A Key, a Lock, and a Shift in How I Feel about Obesity

Click to subscribe

GLP-1 receptor agonists are everywhere right now. They’re talked about on social media, in exam rooms, and at dinner tables. But they aren’t new. This class of medications was originally developed to treat diabetes.

GLP-1 stands for glucagon-like peptide-1. I like to think of it as a key. And the GLP-1 receptors? Those are the locks. These locks live all over the body—in the brain, the pancreas, the heart, and the gastrointestinal tract. When the key fits into the lock, a few important things happen:

· Insulin is released when blood sugar is high, while glucagon

is suppressed, helping prevent blood sugar from climbing too high.

· The brain senses fullness, quieting hunger and reducing cravings.

·The stomach empties more slowly, helping people feel

satisfied longer.

·Heart function improves, lowering the risk of heart disease.

A lock and key illustration symbolizing the interaction between chemicals and receptors, highlighting the specificity and precision in biological systems. Picture created by AI.

GLP-1 receptor agonists are simply medications that mimic

this process. When they enter the bloodstream, they act like a stronger, longer-lasting version of the key our bodies already make. They find the locks, turn them, and things start to shift. Insulin is released. The stomach slows down. The brain finally gets the message: I’m full.

And then we see results.

Not just on the scale.

But in blood sugar numbers.

And cardiovascular risk. And stroke risk. And maybe—still

being studied—even changes in neurological behaviors.

Here’s the part that surprises most people: the first GLP-1 agonist was approved in 2005.

A quick fun fact (file this away for your future

Jeopardy! appearance): Gila monsters can eat up to half their body weight in a single meal—without a spike in blood sugar. That’s thanks to a chemical in their venom called exendin-4. Scientists figured out how to turn that chemical into a medication called exenatide—the first GLP-1 agonist, better known as Byetta.

A vibrant depiction of a Gila Monster, whose venom contains a chemical known for its potential to stabilize blood sugar levels, set against a bold background dotted with lively foliage. Picture created by AI

So if these medications have been around for nearly 20 years, why does it feel like they came out of nowhere? People with diabetes have known about them for decades—they’ve been using them to control blood sugar for years. But everything changed in 2021 and 2023, when Ozempic and Zepbound

were approved for chronic weight management and

suddenly entered the public conversation.

That’s when the story shifted.

Science wasn’t just asking, Can we make another drug? It started asking, What else can these medications do? GLP-1 agonists are now approved to treat obstructive sleep apnea

and nonalcoholic fatty liver disease. And researchers are still exploring their effects on the brain. Could they help with dementia? Alcohol use disorder? Parkinson’s disease?

We don’t know yet—but we’re finally asking the questions.

Of course, none of this comes without trade-offs.

These medications have side effects, and because they affect so many systems in the body, you feel them. One of the first things I noticed—and mentioned in a previous post—was the drop in “food noise.” And honestly? It was unsettling. The quiet in my head felt unfamiliar, almost like I was changing something fundamental about myself. I found myself paying attention to the absence of thoughts, wondering what it meant to no longer be consumed by them.

Then there’s the gut. Everything slows down. Constipation, nausea, vomiting—and in rare cases, things can slow so much that obstruction becomes a risk. This isn’t something to brush off. At the very young age of 49, I now have a nightly 7 p.m. Miralax alarm. Too much information? Maybe. But it’s also part of the reality.

A refreshing glass of water alongside a mound of white powder, symbolizing the addition of Miralax for digestive health. Photo created by AI

There are other risks to consider. In rodent studies, this class of medications was linked to certain types of thyroid cancer, which is why anyone with a personal or family history of thyroid cancer should not take them. They can also increase the risk of inflammation in the pancreas and gallbladder, so caution is needed if you have a history of either.

Still, I can’t ignore what I’m seeing—both in medicine and in myself.

GLP-1 agonists are changing how we understand obesity. They’re pushing the medical community to see it less as a personal failure and more as a complex, biologic disease. And maybe, just maybe, they’ll change how the world sees it too.

This isn’t about finding a perfect medication or a perfect body. No process is flawless, and neither am I. But I’m paying attention to how I feel—physically, mentally, emotionally. And I feel better. Quieter. More at ease in my own body. For now, that feels like progress. And for the first time in a long time, it feels like I might finally be moving in the right direction.

A woman admires her reflection in the mirror, capturing a moment of self-confidence and grace. Photo created by AI.

Click to subscribe