GLP-1 Receptor Agonists and Other Drugs

GLP-1 receptor agonists are a type of medication that people with type 2 diabetes and those with obesity can use to lower blood sugar levels and manage weight. 

Now one of the most commonly prescribed medications, GLP-1s date back to 2005 with Byetta (exenatide), the first-ever GLP-1 derived from the venom of a Gila monster lizard. Originally designed for people with type 2 diabetes, the impact of the more recent GLP-1s on body weight has made it a popular option for weight management for many people with overweight or obesity.

In recent years, GLP-1 approvals have expanded beyond blood sugar management and weight loss to include other organs, like the heart, kidneys, and liver. If you’re new to GLP-1s, here’s how they work and what to expect.

What are GLP-1s and how do they work?

GLP-1s are a type of incretin-based therapy that works by copying the actions of natural hormones in the body. GLP-1 is a gut hormone that the body naturally releases after eating to help reduce blood sugar levels. 

Just as GLP-1 in the body naturally does, GLP-1 medications work by:

• Stimulating insulin secretion, which allows cells to take up sugar
• Inhibiting the release of glucagon, which helps lower blood sugar levels 
• Slowing stomach emptying, which can help prevent a post-meal sugar spike, as sugar from food is released more slowly into the bloodstream
• Increase how full you feel after eating

Along with blood sugar management, these medications are also beneficial for weight management and reducing the risk of heart and kidney problems. Their effectiveness has revolutionized diabetes care, and brands like Ozempic and Mounjaro have become household names. 

Who are GLP-1 receptor agonists for?

GLP-1 agonists are most often used by people with type 2 diabetes to manage blood sugar levels, but in recent years, they’ve become a top treatment choice for people with overweight or obesity for weight management. GLP-1s are most effective when combined with healthy lifestyle habits, such as eating nutritiously and getting regular exercise. GLP-1s can be taken alone or with other medications, including insulin, metformin, and SGLT-2 inhibitors.

GLP-1s are not currently approved by the FDA for people with type 1 diabetes due to concerns around risks for hypoglycemia and diabetic ketoacidosis (DKA). However, some healthcare providers may prescribe GLP-1s off-label to people with type 1, as research indicates they can improve blood sugar levels, manage weight, reduce the need for insulin, and offer protection for the heart and kidneys. 

Who should not take a GLP-1?

People with a history of pancreatitis or severe stomach or intestinal problems are advised not to take incretin-based therapies like GLP-1s. These drugs are not recommended for people with severe kidney issues or end-stage kidney disease. Some GLP-1 drugs should not be used for people with a personal or family history of certain types of thyroid cancer. Ask your healthcare provider if you fall into one of these groups.

What are the benefits of GLP-1 drugs?

GLP-1s and similar drugs are highly effective at lowering blood sugar and A1C levels. A large meta-analysis of 64 trials with over 25,500 adults with type 2 diabetes showed that GLP-1s were more effective at reducing A1C levels compared to placebo and traditional diabetes drugs. Another meta-analysis including children ages 6-17 with obesity, type 2 diabetes, or prediabetes found that GLP-1s significantly reduced A1C and weight compared to placebo.

GLP-1 therapies like Ozempic have also been shown to lower the risk of heart and kidney disease, leading to additional FDA approvals for heart and kidney protection. Likewise, GLP-1s have shown other wide-reaching benefits, such as improving cholesterol and blood pressure levels, and reducing the risk of stroke. 

Currently, GLP-1s are probably most well-known for their weight loss effects, with studies showing people with overweight and obesity lose an average of 10 pounds or more using them. Although not approved for these conditions, they have also shown promise for addiction and substance use disorders, as well as Alzheimer’s disease and dementia.

What are the drawbacks of GLP-1s?

Most GLP-1s are taken by injection, which can lead to irritation or pain at the injection site. The only current exceptions are Rybelsus, an oral pill for type 2 diabetes, and, recently in 2026, Wegovy – the first oral GLP-1 drug available for weight loss.

Common side effects of GLP-1s are gastrointestinal issues, including nausea, vomiting, diarrhea, dehydration, and constipation. Many people who discontinue treatment with GLP-1s attribute it to side effects, with cost and insurance issues being other reasons. A gradual increase in drug dosage over time has been shown to reduce these side effects. 

Other side effects may include dizziness, headaches, and mild tachycardia (increased heart rate). GLP-1s have also been reported to interfere with birth control. Less common side effects may include fatigue, vertigo, and hair loss.

GLP-1s on their own have a low risk of hypoglycemia. However, hypoglycemia can become a serious risk if GLP-1s are taken with medications that lower blood glucose, such as sulfonylureas or insulin.

GLP-1s can cause significant, rapid weight loss, which often also results in the loss of lean muscle mass. Up to 40% of weight lost on these medications may be muscle, which can weaken the body, slow metabolism, and impair function. This may be especially of concern for older adults and those with sarcopenia (accelerated muscle loss). To maximize muscle health, experts recommend combining GLP-1s with a high-protein diet and regular exercise, including both aerobic activities (like brisk walking, running, or biking) and strength training.

A key point to consider before starting GLP-1s is that they are typically taken for life. Discontinuing often leads to gaining back the weight lost while taking the medication. Though often covered by insurance, newer GLP-1 medications are often much more expensive than other glucose-lowering medications like sulfonylureas, metformin, and thiazolidinediones. For people paying out-of-pocket, patient assistance programs exist for those who meet eligibility criteria.

Commonly used GLP-1 drugs

Here are some of the most common GLP-1 medications used for blood sugar and weight management. Note that the costs, dosages, and approved uses are U.S.-based; many of these drugs are also approved in other countries, but may have different indications and costs.

Foundayo (orforglipron)

Approved uses: Adults with obesity or adults with overweight and at least one weight-related condition.

Lilly has said they plan to submit the drug to the FDA for type 2 diabetes approval sometime in 2026.

Doses: Available in six doses: 0.8 mg, 2.5 mg, 5.5 mg, 9 mg, 14.5 mg, and 17.2 mg.

Drug type: Once daily pill, taken at any time of day, with or without food or water

Cost: Foundayo will be available through the LillyDirect online pharmacy with free home delivery, starting at $25 per month with commercial insurance coverage and $149 for self-pay. Higher doses could cost as much as $349 a month or $299 for those who refill within 45 days.

Ozempic (semaglutide)

Approved uses: Adults with type 2 diabetes, heart disease, and kidney disease

Drug type: Once-weekly injection or once daily pill. (The pill, initially sold under the name Rybelsus, was rebranded as Ozempic in May 2026.)

Doses: The pill starts with a 1.5 mg dose for the first month, then 4 mg for at least a month. If a person needs a higher dose to manage their blood sugar, there is also a 9 mg dose. 

Ozempic pens come in 0.25 mg, 0.5 mg, 1 mg, and 2 mg. When starting, 0.25 mg is taken for the first four doses before increasing to a higher dose. It’s recommended to increase the dose gradually (every four weeks) if additional blood sugar management is needed.

Cost:  With commercial insurance, the Ozempic pill or pen costs between $25 and $100 a month. 

Without insurance, the price can vary from $149-299 for the pill, and $199-499 per month for the pen, depending on the dose. New patients without insurance can use a limited-time offer and pay $199 per month for the first two months.

Wegovy (semaglutide)

Approved uses: Adults with overweight or obesity or one weight-related medical condition 

Drug type: Once-weekly injection (for people 12 years and older) or once-daily oral pill (adults only)

Doses: 1.7 mg or 2.4 mg once-weekly injection, 25 mg daily tablet

Cost: With commercial insurance, Wegovy pens and pills cost as little as $25 per month. Without insurance, Wegovy pens start at $199 for the first two months, then increase to $349 per month. Without insurance, the pills cost $149 per month. On April 15, 2026, the price will increase to $199 per month. See if you are eligible for their savings program here. 

Mounjaro (tirzepatide)

Approved uses: Adults and children 10 years and older with type 2 diabetes

Drug type: Once-weekly injection

Doses: 2.5 mg, 5 mg, 7.5 mg, 10 mg (max dose for children), 12.5 mg, and 15 mg. It’s recommended to increase the dose gradually (every four weeks) if additional blood sugar management is needed.

Cost: With commercial insurance, you can pay as little as $25 for a three-month supply. If Mounjaro is not covered with commercial insurance, you can pay $499 per month. Without insurance, the list price is $1,112.16 per fill. See if you are eligible for a savings card here. 

Zepbound (tirzepatide)

Approved uses: People with overweight or obesity and moderate-to-severe obstructive sleep apnea

Drug type: Once-weekly injection

Doses: 2.5 mg (initial dose), 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg 

Cost: With commercial insurance that includes Zepbound coverage, the cost of a three-month prescription is as low as $25. If your commercial insurance does not cover Zepbound, the cost can rise to $499 per month. Without insurance, the price varies by dose. The starting dose for the first month (2.5 mg) is $299 per month, while higher doses vary from $399-$1,049. You can check your coverage and savings eligibility here. 

Trulicity (dulaglutide)

Approved uses: Adults and children over age 10 with type 2 diabetes, and adults with type 2 diabetes at risk for major cardiovascular events

Drug type: Once-weekly injection

Doses: 0.75 mg, 1.5 mg, 3 mg, and 4.5 mg 

Cost: With commercial insurance and the Trulicity Savings Card, a three-month prescription can cost as low as $25. Without insurance, the list price is $1,006.93 per month. You can see if you are eligible for a Trulicity Savings Card here. 

Victoza (liraglutide)

Approved uses: Adults and children over 10 with type 2 diabetes, and adults with type 2 diabetes and heart disease

Drug type: Once-daily injection

Doses: 0.6 mg (initial dose), 1.2 mg, and 1.8 mg

Cost: Victoza is covered by most health plans, including Medicare and Medicaid. See if your insurance covers Victoza here. The list price varies based on the dose, ranging from $543.51-$851.27. Novo Nordisk also has a Patient Assistance Program that provides free medication to qualifying patients.

Saxenda (liraglutide)

Approved uses: Children ages 12-17 with obesity and adults with overweight, obesity, or a weight-related condition

Drug type: Once-daily injection

Doses: 0.6 mg (starting dose), 1.2 mg, 1.8 mg, 2.4 mg, and 3 mg. It’s recommended to increase the dose one week.

Cost: You can check your insurance coverage for Saxenda here. Saxenda has a list price of $1,349.02. Currently, the website mentions that significant demand for Saxenda has made it difficult to fill each prescription in a timely manner, limiting its availability and impacting care. 

What's in development? 

Right now, there are hundreds of new incretin-based medications in development. One example is orforglipron, an oral GLP-1 for the treatment of type 2 diabetes and obesity. New research showed that orforglipron was more effective than oral semaglutide at lowering A1C and body weight in adults with type 2 diabetes. The reported side effects were similar to those of other GLP-1s, including gastrointestinal effects. 

Researchers have also been developing newer drugs that go beyond GLP-1. For instance, Mounjaro (tirzepatide) stimulates both GLP-1 and GIP receptors, another gut hormone involved in blood sugar regulation. 

Also in development is CagriSema, a new type of medication for type 2 diabetes and weight management that combines semaglutide and cagrilintide. Cagrilintide mimics the actions of amylin, a hormone made by the pancreas that helps you feel full after eating. In a recent clinical trial, CagriSema led to significant weight loss and reductions in A1C, with participants experiencing gastrointestinal side effects associated with GLP-1s.   

Also in the pipeline is retatrutide, a triple agonist that activates GLP-1, GIP, and glucagon receptors. Early research shows retatrutide results in significant weight loss in people with overweight and obesity; larger trials are ongoing investigating retatrutide for people with type 2 diabetes, non-alcoholic fatty liver disease, and obesity. 

So far, studies on these new, multi-agonist drugs suggest that activating multiple receptors may lead to greater weight loss than GLP-1 alone.

The bottom line

GLP-1s and similar drugs are effective therapies for people with type 2 diabetes, overweight, and obesity. These medications are most effective when combined with healthy lifestyle habits, including diet and exercise. 

GLP-1s tend to be expensive, but are often covered by insurance; many manufacturers also have savings programs, so check your eligibility before paying full price. GLP-1s should be taken for life, and with many options on the market with different FDA-approved uses, it is crucial to work with your health care professional to find the right medication and dose for you. 

Learn more about GLP-1s and other diabetes medications here:

• 6 Benefits of Combining Insulin and GLP-1 Drugs
• 7 Tips for Navigating Nausea on a GLP-1 Medicine
• Metformin: Everything You Need To Know