“Dear HER-Health” with Heather Florio: GLP-1 Medications

Dear HER-Health,

Everyone is talking about GLP-1 medications for weight loss—are they safe, and what are the real pros and cons?

Great question—and you’re not alone in wondering. GLP-1 medications (like semaglutide and tirzepatide) were originally developed to help manage blood sugar in type 2 diabetes, but they’ve also been shown to support significant weight loss by reducing appetite, increasing fullness, and helping people feel more in control of cravings.

The Pros

1) Meaningful weight loss for many people.
For some, GLP-1s can be the tool that finally helps weight loss “click,” especially if hormones, insulin resistance, or a history of yo-yo dieting have made progress difficult.

2) Improved metabolic health.
Many people see improvements in blood sugar, cholesterol, and blood pressure—benefits that go beyond the number on the scale.

3) Less “food noise.”
One of the most reported benefits is mental relief: fewer obsessive thoughts about food and less intense cravings.

4) Sexual confidence may improve as weight and inflammation decrease.
For many people, GLP-1–related weight loss can support body confidence, comfort during intimacy, and overall desire—especially if improved energy, sleep, and blood sugar regulation reduce stress and self-consciousness.

The Cons

1) Side effects can be tough.
Nausea, constipation, diarrhea, acid reflux, fatigue, and reduced appetite can all happen—especially when starting or increasing the dose.

2) Muscle loss is a real risk.
When you lose weight quickly—especially without enough protein and strength training—you can lose muscle along with fat, which matters for long-term metabolism, strength, and aging.

3) Weight regain is common after stopping.
Many people regain some (or most) weight once they discontinue, which doesn’t mean “failure”—it means obesity and metabolic dysfunction can be chronic conditions that require long-term support.

4) Cost and insurance barriers.
These medications can be expensive, and coverage varies widely. That adds stress and can limit long-term use.

5) Thyroid considerations: GLP-1 medications carry a warning for people with a personal or family history of medullary thyroid cancer (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), and they may not be recommended in those cases. If you have a thyroid condition such as hypothyroidism or Hashimoto’s, or you’ve had a partial thyroidectomy, it doesn’t automatically mean you can’t use a GLP-1—but it’s important to discuss your surgical history and thyroid labs with your provider. You may need closer monitoring and medication adjustments as weight loss and hormone needs change.

6) Appetite changes can affect libido and arousal for some people.
Because GLP-1s can lower overall appetite and sometimes cause fatigue, nausea, or reduced calorie intake, some people notice a temporary dip in sex drive or vaginal dryness—especially if hydration and nutrition aren’t well supported.

Bottomline

GLP-1s can be incredibly helpful, but they’re not magic and they’re not for everyone. The best results happen when they’re used alongside the basics: protein, hydration, strength training, fiber, and a sustainable routine. If you’re considering one, talk with a qualified medical provider about your health history, goals, side effects, and what a long-term plan would look like.