Scroll through your social media, turn on your TV or tune in your radio and you’ll likely be inundated with messages about how you too can lose weight with new GLP-1 medications. And like many people, you’re probably left with many questions. So let’s dive in!
What is GLP-1 and How Does it Work?
GLP-1 (glucagon-like peptide-1) is a hormone that plays a key role in glucose metabolism and appetite regulation. It is released by cells in the small intestine (known as L cells) in response to food intake, especially after consuming carbohydrates and fats. Here’s how GLP-1 works in the body:
1. Stimulates Insulin Secretion:
- Enhances glucose-dependent insulin release: GLP-1 stimulates the pancreas to release more insulin, but only when blood sugar levels are high. This makes it a glucose-dependent process, meaning it doesn’t cause hypoglycemia (low blood sugar).
- Insulin helps cells absorb glucose from the bloodstream, reducing blood sugar levels.
2. Suppresses Glucagon Secretion:
- GLP-1 inhibits the release of glucagon, another hormone produced by the pancreas. Normally, glucagon increases blood sugar by stimulating the liver to release stored glucose. By reducing glucagon, GLP-1 prevents the liver from releasing more glucose into the bloodstream, helping to keep blood sugar levels under control.
3. Delays Gastric Emptying:
- GLP-1 slows down the rate at which food leaves the stomach and enters the intestines. This leads to a prolonged feeling of fullness (satiety), reduces post-meal spikes in blood sugar, and helps with appetite control.
4. Reduces Appetite and Promotes Satiety:
- In the brain, GLP-1 acts on areas that regulate appetite and hunger. It promotes the feeling of fullness, which leads to a reduction in food intake. This appetite-suppressing effect makes GLP-1 a valuable target for weight loss therapies.
5. Cardioprotective Effects:
- GLP-1 has shown beneficial effects on the cardiovascular system, including improving endothelial function, reducing inflammation, and possibly lowering blood pressure. This is why GLP-1 receptor agonists (GLP-1 medications) are sometimes used in people with type 2 diabetes and cardiovascular risk.
Summary of GLP-1 Effects:
- Increases insulin release (in response to high glucose)
- Decreases glucagon release (prevents unnecessary glucose production)
- Slows gastric emptying (promotes satiety)
- Reduces appetite (helps with weight loss)
- Improves cardiovascular health
This combination of effects makes GLP-1 a powerful hormone for controlling blood sugar levels, reducing body weight, and potentially improving heart health.
Can Bariatric Surgery Increase Your Body’s Natural GLP-1?
Yes, bariatric surgery can boost your body’s production of GLP-1 (glucagon-like peptide-1), a hormone that plays a key role in regulating blood sugar and appetite. After certain types of bariatric surgery, especially Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy, levels of GLP-1 tend to increase significantly. This rise in GLP-1 is thought to contribute to the weight loss and improved blood sugar control seen after surgery.
How Bariatric Surgery Increases GLP-1:
- Anatomical changes: Bariatric surgeries alter the digestive tract, speeding up the passage of food to the intestines. This rapid delivery stimulates the intestines to release more GLP-1.
- Altered gut hormone signaling: Surgery can change how the gut communicates with the brain and other organs, leading to enhanced hormone regulation, including GLP-1.
GLP-1 Medications vs. Bariatric Surgery:
- GLP-1 medications (like semaglutide or tirzepatide) mimic the effects of the natural hormone. They help with weight loss and blood sugar control by enhancing insulin secretion, reducing appetite, and slowing gastric emptying. These medications can be effective, but their benefits are typically dependent on continued use.
- Bariatric surgery not only increases GLP-1 levels but also has a range of other metabolic effects, including improvements in insulin sensitivity and changes in other gut hormones like peptide YY (PYY) and ghrelin, which further aid in weight loss and metabolic health. Surgery may provide more sustained and durable weight loss compared to medications, but it is an invasive option with potential risks and complications.
Is Surgery Better?
- Long-term effects: Bariatric surgery often results in greater and more sustained weight loss than medications alone. The improvement in GLP-1 production is one of several mechanisms that contribute to this effect.
- Safety: Surgery carries risks like infection, nutrient deficiencies, and digestive issues. GLP-1 medications, while generally safe, can also have side effects such as nausea, vomiting, and gastrointestinal discomfort.
Ultimately, the choice between surgery and GLP-1 medication depends on the individual’s health, weight loss goals, and tolerance for surgery or long-term medication use. Many people might benefit from both interventions together, either as complementary or sequential therapies. It’s important to consult with a qualified physician to determine the best treatment. If you’re struggling with weight loss, at Weight Loss Specialists of North Texas, we’re here to help. No blame. No shame. Just compassionate care that gets results.
