The GLP-1 boom: Rising usage and its impact on the microbiome

Over the past year, commercial GLP-1 usage has skyrocketed, with experts anticipating the global market will grow to a projected $157 billion by 2035.¹ While there was a measurable surge in demand as a result of the U.S. Food and Drug Administration (FDA) approving the medications for chronic weight management in adults in 2021,² GLP-1s were originally developed to treat patients with Type 2 diabetes.

For the most part, the benefits that patients are observing as a result of taking these medications far exceed the potential side effects. However, there may be a way that the supplement industry can help consumers address mild side effects that occur as a result of short term and long-term GLP-1 usage. In particular, introducing supplements that increase the level of Veillonella, a gut bacteria that metabolizes lactate produced during exercise into the short chain fatty acid propionate, could potentially influence a person’s gut metabolism and exercise performance. If a person is more motivated to work out, they are less likely to experience negative side effects of GLP-1s, such as loss of muscle mass.

GLP-1 Agonists, Weight Management, and Long-Term Metabolic Health

Glucagon-like peptide-1 (GLP-1) receptor agonists have revolutionized weight loss and diabetes management. Drugs like semaglutide (Ozempic/Wegovy) and liraglutide (Saxenda/Victoza) mimic the natural GLP-1 hormone, regulating blood sugar and suppressing appetite. While these medications offer promising weight loss results, they work best when combined with lifestyle changes, including diet, exercise, and gut health support.³

How Do GLP-1 Agonists Work?

GLP-1 is a hormone released in the gut in response to eating. It helps regulate blood sugar by increasing insulin production and slowing gastric emptying, leading to prolonged satiety. By mimicking this hormone, GLP-1 agonists reduce appetite and promote weight loss, often leading to significant reductions in body weight. They are a tool to assist in long-term weight management.⁴

Benefits of GLP-1 Agonists

GLP-1 receptor agonists offer several benefits beyond weight loss:

• Improved Blood Sugar Control: Helps manage type 2 diabetes by stabilizing glucose levels.⁵
• Cardiovascular Benefits: Studies show reductions in blood pressure and cholesterol levels.⁶
• Reduced Fat Mass: Particularly in visceral fat, which contributes to metabolic diseases.⁷
• Possible Neuroprotective Effects: Emerging research suggests GLP-1 may benefit cognitive function and reduce Alzheimer’s risk.⁸

Common Side Effects

While effective, GLP-1 agonists come with potential side effects:

• Gastrointestinal Issues: Nausea, vomiting, diarrhea, and constipation are common, particularly in the initial weeks.³
• Loss of Muscle Mass: Rapid weight loss can result in muscle loss if protein intake and exercise are insufficient.⁹
• Weight Regain After Discontinuation: Many patients regain weight once they stop taking the medication, known as “Ozempic rebound.”¹⁰
• Interactions with Anesthesia: Recent studies presented at the American Academy of Orthopaedic Surgeons annual meeting suggest that the use of semaglutide boosted the risk of adverse anesthesia events among patients undergoing total hip or knee arthroplasty.¹¹
  

Additionally, there is an increased risk if patients take counterfeit medication. The FDA recently flagged their concern¹² regarding the prevalence of unapproved GLP-1 drugs. It’s important to note that unapproved versions of the drug “do not undergo FDA’s review for safety, effectiveness and quality before they are marketed.” In other words: buyer beware.

The Role of Gut Microbiome and Veillonella in Weight Management

An emerging area of research is how gut bacteria influence metabolism and exercise performance. One such bacterium, Veillonella, has been found in higher concentrations in endurance athletes. As stated previously, Veillonella metabolizes lactate (produced during exercise) into propionate, a short-chain fatty acid that enhances mitochondrial function and energy production.¹³

To further promote propionate production, individuals can also increase dietary fiber intake, especially fermentable fibers like inulin, resistant starch, and pectin, which feed propionate-producing bacteria. Foods such as almonds, lentils, oats, and legumes are excellent sources of fiber.

Propionate has been linked to:

• Reduced Inflammation: Lowering systemic inflammation, which is often elevated in obesity.¹⁴
• Improved Exercise Efficiency: Enhancing endurance by recycling lactate for additional energy production.¹³
• Appetite Regulation: Supporting gut-brain communication to help regulate hunger signals and minimize food noise.¹⁵
• Lower Cholesterol: Reducing the formation of new fat cells and causing cholesterol-lowering effects.¹⁶

Since GLP-1 drugs emphasize movement as part of weight management, Veillonella could play a supportive role by improving exercise capacity and metabolic efficiency. Additionally, maintaining an active lifestyle can help foster a microbiome that supports metabolic health and long-term weight maintenance.

Weaning Off GLP-1 Agonists and Preventing Weight Regain

Research suggests that patients who taper their dosage slowly while implementing lifestyle changes have better long-term outcomes. Here are key strategies:

• Gradual Dose Reduction: Tapering off rather than stopping abruptly can help prevent rebound hunger.⁴
• Nutrient-Dense Diet: A high-protein, fiber-rich diet helps control hunger and supports muscle retention.¹⁷
• Regular Exercise: Strength training and cardiovascular activity counteract metabolic slowdown and weight regain.¹⁸
• Gut Health Support: The gut microbiome plays a role in metabolic health, making probiotics and prebiotic-rich foods beneficial.¹⁴

Long-Term Strategies for Weight Management

Regardless of GLP-1 medication use, sustainable weight management requires a holistic approach:

• Prioritize Protein and Fiber: These nutrients support satiety and muscle preservation.¹⁷
• Stay Active: Resistance training builds muscle mass, while aerobic exercise helps maintain weight loss.¹⁸
• Optimize Gut Health: Eating fermented foods and fiber-rich vegetables can promote beneficial bacteria.¹⁴
• Manage Stress and Sleep: Poor sleep and high stress can increase cravings and disrupt metabolism.¹⁹

Conclusion

GLP-1 agonists are valuable tools for weight loss but work best as part of a comprehensive approach that includes diet, exercise, and microbiome health. While these drugs help suppress appetite and promote metabolic improvements, sustainable weight management depends on lifestyle habits that support long-term success. Incorporating strategies like strength training, gut-friendly nutrition, and metabolic-boosting exercise can maximize benefits and minimize post-medication weight regain.

Understanding the role of the gut microbiome, particularly the potential of Veillonella to enhance movement and metabolism, opens new possibilities in weight management beyond pharmaceuticals. By combining science-driven interventions with sustainable habits, individuals can achieve long-term metabolic health and weight stability.

References

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