to lose weight the “ole fashion way,” through diet and exercise.
What I found out very quickly is how hard it was to do. Constantly thinking about food, having to plan meals, weigh food, and exercise for hours every day. It wasn’t easy, but I lost weight. It certainly helped that I worked in a gym (and still do to this day). If I’m honest, much of my life has been constructed around managing my weight. I still exercise 2+ hours every day, weigh all of my food, count all my calories, and weigh myself weekly. I might be what some in the medical community would call a success story, but I have a better term, an outlier. This I know from my other perspective as an exercise physiologist.
My Exercise Physiologist Perspective on AOMs (GLP-1 Drugs)
Early in my career as an exercise physiologist I attempted to just implement the plan that “worked for me” (I put this in quotes because this is so common among people who have been successful with achieving any level of fitness or weight loss). To my shock and horror my clients weren’t willing to exercise 2+ hours every day, weigh all of their food, count all of their calories, and weigh themselves weekly. As I progressed through my career my shock and horror turned to empathy, understanding, and compassion. I truly wanted to help people on their weight loss journey, but the answers always seem to come back to very restrictive interventions people struggled to follow.
It almost didn’t matter what I tried, people would lose weight, but struggle to keep it off. Sure there were the outliers like me that decided to devote much of their time to all weight management behaviors I mentioned before, but they were the exception not the rule. You know this from either your own experience or from your friends and family. Losing and sustaining weight loss is HARD. It requires a lot of attention to many aspects of life and most people don’t have that bandwidth. The research even backs this up. Most people (other than the outliers) regain more than 80% of their lost weight in 5 years.
Based on my personal experience, my clinical experience, and the research it’s clear to me that losing weight and keeping it off is more than just a matter of willpower or discipline. I’ve met literally hundreds of people over the years who were incredibly disciplined and successful people that simply couldn’t lose weight and keep it off. Deep down inside (probably somewhere around that inner fat kid voice) I also knew there had to be more to it than simply “working harder.”
The behavior side of this still needs a structure, whether or not someone is on a medication. That is the case I make in Accountability is Calling: Five Ways Health Coaches Keep You on Track, and it is also why resistance training for muscular power belongs in the plan when someone is losing weight quickly.
AOMs (GLP-1 Drugs) & Neurobiology
While we’re learning more and more about the AOMs everyday, one thing that’s become clear from the research is how AOMs address the neurobiological basis for obesity. Put simply, this is how the brain interprets hunger signals. Individuals who struggle to manage their weight effectively interpret hunger signals differently than normal weight individuals. In short, they don’t stay full and they get hungrier sooner, which drives weight gain. Individuals who struggle to manage their weight also talk of “food noise,” which is essentially constantly thinking about food. GLP-1 drugs have been reported to reduce food noise, which has huge benefits for losing and sustaining weight loss.
Hunger signals read differently
People who struggle with their weight do not stay full as long and get hungry sooner. The brain is reading the same hunger information and reaching a different conclusion.
Food noise runs in the background
Constant thinking about food takes up attention all day. Reports of GLP-1 drugs quieting it are one of the clearest accounts we have of what these medications change.
Going much deeper on the neurobiology of obesity is beyond the scope of the article, but I’d encourage those who are interested to read more.
Why Taking a GLP-1 Drug (or any AOM) Isn’t the Easy Way Out
This brings us back to the title of this article to reinforce the point. Based on research that has been emerging for years, it’s becoming increasingly clear that weight management has clear biological predispositions. Beyond that we live in a world that exacerbates these predispositions by having limited opportunities for movement and being around high fat/high sugar hyperpalatable foods. This combination of biology and environment stacks the deck against anyone looking to manage their weight effectively.
Saying taking a GLP-1 drug (or any AOM) is “the easy way out,” is like saying someone taking a statin for high cholesterol or a beta blocker for high blood pressure is “the easy way out.” While cholesterol and blood pressure both can be managed by a healthy lifestyle, in many cases people need some help from medications. That doesn’t mean they’re taking the easy way out, they’re just benefiting from modern medicine, like all of us have to some degree.
Two Conditions, Two Standards
The same reasoning, applied to two chronic conditions, lands in two very different places.
Lifestyle moves cholesterol. It often does not move it far enough. Adding a statin reads as reasonable medicine, and no one calls a cholesterol of 300 a moral failing.
Lifestyle moves weight. It often does not move it far enough, or hold it. Adding a medication gets called cheating, because obesity is visible and cholesterol is not.
Cholesterol and blood pressure aren’t visible when you walk down the street. Those medical conditions aren’t stigmatized like obesity has been for decades. No one considers a cholesterol of 300 a moral failing, but a BMI of 35 makes someone “undisciplined.” That type of thinking fails to recognize the neurobiology of weight management. These statements are most often made by someone who’s never had a challenge managing their weight, never been stigmatized in social environments, and never had to deal with the food noise.
Obesity is a medical condition, plain and simple. Obesity treatment is healthcare. Healthcare uses many different types of interventions and drugs are one of those interventions. Taking GLP-1 drugs (or any AOM) is not the easy way out, it’s healthcare, full stop.
For a deeper understanding of how these drugs work and what to consider alongside an exercise plan, watch our free webinar that explains all of this and more.
Medication Is One Tool. You Still Need the Rest of the Plan.
The MY180 program pairs you with a Health Coach, a Registered Dietitian, and an Exercise Physiologist working from one plan for 180 days that fits your lifestyle and your goals, whether or not a medication is part of it.
Talk With a Health Coach →
Sources
- Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Medical Clinics of North America, 2018.
- Rodriguez PJ, et al. Semaglutide vs Tirzepatide for Weight Loss in Adults With Overweight or Obesity. JAMA Internal Medicine, 2024.
- Dalton M, Finlayson G, Esdaile E, King N. Appetite, Satiety, and Food Reward in Obese Individuals: A Behavioral Phenotype Approach. Current Nutrition Reports, 2013.
- Hayashi D, Edwards C, Emond JA, et al. What Is Food Noise? A Conceptual Model of Food Cue Reactivity. Nutrients, 2023.
- Sutton CA, Stratton M, L’Insalata AM, Fazzino TL. Ultraprocessed, hyper-palatable, and high energy density foods: Prevalence and distinction across 30 years in the United States. Obesity, 2024.
- Becetti I, et al. The Neurobiology of Eating Behavior in Obesity: Mechanisms and Therapeutic Targets. A Report from the 23rd Annual Harvard Nutrition Obesity Symposium. American Journal of Clinical Nutrition, 2023.
- Fulton M, Dadana S, Srinivasan VN. Obesity, Stigma, and Discrimination. StatPearls, 2023.