GLP-1 Medications: Your Questions Answered
Written by Larissa Ens, RD, CDE
Back in 2018, I worked as a clinical research coordinator on the STEP 1 trial, one of the first studies exploring semaglutide (now marketed as Wegovy in Canada) for weight loss. Since then, my practice has shifted significantly as I now support clients in healing their relationship with food through a weight inclusive lens, but I continue to work with people taking GLP-1 medications (glucagon-like peptide-1 receptor agonists) for blood sugar management and a variety of other health concerns.
Over the past few years, public conversation around GLP-1 medications has grown rapidly. What I've noticed most is how polarized these conversations have become. Some describe these medications as "miracle drugs," while others portray them as inherently dangerous or harmful.
In reality, the picture is much more nuanced. Like any medication, GLP-1s come with both potential benefits and potential risks. My goal is to offer a balanced perspective that acknowledges this complexity and helps people make informed decisions based on their own health, values, and circumstances.
What are GLP-1s, and how do they work?
GLP-1 medications were originally developed to help manage blood sugar levels in people with type 2 diabetes. During early clinical trials, researchers noticed that many participants also experienced weight loss, leading to further research into their use for chronic weight management. The main GLP-1 medications currently available in Canada include Ozempic and Wegovy (semaglutide) as well as Mounjaro and Zepbound (tirzepatide).
GLP-1 itself is a hormone naturally produced by the small intestine after eating, particularly after consuming carbohydrates. It communicates with several parts of the body:
It stimulates the pancreas to release insulin, helping move glucose from the bloodstream into tissues like the muscles and brain for energy.
It slows stomach emptying, resulting in a slower release of glucose into the bloodstream and helping stabilize blood sugar levels.
It signals the brain's appetite centres, increasing feelings of fullness and reducing the amount of food needed to feel satisfied.
More recent research also suggests GLP-1 may have anti-inflammatory effects, which has expanded research into its potential use for other medical conditions.
Whether prescribed for diabetes or weight management, GLP-1 medications are generally intended as long-term treatments. Their effects on blood sugar and body weight typically diminish if the medication is discontinued.
Can GLP-1s impact your relationship with food?
Although research has not specifically examined how GLP-1 medications affect a person's relationship with food, there are several patterns I commonly see in clinical practice.
Many people report experiencing less "food noise," meaning food occupies less mental space throughout the day. For some, this can feel freeing and reduce the emotional energy spent thinking about food.
Others notice changes in taste or food preferences. While not commonly discussed, some people develop aversions to foods they previously enjoyed, with meat and coffee being two of the most common examples I see in practice.
Some people also notice food feels less pleasurable. Because GLP-1 receptors are found in areas of the brain involved in reward and pleasure, eating may become less emotionally satisfying. Depending on the individual, this may feel relieving, unusual, or even distressing—especially if food has been an important source of comfort, culture, or connection.
Side effects can also shape food experiences. Around 85% of people report some gastrointestinal symptoms, including nausea, vomiting, diarrhea, constipation, or indigestion. Certain foods may worsen these symptoms, creating negative associations with eating.
Finally, people who discontinue GLP-1 medications—particularly if they stop abruptly—often describe a significant increase in appetite and cravings. Many tell me these hunger cues feel stronger than anything they experienced before starting the medication. This is an area that deserves much more research and discussion.
Together, these changes can influence not only what and how much you eat, but also how you think about food and how connected you feel to your body's needs.
Are there nutritional risks associated with taking GLP-1s?
The effects of GLP-1 medications on appetite vary considerably from person to person. While many experience reduced appetite, others notice very little change—or even increased hunger.
Regardless of appetite changes, it's important to continue meeting your body's nutritional needs. Not eating enough can lead to fatigue, low energy, loss of muscle mass, and over time, decreased bone density.
Adequate nourishment means eating regularly, eating enough to meet your body's needs, and including a variety of foods. To help prevent the risks associated with undernourishment, it is important to eat regularly, include a wide variety of foods, and ensure that you are getting enough macro and micronutrients to meet your body's needs. Being mindful of changes to your relationship with food may also be protective. If you notice persistent food aversions, increasing difficulty eating regularly, negative associations with food, disconnection from hunger and fullness cues, or increasing preoccupation with body size, it's worth discussing these changes with your healthcare provider.
It's also helpful to pay attention to changes in your relationship with food. If you notice persistent food aversions, increasing difficulty eating regularly, negative associations with food, disconnection from hunger and fullness cues, or increasing preoccupation with body size, it's worth discussing these changes with your healthcare provider.
Can I stay connected to my body while taking a GLP-1?
Yes—but it may require more intentional attention.
For some people, the reduction in food thoughts becomes so significant that they begin feeling disconnected from eating altogether. Others find that clearer fullness cues actually help them become more attuned to their body's signals.
One helpful strategy is to regularly check in with your body throughout the day. Notice how hunger feels for you now, how fullness develops, and whether you're eating consistently enough to maintain your energy and wellbeing.
If hunger cues become difficult to recognize, other body signals—such as mood, concentration, fatigue, or energy levels—can provide valuable information about whether you're getting enough nourishment.
If appetite suppression becomes so strong that you frequently forget to eat or rarely experience hunger, it may indicate that your medication dose is too high and should be discussed with your prescribing provider.
What if I have a history of an eating disorder or GI concerns?
These are the two groups I tend to approach with the greatest caution.
Eating Disorders
Large clinical trials of GLP-1 medications excluded people with diagnosed eating disorders, meaning we have very limited research on how these medications affect this population.
For individuals with a history of restrictive eating or other eating disorders, appetite suppression or changes in body size may reinforce disordered thoughts or behaviours. The medication can unintentionally strengthen beliefs that eating less is always better or increase rigidity around food choices.
Anyone with a current or past eating disorder should have thoughtful conversations with their healthcare team before starting a GLP-1 medication and should be monitored closely throughout treatment.
Gastrointestinal Conditions
Because GLP-1 medications intentionally slow digestion, people with existing digestive conditions—including irritable bowel syndrome, inflammatory bowel disease, or chronic gastrointestinal symptoms—may experience more pronounced side effects.
Reduced appetite combined with digestive challenges may also increase the risk of inadequate nutrition or nutrient deficiencies, making ongoing monitoring especially important.
Can I still work on my food relationship if I am taking a GLP-1?
Working on your relationship with food doesn't stop because you're taking a GLP-1. In most cases, it's even more important to explore how your eating patterns, body cues, and beliefs around food may be changing.
As a dietitian, I've seen tremendous value in supporting people taking GLP-1 medications. Dietitians can help you:
Navigate gastrointestinal side effects.
Meet your nutritional needs despite reduced appetite.
Protect muscle mass and bone health.
Adapt to changes in hunger, fullness, and food preferences.
Process changes in your relationship with food and your body.
Prepare for potential appetite changes if the medication is discontinued.
Ultimately, the goal is continuing to nourish your body in a way that supports both your physical health and your relationship with food.
A Balanced Perspective
Given the amount of media attention surrounding GLP-1 medications, it's understandable that people have questions. There are many valid reasons someone may choose to take—or not take—these medications, and that decision deserves to be made through informed consent rather than fear or hype.
Like all medications, GLP-1s have potential benefits, limitations, and risks. Understanding those nuances allows people to make decisions that align with their own health goals and circumstances.
It's also important to remember that food is about much more than nutrition. Food is joy, culture, community, comfort, and connection. Those aspects of eating deserve just as much care and attention as the physical effects of any medication.
If you're currently taking a GLP-1 medication, considering one, or simply looking to better understand your relationship with food and your body, we'd be happy to support you.
