Unpacking the Truth Behind GLP-1 Myths

Glucagon-like peptide 1 (GLP-1) receptor agonists have transformed the treatment of type 2 diabetes and obesity since the FDA approval of Byetta (exenatide) for type 2 in 2005. However, their growing popularity has also created widespread misconceptions.

According to a KFF Tracking Poll, about 1 in 8 adults (12%) have taken a GLP-1 medication, with 6% currently using one for weight loss, diabetes or heart disease prevention.

Demand has surged, driven by new medical indications, social media buzz and their effectiveness in promoting weight loss.

In 2023, Novo Nordisk’s semaglutide—sold as Ozempic, Wegovy and Rybelsus—accounted for 88% of all new GLP-1 prescriptions, according to a report published in Forbes.

In addition, a medRxiv study found that between 2018 and 2024, more than 1.8 million patients were prescribed a GLP-1, with semaglutide being the most common first-time medication.

As the use of these medications increases, healthcare providers are meeting challenges such as high costs, limited insurance coverage and concerns over off-label use.

Despite their benefits, misinformation continues to shape public perception and influence patient decisions.

Experts across the healthcare space discussed some of the most common myths about GLP-1s with Managed Healthcare Executive and provided their insights to separate fact from fiction.

• Myth 1: GLP-1 drugs are a quick fix for people who are overweight or obese
  Reality: Geoffrey Rutledge, M.D., chief medical officer of HealthTap, debunks this myth by clarifying they are not a one-time solution for weight loss. Although GLP-1s can help suppress appetite and lead to significant weight loss, it’s important to understand that these effects are not permanent, he said. “It's not a magic bullet that just solves the problem,” Rutledge added. He stressed that lasting weight loss requires a combination of medication and long-term lifestyle changes, adding that when patients stop taking the medication, they often regain the weight lost. Adopting healthy eating habits, regular exercise and stress management are key factors in maintaining weight loss after discontinuing the medication.

Geoffrey Rutledge, M.D.

• Myth 2: Lifestyle adaptation with GLP-1s is easy
  Reality: GLP-1s impact appetite, social habits and daily routines, according to Jen Butler, chief commercial officer at Pleio. Patients often struggle with changes in eating patterns and reduced cravings, sometimes leading to social isolation. Butler noted that some patients report increased loneliness as they avoid meals and drinks with friends. Long-term success requires lifestyle adjustments, including new meal schedules and social adaptations, she said. Emotional support and education help patients navigate these changes effectively.

Jennifer Butler

• Myth 3: GLP-1 drugs only require a prescription; no additional support is needed
  Reality: Starting a GLP-1 medication isn’t just about getting a prescription — it requires emotional and behavioral support, Butler said. Many patients feel stigma or hesitate to share their treatment with others, according to research. It was found that patients with emotional support had a 24% increase in prescription adherence, rising to 27% for obesity patients. Support networks help patients adjust to injections, manage side effects and stay on track. Without guidance, many struggle to maintain treatment long-term, she said.
• Myth 4: GLP-1 drugs are a cost-effective solution for obesity care
  Reality: At their current retail price, these medications are not yet affordable in the U.S., according to Rutledge. In fact, if the price went down by half or by two-thirds, then the drugs would become cost-effective, as mentioned in a recent study published in JAMA Network Open. Although GLP-1s are already considered cost-effective in some countries, the high U.S. retail cost— approximately $1,000 per month — has made them financially challenging for many patients, Rutledge claimed. However, he predicts that as competition increases and patents expire, the price of these drugs will likely decrease, making them more affordable in the future.
• Myth 5: Telehealth providers make GLP-1 drugs easily accessible without proper support
  Reality: While telehealth can make GLP-1 medications more accessible, Rutledge pointed out that the quality of care depends on the structure of the telehealth provider. The challenge is that people have the expectation of just getting a quick prescription without the necessary follow-up and support, he said. For GLP-1 therapy to be effective, it must be part of a comprehensive care plan that includes ongoing patient engagement, lifestyle support and monitoring. Rutledge encourages that telehealth can work well, but only when it involves personalized care and continuous guidance from a healthcare provider.

Angela Fitch, M.D.

• Myth 6: Obesity is just about diet and exercise and is not a medical condition
  Reality: Knownwell Chief Medical Officer Angela Fitch, M.D., noted that obesity is a chronic disease influenced by genetics, environment and biological factors, not simply lifestyle choices. Fitch emphasized that the body actively resists weight loss by lowering metabolism and increasing hunger hormones, making long-term weight management complex. “We've been trying to fix it with diet and exercise for centuries, and the rates are just going up,” she said. Just as hypertension requires medication beyond lifestyle changes, obesity management often needs medical intervention.
• Myth 7: GLP-1 drugs are only for people looking to shed a few pounds
  Reality: Beyond type 2 diabetes, GLP-1 medications are designed to treat obesity, a recognized medical condition, not just for cosmetic weight loss. Fitch compared them to hypertension medications, explaining that these drugs help manage obesity rather than cure it. Treatment is long term and should be combined with lifestyle modifications, including sleep and metabolic health management.
• Myth 8: Patients know how to use GLP-1s without additional guidance
  Reality: Many patients assume they can take GLP-1s without guidance, but education is crucial, said Butler. Pleio’s AI analysis found injection techniques, lifestyle adjustments and side effects are top concerns. Patients need clear instructions on proper use and how to adapt their routines, she explained. Misunderstandings can lead to skipped doses or anxiety over side effects. Butler recommends healthcare providers offer structured education to improve adherence and confidence.

John Buse, M.D., Ph.D.

• Myth 9: GLP-1s are only effective for weight Loss, not for blood sugar control
  Reality: John B. Buse, M.D., Ph.D., a professor at the University of North Carolina (UNC) School of Medicine and director of the UNC's Diabetes Care Center, shared that the “highly effective” GLP-1s, including Trulicity (dulaglutide), Ozempic, Wegovy and Rybelsus (semaglutide) and Mounjaro (tirzepatide), are by far the best drugs for managing blood sugar, including insulin. For most patients, he said, they are often sufficient for controlling blood sugar levels without the need for other blood sugar-lowering drugs.
• Myth 10: GLP-1s are only for patients who haven’t responded to other diabetes medications
  Reality: The GLP-1s may be used as first-line therapy in diabetes, according to international guidelines, Buse noted. It’s about picking the drug or drugs that are expected to do the job of reaching the targets that the patient and provider are aiming to achieve. Often insurance carriers require that other drugs be used first because the GLP-1 drugs are expensive.
• Myth 11: GLP-1s cause severe gastrointestinal side effects for all patients with Type 2 diabetes
  Reality: Buse shared that he’s taken GLP-1s firsthand for three years and has never experienced any gastrointestinal (GI) issues. Severe issues are quite rare. In fact, only about 40% to 50% of patients have any GI side effects, and for most that do, they are mild or transient and go away over time as the body adapts to the drugs.
• Myth 12: Access to obesity specialists isn’t a barrier in effective obesity care
  Reality: While access to specialists is limited, obesity treatment is becoming more integrated into primary care. Fitch noted that just as primary care providers manage diabetes and hypertension, they can also treat obesity with the right tools and education. As GLP-1s become more common and easier to prescribe, more patients will receive treatment through their primary care providers, improving accessibility.

LeAnn Boyd, Pharm.D.

• Myth 13: GLP-1s will automatically lead to lower healthcare costs
  Reality: LeAnn Boyd, Pharm.D., CEO of Liviniti, said that while there is evidence showing cardiovascular and kidney benefits, there is no definitive data to prove that covering GLP-1s will automatically lower overall healthcare costs. “Everyone's really eager and hungry to find and see the data that demonstrates it will lower larger healthcare cost,” she added.
• Myth 14: Prior authorization and step therapy are not required for employer-based coverage
  Reality: Boyd noted that employers typically want to ensure that these medications are being used for medical necessity—such as managing obesity-related conditions—so prior authorization is a common requirement. “An employer could choose not to utilize prior authorization, but we would encourage that simply to allow to make sure it's being used for medical necessity, not lifestyle or cosmetic use.”
• Myth 15: Weight loss from GLP-1s leads to immediate cost savings for employers
  Reality: Health plans typically operate on 12-month cycles, Boyd explained. This means that weight loss and related health benefits might not lead to immediate cost savings. She emphasized that adding millions of dollars in expenses to cover these drugs requires careful consideration. “When you add that much cost to a plan, everyone’s premium is going to rise. It’s a big decision,” she said, adding that it’s one that creates a real dilemma for employers trying to balance affordability with access.

As the popularity of GLP-1 medications continues to grow, healthcare professionals play a critical role in guiding patients through the complexities of these treatments.

While GLP-1s offer promising benefits for managing type 2 diabetes and obesity, it is crucial for providers to manage patient expectations, emphasize the need for lifestyle changes, and offer ongoing support throughout the treatment journey.