Dr. Tro shares his clinical perspective on GLP-1 medications, behavior change and the support that matters alongside a prescription.
I have used GLP-1 medications for ~10 years in practice. I can say with 100% confidence that the effects on hunger wane between 1-2 years, and after 2 years, weight gain often occurs. This aligns with research indicating diminishing returns with long-term GLP-1 use. Additionally, the nausea and vomiting, which are common side effects, can contribute to muscle loss due to reduced food intake, as noted in clinical studies.
GLP-1 drugs do not change behavior, much like Lap-Band surgery failed to address emotional and psychological issues related to food. Behavioral modification remains key, supported by evidence that lasting weight loss requires more than just pharmacotherapy. If you’re angry or resistant when advised to avoid junk food, GLP-1 won’t alter that mindset. Similarly, if you blame willpower, remain inactive, and ignore your health goals, the drug alone won’t help.
If you treat your finances or car maintenance with urgency but wait until “Monday” to change your lifestyle, GLP-1s won’t shift this self-care procrastination and years of all-or-none thinking. We’ve successfully weaned patients off these drugs through coaching and behavior change techniques. Those who continue using the medication must agree to commit to resistance training and increased protein intake to mitigate muscle loss. Research supports this approach, highlighting the importance of exercise and nutrition for muscle preservation.
We have seen severe reactions, including nausea and vomiting so extreme that patients required ER visits for hydration. However, we’ve also witnessed life transformations. Some patients gained the confidence to start exercising, stayed consistent, and eventually discontinued the drug with great success.
Bottom line: don’t believe the hype. Programs that hand out prescriptions without addressing the real journey—your mind—are missing the point. Studies consistently show that a clear vision of health and overcoming psychological barriers is crucial for long-term success. Without this, achieving sustainable results will be difficult.
