GLP-1s: For Much More Than Weight Loss
Over the past few years, you’ve probably heard a lot about GLP-1 medications like Ozempic® and Wegovy® — mostly in the context of weight loss. And while weight loss is certainly a major benefit, GLP-1 receptor agonists offer much more at the cellular level, with wide-ranging benefits for metabolic health, cardiovascular risk, aging, and even certain cancers.
How GLP-1s Work
GLP-1 (glucagon-like peptide-1) is a naturally occurring hormone released from your gut when you eat.
It plays several roles:
Pharmaceutical GLP-1s mimic this hormone while extending its effect, which helps patients feel full sooner, eat less, and maintain better glucose control.
But the benefits don’t stop there.
At the cellular level, GLP-1s improve insulin sensitivity, reduce inflammation, improve endothelial (blood vessel) health, and support mitochondrial function — essentially helping your cells produce energy more efficiently, which can correct some of the underlying metabolic dysfunction that drives obesity, diabetes, cardiovascular disease, and even many of the diseases we associate with aging.
GLP-1s Have Been Around Longer Than You Think
While Ozempic and Wegovy have dominated the headlines recently, GLP-1 medications aren’t new. The first GLP-1 agonists were FDA-approved over 15 years ago for managing diabetes. Since then, research has shown these medications offer much broader benefits, even for patients without diabetes — improving metabolic flexibility, reducing cardiovascular events, lowering cancer risk related to insulin resistance, and potentially offering anti-aging properties.
What Are Peptides — And How Do GLP-1s Fit In?
Simply put, peptides are short chains of amino acids — essentially small proteins — that act as signaling molecules in the body. They help regulate a wide range of physiological functions like metabolism, tissue repair, inflammation, and hormone production.
Many of the most cutting-edge therapies we use today are peptides.
For example:
GLP-1 medications are peptides that mimic your body's natural glucagon-like peptide-1 hormone. Because they are peptides, they integrate seamlessly into your body’s existing signaling systems — helping regulate appetite, glucose control, and cellular health at the root cause level.
Muscle: The Other Half of the Equation
GLP-1s are not magic. To maximize long-term results, you need muscle. The more lean muscle you have, the better your metabolism functions. Muscle is an active metabolic organ that burns glucose, improves insulin sensitivity, and reduces systemic inflammation.
Here’s the good news: you don’t need to live in the gym to build and maintain muscle.
These benefits are not just theoretical:
Adults who strength train regularly reduce their risk of all-cause mortality by up to 27% (Shailendra et al., 2017).
Nutrition: Simplify and Prioritize Protein
GLP-1s naturally help reduce cravings and make portion control easier, but nutrition still matters. One simple and effective approach is:
Higher protein intake helps preserve muscle mass during weight loss, increases satiety, and boosts thermogenesis — meaning your body burns more calories even at rest.
Protein also plays a critical role in preventing muscle loss during calorie deficits.
Simply avoiding ultra-processed foods and increasing lean protein intake to 1g/pound of body weight per day can result in modest weight loss over several weeks.
Compounded Semaglutide and Tirzepatide: Added Support with Glycine to prevent muscle wasting
For those interested in compounded versions of semaglutide or tirzepatide, many compounding pharmacies now combine these peptides with glycine, an amino acid that supports muscle preservation. Glycine plays a role in collagen formation, tissue repair, and muscle maintenance — which is especially valuable during rapid fat loss.
While some headlines suggest that medications like Wegovy® cause significant muscle wasting, this is largely avoidable. With just two days per week of strength training, proper protein intake, glycine-compounded peptides, and creatine supplementation (discussed further below), patients can effectively preserve — and more importantly, increase — lean muscle mass while losing fat. This approach allows for safe, sustainable fat loss while protecting long-term metabolic health.
Hormone Optimization
Untreated hormone imbalances can make weight loss harder and diminish the benefits of GLP-1s. At Pure Medicine, we evaluate and optimize key hormones (such as testosterone, thyroid, DHEA, cortisol, estrogen, and progesterone) to support metabolic health, muscle growth, mood, energy, and long-term success.
Microdosing GLP-1s for Long-Term Health
For many patients, low-dose GLP-1 therapy may provide ongoing benefits long after initial weight goals are met.
These include:
As always, dosing is tailored based on your progress, tolerance, and long-term maintenance goals.
Supplementation: Small Changes That Matter
Often overlooked, micronutrient deficiencies can quietly sabotage your metabolic health and fat loss progress. Correcting even mild deficiencies can dramatically improve energy, mood, muscle maintenance, insulin sensitivity, and long-term metabolic stability. Here are a few of the most common and impactful supplements we regularly optimize at Pure Medicine:
Vitamin D3: The Foundational Hormone You’re Probably Missing
Vitamin D3 isn’t just a vitamin — it functions more like a hormone, directly impacting immune function, inflammation, insulin sensitivity, bone health, mood, and even cancer risk. Low vitamin D levels are extremely common, especially in individuals with metabolic dysfunction, obesity, or limited sun exposure. Optimizing vitamin D can support blood sugar control, reduce systemic inflammation, and lower the risk for cardiovascular and autoimmune diseases.
I recommend 20 minutes of daily sunlight exposure to support natural vitamin D production. However, in most cases, sunlight alone isn’t sufficient — especially for those with darker skin tones, indoor lifestyles, or living at northern latitudes. The vast majority of patients — if not all — require some degree of Vitamin D3 supplementation to achieve and maintain optimal levels.
Vitamin D3 should always be paired with Vitamin K2, which helps direct calcium into the bones and away from soft tissues like arteries. Without adequate K2, higher doses of Vitamin D3 may increase calcium absorption but not regulate where that calcium goes, potentially increasing vascular calcification risk - see more at Cardiac Calcium Scoring.
By combining D3 with K2, we support both bone strength and cardiovascular safety.
At Pure Medicine, we typically target blood levels between 50–80 ng/mL (or even slightly higher if serum calcium remains normal). To put things in context, most patients I see have Vitamin D3 levels somewhere between 25 and 35 (and a few patients have levels in the single digits). While needs vary, most adults require 2,000–5,000 IU daily — and sometimes more — to maintain optimal levels. Vitamin D3 should be taken with a meal containing fat for better absorption and preferably in the morning to avoid any possible sleep disruption. When properly repleted and maintained, vitamin D becomes one of the most powerful — and often simplest — metabolic optimizations.
Magnesium: The Unsung Metabolic Support
Magnesium plays a crucial role in over 300 enzymatic reactions in the body, including those involved in energy production, glucose control, sleep regulation, blood pressure management, and mood stabilization. Magnesium deficiency is extremely common — particularly in patients with insulin resistance, high levels of physiologic stress, and alcohol use.
Certain forms of chelated magnesium are much better absorbed and tolerated:
Most adults benefit from 200 mg to over 800 mg daily of a high-quality, bioavailable form like glycinate or malate. If loose stools occur (the most common sign of too high a dose), simply reduce the dose slightly to find your personal tolerance. Magnesium can safely and effectively support metabolic stability, improve insulin sensitivity, reduce blood pressure, and promote overall cellular health for most patients — unless there is significant kidney impairment.
Zinc: The Cellular Repair and Hormone Balancer
Zinc is an essential trace mineral involved in hundreds of metabolic functions, including immune regulation, wound healing, thyroid function, testosterone production, insulin signaling, and cellular repair. Zinc deficiency may contribute to fatigue, poor recovery, hormone imbalances, and impaired metabolic function.
Most adults do well with 15–30 mg daily of a well-absorbed form such as zinc picolinate or zinc glycinate. Zinc supplementation helps reduce chronic inflammation, support thyroid function, and maintain hormone balance — all critically important for preserving lean muscle mass and protecting metabolic rate during weight loss. Zinc should generally be taken with food to avoid nausea. After a few weeks of supplementation, dosing can normally be reduced to 2-3 times weekly.
Creatine: Strength, Metabolism, and Brain Health
Creatine is one of the most well-studied, safest, and most effective supplements available for both muscle and brain support. While often associated with athletes and bodybuilders, creatine is equally beneficial for adults trying to preserve or build lean muscle mass during fat loss, especially while using GLP-1 medications.
In addition to improving strength, muscle size, and power output, creatine has emerging evidence supporting its role in:
Most adults benefit from 3–5 grams of creatine monohydrate daily, taken consistently. Creatine is extremely well tolerated, does not harm the kidneys in healthy individuals (though hydration is especially important, since creatine moves fluid into the muscles), and can be a powerful tool to preserve muscle, support metabolism, and protect cognitive function over time.
Comprehensive, Personalized Care
At Pure Medicine, we don’t treat you like a lab value or a diagnosis code. We build a comprehensive, individualized plan that includes:
You deserve medical care that treats the whole person, not just the symptoms.
