#137 - Our Honest Opinions About GLP-1s

GLP-1 medications have gone from a diabetes drug to a cultural force, and the hype can make it feel like weight loss finally has a “one and done” answer. We slow the conversation down and ask a tougher question: are Ozempic, Wegovy, Mounjaro, and Zepbound being used as a smart medical tool, or as a substitute for changing the habits that created the problem in the first place?

We walk through what GLP-1 receptor agonists actually do in the body so the benefits make sense: glucose-dependent insulin support, glucagon suppression, slower gastric emptying, and appetite signals in the brain that can quiet cravings and reduce food noise. Then we talk about the tradeoffs people do not always hear clearly, including common side effects and the long-term concern that a meaningful slice of weight loss can come from lean mass, not just fat. If muscle and bone density drop, your metabolism, mobility, and resilience can suffer, especially as you age.

We also get practical about what “taking ownership of your health” looks like when you are on a GLP-1. That means using early momentum to build a sustainable plan: better food choices, more protein and fiber for fullness, and resistance training to protect lean body mass. If you want real, lasting weight management and better metabolic health, the scale is only part of the story.

Subscribe to Frontline Health Podcast, share this with someone considering a GLP-1, and leave a review with your biggest question about GLP-1 weight loss, side effects, or keeping results long term.

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Transcript

Are GLP-1s Being Overused?

SPEAKER_00 0:00

Today on the Frontline Health Podcast. So do you think uh the GLP ones are being prescribed appropriately or are things starting to get a little loose?

SPEAKER_01 0:11

Uh super loaded question. I think it is truly a little bit of both. There is certainly an issue with obesity in our society. And I think that it can be used as a tool in the toolbox, but using that alone when you're trying to deal with weight loss is an issue. And I think there are a lot of people who are doing that. But that's not uncommon. I mean, it's not just GLP1s we do that with. We do that with everything that we take in medicine. We we tend to think, okay, I've got a cholesterol medicine, I don't need to watch what I eat anymore. I've got a blood pressure medicine, I don't need to watch what I take from a salt intake or anything else, and I don't need to exercise because I've got these medications. I don't think GLP1s are any different, and it's our psyche that really needs to change about why we're taking these drugs to begin with, and what can we do to help improve the outcome on them?

SPEAKER_00 1:06

Hello, welcome back to another episode of the Frontline Health Podcast. I'm Evan Patrick, and with me is Troy Duell, founder and CEO of Centurion Health. Over the past few years, it's become almost impossible to ignore the conversation around GLP1 medications. Drugs like Ozempic, Weigovi, Manjaro, what started as a treatment for type 2 diabetes has quickly turned into one of the biggest trends in modern healthcare. And honestly, one of the most talked-about topics in culture right now.

SPEAKER_01 1:38

There is no doubt about that. And just to kind of give a sense of how big it's come, about one in eight adults in the U.S. are now using some form of GLP1. And that's whether they're using it for weight loss or diabetes or some other condition. And it has more than doubled in the last year. So this is becoming a huge product. And I know that uh here in the state of Alabama, I believe it's uh Eli Lilly has come in and purchased a plant, and they're going to be putting in five billion dollars just in that plant alone, which gives you an understanding. If they're investing five billion dollars, they're expecting that product, which is a new peptide that's not on the market yet, to be a multi, multi-billion dollar product for years to come. So we know that uh just from 2018 to 2023, spending increased by over 500% on these peptides. So it was around 13 billion in 2018 and it's bumped up to 70 billion dollars annually in 2023. And this has especially uh seen greater increase amongst those who are doing it without diabetes because each of these products came out of uh initially for a diabetes indication, but now you're seeing a 20-fold increase in off-label use for weight loss, which is huge and something that I think is here to stay, and something we need to talk about because more and more people are using it for sure.

Obesity Reality And Honest Intent

SPEAKER_00 3:12

Yeah, absolutely. And I do think it's important, you know, as as we kind of start this conversation, um, just to point out the facts, like the reason that this is so big is because people are struggling with obesity. They're struggling with their weight, they have a real problem, and maybe they've tried to address it in a variety of ways in times past through changing lifestyle or diet or habits, whatever, whatever the case may be. And people have had a battle with it. Um, and so maybe we can talk about just kind of some of the, you know, the the positives, the negatives, the dangers, all that kind of stuff. But at the heart of it, understand we want to be able to help people to think about this for ultimately the the best, um, to be able to make the best decisions for their health possible. And we're not not bashing anyone. I know people who are on this stuff. Um, you know, my my wife practices medicine and she has people come in every single day and they think this is the only way that they're gonna be able to fix their health problems. It's not even a thought to them to try to to try to do anything else than um one of these GLP ones to address a major part of their lifestyle. So you're right, this is just so huge, and um we want to we want to be able to share kind of the honest truth around it and some things that maybe people are not as aware of, um, and not just the the pluses.

SPEAKER_01 4:28

Absolutely. And I I think you really can't go anywhere these days without hearing someone talk about one of these GLP ones and somebody that they know who's on it and the weight that they've lost or somebody that they've seen lose weight on it. And I'm sure the fact that several celebrities have done it and they've had such great results certainly helps compound that fact. I guess it was uh who's the the country singer who lost basically 400 pounds? Jelly roll. Um yeah, jelly roll. He's no longer a roll uh or roll full of jelly. He he took his GLP one and he he lost a lot of weight.

SPEAKER_00 5:04

So no, I thought so I thought jelly roll actually did it without the GLP ones.

SPEAKER_01 5:11

You may be right, you may be right. Um, but I I find it hard to believe. Um that that quickly, I think I think there was probably some help with some of that, but we'll we'll see. Um, and you know, really these GLP ones, when you're talking about obesity and people who have been fighting this forever, it is truly a breakthrough. And I think it is a great thing, but there is that other side that you talked about. There are some real side effects that come along with it, and we've got to be careful of them, we've got to be mindful of them. And I think to truly take ownership of our health is not just to no longer be obese, but it's no longer be obese and understand what you're getting into when you take these GLP ones. And hopefully that's what we're here to talk about because we know some of the most common issues are like nausea, vomiting, constipation, fatigue, all those things that are there. I think if you hear any commercial, you hear that on just about every ad that has a medicine with it, and GLP ones are no different. So just because they're having a great and great results and they're having a good um uh profile of what people are wanting, the benefits, there are some side effects to it, and we need to we need to be sure that we understand those. But then we also need to understand that we can't just rely on drugs to really change the root of whatever's going on in us. So we've got to get to the root of the issue and try to get around just this management of symptoms of sorts and really get down to the nitty-gritty of how can we help use this as a tool, but not be so reliant on it that uh we lose the ability to affect what's really going on, the underlying cause of our obesity or or health issues.

SPEAKER_00 7:06

Yeah, and so probably for most people the main thing that they know about GLP1s is that they're gonna help them lose weight. I think it's really important with any drug, but especially something like this that so many people are jumping on, is to understand how does it actually work? What is so can you answer us that question? What do GLP1s actually do in the body?

SPEAKER_01 7:27

Yeah, so there are really four main things that GLP1s do. First, they raise insulin secretion in a glucose-dependent way. So, what does that mean? Basically, it's gonna help lower your blood sugar after meals, which is why initially it was used just to help people with diabetes. We also know that it's gonna suppress glucagon, which helps prevent the liver from releasing too much glucose. So, again, it's all on the blood sugar side of things and the diabetes. And then this third piece is really where it comes in for the weight management, where it starts. It slows that gastric emptying, which means it's gonna be held in the stomach much longer, which is gonna reduce that post-meal glucose spike that most people get, and it's gonna make you feel full longer. And then the fourth thing is it works on the brain to kind of reduce your appetite and really increase that feeling of I'm full, I don't need to eat anything else. So those are the four things that it really does to help people, uh, especially when it comes to the weight loss and the diabetic side.

SPEAKER_00 8:34

Yeah, so you you kind of already meant already answered this partially, but why are they so effective for weight loss specifically?

SPEAKER_01 8:42

Yeah, I mean, I I think we just mentioned the three main reasons. So one is that appetite suppression in the brain, including those cravings and that food noise that we get of, hey, I need to eat, I'm hungry, let me let me go get that. Well, it it does a super effective job of just quieting that noise. The second is that gastric emptying. So you not only have that mental piece of, hey, I'm full, I don't need, I don't need this, but you also have that stomach where your your stomach feels full and you've got the physical feeling. So you feel full longer, and then you get that better blood sugar control. So then the cravings don't come in uh at the end, and it reduces kind of those energy swings that we all have that kind of drives that that eating and hunger feeling that we need to do.

Why Weight Loss Feels Easier

SPEAKER_00 9:31

Yeah, that is so interesting. Um, I want to ask you a question where we kind of get to to the good stuff uh a little bit and get kind of your honest opinions on how this is being used. So I think it would be helpful if you you know said to the camera that you're happy with your life, you're very, very fulfilled. Uh that's right.

SPEAKER_01 9:49

I I don't have any tendencies to uh let go of my life at this point.

SPEAKER_00 9:54

So do you think uh the GLP ones are being prescribed appropriately, or are things starting to get a little loose?

Tool Versus Crutch Mindset

SPEAKER_01 10:02

Uh super loaded question, and I I see why you um laid it out the way you did about me not having any suicidal tendencies, but I I think it is truly a little bit of both. There is certainly an issue with obesity in our society, and I think that it can be used as a tool in the toolbox, but using that alone when you're trying to deal with weight loss is an issue. And I think there are a lot of people who are doing that, but that's not uncommon. I mean, it's not just GLP1s we do that with, we do that with everything that we take in medicine. We we tend to think, okay, I've got a cholesterol medicine, I don't need to watch what I eat anymore. I've got a blood pressure medicine, I don't need to watch what I take from a salt intake or anything else, and I don't need to exercise because I've got these medications. I don't think GLP1s are any different, and it's our psyche that really needs to change about why we're taking these drugs to begin with, and what can we do to help improve the outcome on them on those?

SPEAKER_00 11:05

So you would say that GLP1s do have a place in medicine today?

SPEAKER_01 11:09

Yeah, absolutely. I I think uh they certainly have their place, but you really need to couple it with those other healthy decisions like eating better. So change your diet, start exercising, using as a using it as a catalyst, if you will, to kind of help people in losing weight until they make the necessary changes to maintain those losses and get them over the hump. Because I think a lot of times there's that mental pressure that we go through. Oh my gosh, I've been on this diet for two weeks and I've been exercising for two weeks and I've only lost half a pound. Well, in this case, if you get on a GLP one and you're doing those things, you'll get the positive reinforcement of what you're doing, and then you can maintain that loss without the uh detrimental issues of just dropping off of a product because we know that the weight will come back if you're not changing the habits that you've built.

SPEAKER_00 12:05

No, yeah, that's huge. And and just to touch on that for a second, do you have any statistics off the top of your head of people, you know, putting the weight back on? I know we might have mentioned some before, but it's like a crazy high percentage of people who once they get off of them, they they put the weight right back on, right?

SPEAKER_01 12:21

I yeah, I mean, it it is definitely happening. I don't know that anybody's looked to see exactly the amount because what what we're finding is people are no longer using it as just a tool, they're using it as the tool, and they're not getting off of it, which has other long-term effects with that. So I I'm not familiar with the exact percentage of what that is, but I know that it's pretty high.

Protein Fiber And Craving Cycles

SPEAKER_00 12:48

I may be thinking of some things that um that my wife has shared with me that most of the people who, or at least a lot of the people who get on GLP ones, have to be on them basically for the rest of their lives because exactly what you just said, it's just gonna be the same kind of cycle of them for a lot of them of putting the weight um back once they once they get off of them. So they have to have to kind of continue to use it as a crutch. And the the crazy thing, Troy, is really I think to address some of these issues, like it really is it's just a little bit of education on the foods that will help you feel full for longer. Um because I, you know, like for me personally, I I just kind of have a habit of eating a lot of protein and a decent, I should do better on the fiber side, but a decent amount of fiber as well. And I feel full most of the time, you know, unless it's like coming up on on a meal time. And I think maybe if people had a little bit more awareness of if you do if you do that sort of, and I understand everyone's different and there are different things going on with different people's situations, but if you ate higher protein and fiber in your diet, you're probably not gonna be as as full. But if you continue to eat things that don't really fill you up, that have a lot of calories, you can understand why this cycle kind of continues.

SPEAKER_01 14:05

Absolutely. And and we know that the more carbohydrates you eat and the more that you put into your body, the more craving you have for those carbohydrates again. So it's just that vicious cycle that that comes up, and you know there is a reason Eli Lilly's Eli Lilly is willing to put in five billion dollars of an investment because they know that for the most part, people are going to be stuck on this product for the rest of their lives if they don't make the changes. And they've got data to show that people typically are not making those changes. And I think that's one of the things that we're all about is how do we help people make those changes and make better decisions.

SPEAKER_00 14:45

And are they also making some complimentary products to try to address some of the side effects that people will also be put on?

SPEAKER_01 14:52

I I am sure that they are. I don't know specifically of any, um, but it's not uncommon to have that happen for sure. And you may know of one, but I I am not aware of one currently.

SPEAKER_00 15:06

I don't know of one confidently enough to to state that uh on the podcast, but um I have have heard that that's a possibility from from some people, but need to do a little bit more digging on that before I can confidently say that. So no accusations being made here.

SPEAKER_01 15:21

That's right.

SPEAKER_00 15:22

So what what concerns you the most about GLP1s?

SPEAKER_01 15:27

Uh, you know, we touched on one of them. The first thing is kind of the psyche of just taking a pill to get the effects we want instead of really taking uh charge or ownership of our health and looking at ways to change our diet and exercise habits. So I think that is to me one of the biggest things. Because if we can get that under control, then that's a a huge step in the right direction. The second thing is there are some side effects that certainly are concerning, and I don't know that we fully understand how it's going to look long term. So the Ozimpic and Wagovi in studies show that about roughly 15 to 40 percent of the total weight loss that people have comes from lean mass, and that's in their own studies, with the rest coming from fat. The Mongiro and the ZEP bound, roughly about 25% of the weight loss comes from that lean mass, while 75% comes from the clinical trial data. So we know that people aren't just losing fat, they're also losing lean mass, which is something that we need and we need to continue to have because that lean mass helps you burn fat uh even while you're resting.

SPEAKER_00 16:42

Yeah, so that's that's pretty concerning, right? Um so so that's a real thing, right? People losing muscle mass in addition to the fat that they lose with GLP1s.

SPEAKER_01 16:53

Yeah, and it's not just it's not just the muscle mass, you're also losing some density in your bones, you're losing density in um all the other things that are considered lean mass. So the one that we hear most about is really that muscle mass. And you know, it's not uncommon during any type of uh weight loss to have some lean mass loss, whether that's muscle or whatever. But if you lose too much, then it starts to really affect your metabolism, your strength, and really some of the long-term health issues that can cause some chronic disease that we want to be careful of. So our goal with everything is to lose as much fat while protecting the muscle and lean body mass as you possibly can.

SPEAKER_00 17:43

You know, when I was growing up, I feel like um a lot of what I learned in health class and in, you know, PE and stuff like that was that, you know, cardiovascular health and cardiovascular exercise is the best way to protect to protect your longevity. Um, more recently, the conversation conversation kind of seems to be shifting more towards strength training and maintaining a you know a decent amount of muscle mass as you age, um, as really, you know, some people even called muscle the organ of longevity. Um so I'm wondering, and you're even talking about bone density and that kind of thing also. So if someone loses weight with GLP1s, but they're also losing muscle mass, they're losing bone density, what does that mean for their long-term health?

SPEAKER_01 18:26

Yeah, well, if you lose that muscle mass or the lean mass that you have, then we know that it's gonna affect your ability to control glucose on its on your own. It obviously affects your mobility and it's gonna affect your ability to take on different things, your resilience as you age. So if you come under some disease or uh condition, then your body can't recover near as quick when you lose that muscle mass, and it causes you to be much more frail over time. So that's one of the things that we know can happen. Now, hopefully uh we won't see that happen, but if people don't make changes and they just stay on the GLP1s, I'm sure that I'm sure that we'll see it.

How To Keep Results Long Term

SPEAKER_00 19:14

Yeah, thanks for sharing that. And um, you know, kind of getting ready to wrap this up, we want to give our listeners some takeaways. So if someone listening to this podcast is currently taking a GLP1, they're considering all of this, what should they do to really take ownership of their health?

SPEAKER_01 19:32

I think the biggest thing is really embrace the positive sides of taking that GLP1. If you're uh starting to lose weight, embrace that positive momentum, but then implement those strategies that are going to help you sustain it long term. And that would mean changing your diet, changing your exercise, or starting to exercise, and also on top of that, making sure that you're fighting against that lean body mass loss by eating some more protein. And really, part of your exercising should be, like you already talked about, lifting weights and getting into the resistance training more than um just the cardiovascular or just walking.

SPEAKER_00 20:17

Yeah, I think that's great advice for anyone on an on an individual basis who, you know, they're doing this and hope you don't hear us just you know bashing you for doing this, not at all. Um you're you're having conversations with your healthcare provider, you're trying to trying to do what you can to take care of your health, and that's a fantastic thing. So um, so yeah, like you said, Troy, we want to encourage you to you know use that positive momentum and um and try to do what you can to take ownership of your health. Um on a more of a broader basis, Troy, what do you think the long-term consequences of GLP1s will be on health on overall health in America?

SPEAKER_01 20:56

Yeah, I mean, my hope is that it is a net positive, that people really start to begin to enjoy the benefits of being leaner, that it creates a long-term desire to take more ownership of their health and get into better health and really change their diets and exercise activity levels uh based on the positive momentum that they're getting. Because I think that's the key. If we can use it as a catalyst to propel us to better health by making other decisions, then I think this can be a net positive for our culture. But really, that is an individual choice. Every time someone takes something, what are you gonna do besides just take that medication? And hopefully it's adding in other things like diet and exercise to really take you to the next level.

Closing And How To Connect

SPEAKER_00 21:45

Well, this has really been a great conversation, Troy. I have learned a lot about GLP ones, and I know our listeners have as well. Um, so thank you so much for having it. And thank you for everyone listening out there for listening to this episode of the Frontline Health Podcast by Centurion Health. Uh, as always, yeah, we encourage you go out, take ownership of your health because you are your best health advocate. We'll see you next time. If you enjoyed what you heard today on the podcast, please consider subscribing and leaving us a review. We would love to hear your comments or questions about anything we've talked about on the show. For more health news, tips, and insights, follow us at Centurion Health on Instagram, Facebook, X, and YouTube. And for safe, effective, and affordable healthcare products made in the USA to help you elevate your health in life, visit centurion.health. We look forward to you joining us next time on the Frontline Health Podcast by Centurion.