GLP-1 medications are fascinating medications that add stabilised Glucagon-Like Peptide-1 Receptor Agonists into your bloodstream, which activate the GLP-1 receptors. This medication is used primarily for weight control and diabetes support, via three mechanisms: 1, balancing blood sugar; 2, supplying the feeling of satiation; and 3, modifying some neurotransmitters which improves brain function. The medication can only help these 3 features if there is a problem with them – trying to stabilise something that is stable doesn’t do anything.

Metabolism: Weight, Diabetes and Satiation

For the last 50 years, it has been well understood by weight scientists that managing weight is a complex balance of nutrition, activity and metabolism. Unfortunately, this has often been misconstrued to only reducing caloric intake and increasing activity (exercise) by medical doctors and so called ‘weight loss experts’, where metabolism and nutrition has been ignored.

Weight

While reduced food (caloric) intake and increased activity works for a few, it mostly fails. By failure, I mean that around 3% of people are able to lose a reasonable amount of weight and keep it off for more than 2 years without approximately returning to their prior weight – that’s 97% failure. The failure isn’t you though, it is with using this overly simplistic model to reduce weight.

Most people who use dieting and exercise find that any losses in weight from this activity will come back soon after 3 months.

• Metabolism is how your body manages nutrition resources to provide health and energy.
• Part of metabolism is how the food you consume is incorporated into your body, part of it is the energy that is released to enable action, and part of it is how your body keeps your stored energy aka weight, balanced.
• Nutrition is about ensuring that the basic building blocks you need to grow and repair your body are consumed – too many diets compromise nutrition, or focus only on sugars and protein – macro rather than micro nutrients.

See Nutrition, Health in Body and Mind and Weight Loss, Facts and Fiction for more .

• Excess weight is a risk factor for many diseases, but often not a cause for them. It is possible to be overweight, fit and healthy.
• A proper diet is easy to maintain – unless you have the satiation problem (see below).
• Metabolism is a big factor in how your body uses resources. Allergies, intolerances, your digestive tract, your immune system and your level of inflammation are all factors that can affect this. Especially recovery mode.

Sugar, Fat and Diabetes

• Glucose is a simple kind of sugar that is a vital component to your bloodstream.
• Fat is a backup version of energy and a base for making a number of hormones such as Testosterone and Oestrogen / Oestradiol.
• Diabetes is a range of health condition that can affect the ability to regulate sugar and fat.

Many carbohydrates (carbon, hydrogen and oxygen) molecules are converted into glucose for easy assimilation. Common examples of these are regular cane sugar, fructose and lactose. Approximately 4-7 grams of glucose need to be in your 6 Litres of blood for your BSL to read between 4 and 5.4 mmol/L (fasting non-diabetes safe range) or up to 7.8 mmol/L (2 hours after eating) [Source 1, Source 2]. Glucose is used by every cell in your body as part of the process of making ATP, the basic fuel your cells use via mitochondria (it is likely a battery that can be recharged via glucose). The cost of insufficient blood sugar is dire, as your cells cannot function, leading first to coma then to death. The cost of high blood sugar is also bad over a long term, as it can lead to long term health issues such as vascular damage and loss of extremities such as fingers, toes and your retina.

Diabetes is a medical condition where your body struggles to correctly balance the blood sugar level. Generally, the problem with diabetes is that your blood glucose cannot be properly regulated to be within optimal levels. If the glucose is too low, your cells cannot make ATP, which is used for all cellular energy actions – which is most of what your body does. If the glucose is too high, it can cause damage to your fine blood vessels, which can lead to damage to peripheral body parts such as fingers, toes and your retina (sight), and has been linked to some forms of Alzheimer’s Disease. There are a 2 major types of diabetes, and several other types (see the Diabetes Page).

Excess glucose can be excreted, or it can be converted into glycogen and stored temporarily in certain organs or fat cells. Our body uses a hormone called insulin to trigger our cells to allow glucose in for ATP production, effectively burning the glucose to make energy. The consequences of this is a reduction is blood sugar / glucose level (BSL). Insulin also triggers our liver and muscles to store excess glucose as glycogen, and for your liver to slow down the conversion of glycogen to glucose. Excess blood glucose can also be absorbed by fat cells and converted to triglycerides for long term storage in our fat cells, which increasing the size of those fat cells, leading to forms of obesity.

GLP-1 Medication can help manage the diabetes side of things by changing how the GLP-1 receptors are signalling the sugar management system in our body.

Food Moral & Comfort Eating Myth: Dopamine Chasing

Diabetes is not the only reason why blood sugar can be high. When we feel brain fog, mood spikes, or discomfort, we can feel drawn to comfort eat. For example, this is very common for ADHDers or people with some form of chronic fatigue. Neurons are a kind of cell, so they also use blood sugar / glucose to form ATP to make energy for cellular processes – in this case, thinking, feeling and triggering body actions. Our brain can feel foggy or moody, that is not working properly, when it runs low on glucose. Our brain isn’t very good at knowing directly why it isn’t able to think or feel properly, so it will trigger the Dopamine Chasing food choices – aka comfort eating and binge eating.

Dopamine Chasing – foods, high in:

• Carbohydrates (sugars)
• Protein (tyrosine, the base building block for the Dopaminergic System)
• Salt (for axon signalling)
• Saturated fat (make oestradiol to upregulate the production of the Dopaminergic System)

When we do not have a strong drive to eat, the choice to eat or not eat is easy. When your eating mechanism is misfiring and you feel constant hunger urge to eat, or a constant need to eat to manage mood and cognition, then choosing not to eat is very hard, and may be impossible. In the situation where you feel constant hunger, the longer that you don’t eat, the greater the feeling that you need to eat. In the situation where you are using food to regulate mood and cognition, then choosing not to eat is choosing to be regulated, which often leads to worse problems in the moment than eating. Hopefully you can see that in these situations, morals around eating are irrelevant to the biological drive.

Comfort eating is where you eat to feel better. As referenced in the paragraph above, we often eat to self regulate, which is an attempt to use part of our biology to offset another part of our biology. That is, comfort eating is an attempt to regulate a biological disruption, by using yet another biological system. Comfort eating means that something is wrong and needs to be addressed. We often don’t have the option to directly address why we feel that we need to comfort eat in the moment. That is, something we need to address when we have support from health professionals, and we aren’t in crisis.

Over Eating Myth-conceptions

• Over Eating isn’t a moral problem, it’s a biological problem.
• Comfort Eating means something is wrong, often biological, sometimes situational – it is not just poor will power.

We also have GLP-1 receptors in our brain, which we think helps manage Dopamine Chasing.

Hunger and Satiation

Our body uses chemicals to do actions, create your body, heal from damage, and so on. Due to the nature of the Second Law of Thermodynamics, any conversion of chemicals will always lose energy. We must supply new chemicals and energy to our body to continue living. To get those new chemicals, we breath, drink and eat.

Second Law of Thermodynamics

“The total entropy (disorder) of an isolated system must always increase over time during any spontaneous process”

That is, every change loses energy. To maintain energy, more energy sources need to be added.

Breathing is about bringing oxygen in (to burn fuel to create useable energy), and carbon dioxide & water out (excreting the burnt fuel ash).

Eating and drinking is what we use to add the majority of all other chemical ingredients. We need sufficient quantity and quality of source chemicals, aka food. We store certain amounts of most chemicals in our body, but once that is depleted, we become unfit very fast – this is called burnout.

• Hunger: The feeling that insufficient food has been consumed, such that our body anticipates it will run low on available ingredients soon.
• Satiation: Satiety is the feeling of satisfaction (satiation) you should have after a filling AND nutritious meal.

Many people who have weight control issues do not feel satisfied after eating a healthy meal, or remain satiated for long when they do find something that seems good, leading to an urge to eat again.

GLP-1 RA Nerdy Knowledge

There are lots of cool nerdy things about GLP-1 RA Medications on our dedicated page.

GLP-1 & Wound Healing

GLP-1 RA medication can reduce certain types of healing in some people [source].

As of the date of writing (28 August 2026), a common wisdom is to cease taking GLP-1 medication a week prior to an operation (if possible), and resume a week after healing has completed.

Stopping the GLP-1 medication isn’t going to cause most people any major issues. That is, other than a return of hunger / food craving, and some destabilisation of blood sugar (for diabetics), there won’t be a major crash or issue for stopping.

• If you have diabetes, check with your diabetic specialist what you need to do around this.
• If you are using GLP-1 medication for food management, use some conscious control strategies for how you will manage food for the next while until you can resume GLP-1 medication.

References

Haney, M. (2021, February 18). What is Glucose? Levels. https://www.levels.com/blog/what-is-glucose

British Heart Foundation . (2022). Why Should I Know My Blood Sugar levels? Www.Bhf.Org.Uk. https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/tests/blood-sugar

Darwish, R., Abu-Sharia, G., & Butler, A. E. (2025). History of glucagon-like peptide-1 receptor agonists. Pharmacological Research, 108045. https://doi.org/10.1016/j.phrs.2025.108045

Wikipedia Contributors. (2019, August 3). Glucagon-like peptide-1. Wikipedia; Wikimedia Foundation. https://en.wikipedia.org/wiki/Glucagon-like_peptide-1

Wikipedia Contributors. (2019). Amino acid. In Wikipedia. Wikimedia Foundation. https://en.wikipedia.org/wiki/Amino_acid

Wikipedia Contributors. (2019). Glucagon. In Wikipedia. Wikimedia Foundation. https://en.wikipedia.org/wiki/Glucagon

Wikipedia Contributors. (2023) GLP-1 receptor agonist. Wikimedia Foundation. https://en.wikipedia.org/wiki/GLP-1_receptor_agonist

Collins, L., & Costello, R. A. (2024). Glucagon-like peptide-1 receptor agonists. In PubMed. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551568/

Story of discovery: how different medications for diabetes and obesity emerged from basic research on one pancreatic hormone – NIDDK. (2021). In National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/news/archive/2021/story-discovery-medications-diabetes-obesity-emerged-research-pancreatic-hormone

Wilcox, G. (2005). Insulin and Insulin Resistance. Clinical Biochemist Reviews, 26(2), 19–39. https://pmc.ncbi.nlm.nih.gov/articles/PMC1204764/

Hui, H., Farilla, L., Merkel, P., & Perfetti, R. (2002). The short half-life of glucagon-like peptide-1 in plasma does not reflect its long-lasting beneficial effects. European Journal of Endocrinology, 863–869. https://doi.org/10.1530/eje.0.1460863

American Society of Plastic Surgeons. (2026, March 25). Weight Loss Medications May Affect Some Complications After Panniculectomy. American Society of Plastic Surgeons. https://www.plasticsurgery.org/news/press-releases/weight-loss-medications-may-affect-some-complications-after-panniculectomy