We’ve made it to 2026 and everyone has made their New Year’s Resolutions. After eating cheat meals for every meal for the last 2 months, most of these resolutions circle around weight loss. Over the years, gyms have started to offer discounts at New Year’s in anticipation of the “January Surge” that sees a 33-50% increase in gym memberships that are cancelled by February.
In recent years, however, less people are relying on diet and exercise as the sole method for weight loss. In fact, many people are probably already looking into GLP-1s as a supplement, or even replacement for diet in weight loss. Thanks to strong marketing campaigns, Ozempic and Mounjaro are brand names known in most households across the US. But here are a few quick things everyone considering a GLP-1 should know:
How GLP-1s Work
To understand how GLP-1s work, you need to understand where it was derived from. Gila Monsters produce a venom that provokes inflammation in the pancreas of prey, resulting in progressive blood glucose drops. Biologically, this leaves the prey animal with no energy to escape the Gila Monster. Scientists extracted the compound extendin-4 from the venom and later was able to synthesize a similar compound that showed to decrease blood glucose in diabetic mice.
These synthesized forms have since been developed into an entire pharmaceutical class: The Glucagon-like peptide-1 (GLP-1) receptor agonists, or GLP-1s for short. Newer drugs in this class target other gut receptors as well, such as glucose-dependent insulinotropic polypeptide.
In addition to better blood glucose levels, it became quickly apparent that it consistently reduced body weight in patients. Since then, there have been possible links to improvement in polycystic ovarian syndrome (PCOS), fatty liver disease, Alzheimer’s disease, heart failure, and even cancer, though none of these diseases have been fully authorized for treatment with GLP-1s by the FDA (e.g. off-label indications).
Safety Concerns
So far, GLP-1s sound great, but as with all things (for example, you can drown yourself by drinking too much water), there are some concerns with GLP-1s. The chief concern is the increased risk of thyroid cancer with chronic use. In mice, long-term use of GLP-1 agonists stimulates calcitonin secretion, leading to C-cell hypertrophy and increased risk of thyroid cancer. This was corroborated in a French study of 2,562 patients that found an increase of diagnosed thyroid cancer after 1-3 years of GLP-1 use. The 58% increased risk from GLP-1 use was statistically significant. Interestingly, repeat studies have not been able to repeat these findings, so the risk may not be as great as originally thought.
The next most common concern is with effects on the pancreas, which can be fatal. Though initial trials found no link to pancreatitis or pancreatic cancer with GLP-1s, post-market reports after the drug released may be establishing a link. Accordingly, the American Association of Clinical Endocrinologists have stated those with a history of pancreatitis or develop pancreatic complications should not receive any GLP-1. Furthermore, a 2025 study has found an increased risk of pancreatitis, kidney inflammation and stones, dangerously low blood pressure, and joint disease.
Scam Potential
Along with biological concerns, the GLP-1 market has been ripe for fraud. In my local area, a family physician is facing jail time for compounding adulterated (e.g. impure) GLP-1s to patients. When GLP-1s went on national shortage in 2023, Boards of Pharmacy in many states had to issue warning letters to pharmacies that were using GLP-1 products meant for experimental or animal use. Obviously, there is a lot of inherent risk in using an injectable product not meant for human use.
Non-medical companies have even taken this opportunity to grow their profits. I’m sure everyone has seen TV ads for companies offering GLP-1 products without needing to see a physician. My advice is to use these services with much scrutiny. Many, if not all, of these services compound medications with NO FDA oversight. Thus, the GLP-1 you receive has not gone through the same rigorous quality control and safety checks required by the FDA. The product you receive could be fraudulent, underpowered, or possibly even dangerous. In fact, the FDA is sending letters to many of the pharmacies of these online services to cease operations due to safety concerns.
As an example, I had a patient in my clinic who ordered one of these products from an online service. She was nice enough to bring it in for me to examine it to see if it would interact with any of her other medications. However, upon reviewing the packaging, there was not a single GLP-1 derivative in the ingredient list. It was instead filled with herbal products and some preservatives I could not pronounce. I sadly had to inform her that she was scammed and that she probably shouldn’t take it as some of the herbs in it are known to possibly interact with common prescription medications. If you buy any medical supplement or product online, please consult with your pharmacy or physician.
Who Should Use GLP-1s?
As stated earlier, GLP-1s are helpful for a few specific groups of people. Anyone with diabetes and obesity would certainly benefit from a GLP-1. Likewise, non-diabetic patients who have been unable to lose weight with diet and exercise alone should consider the possibility of using a GLP-1. That being said, it should be used as a last resort after an optimized exercise and diet plan given the proven and possibly fatal risks of GLP-1s. However, it is important to always consult with your doctor, regardless of where you get your GLP-1 from.
Faith, Food and Pharmacy 