42. GLP-1's in Midlife: Benefits, Risks & Muscle Loss

GLP-1 medications like Ozempic have gone from diabetes treatment to viral weight loss trend seemingly overnight. But what do these drugs actually do — especially for women in midlife?

In this episode of Midlife and Glowing, Alicia and Nicole break down the science behind GLP-1 receptor agonists (like semaglutide), including how they impact blood sugar, appetite, muscle mass, metabolism, and long-term health.

If you're navigating perimenopause, weight gain, insulin resistance, brain fog, or fatigue — and wondering whether GLP-1 medications are the solution — this episode offers a grounded, balanced conversation you won’t hear on social media.

This is not a fear-based conversation. And it’s not hype either. It’s the nuance midlife women deserve.

Because in this season of life, strength, metabolic health, and long-term vitality matter more than the number on the scale.

⏱️ Episode Chapters

00:00 The GLP-1 Phenomenon Explained
01:10 What Is GLP-1 and How Does It Work?
02:40 GLP-1s and Weight Loss in Midlife
03:15 Muscle Loss & Why It Matters After 40
04:00 Common Side Effects You Should Know
06:00 Serious Risks: Pancreatitis, Vision & More
08:05 “Ozempic Face” & Rapid Aging Concerns
09:20 Hair Loss and Nutrient Deficiency
10:05 What Happens When You Stop GLP-1s?
10:45 The Real Metabolic Benefits
11:30 Cardiovascular & Blood Sugar Improvements
12:40 Are GLP-1s a Tool or a Shortcut?
13:20 Natural Ways to Support GLP-1
14:30 Final Thoughts on Sustainable Midlife Health

📌 Resources:
✨ Daily Glow Rituals Guide → https://stan.store/thedailyglowlife/p/daily-glow-rituals-guide

Transcript

0:00

Let's talk about the drug that somehow became dinner table conversation, a celebrity beauty secret, and a casual prescription all at the same time. One people mention like it's a new face cream, but it literally alters how your gut, brain, and nervous system communicate. If you've ever heard someone say, oh yeah, I'm just on ozempic, like it's no big deal, this episode is for you. Welcome back to Midlife and Glowing. I'm Alicia. I'm Nicole. And today we're talking about GLP ones, what they are, why they're everywhere, the real benefits, the real risks, and why we're seeing them used so casually sometimes without addressing the lifestyle foundations that actually matter. This episode has been a long time coming. I feel like GLP ones went from medical treatment to pop culture phenomenon overnight. Totally. And what concerns me most isn't that they exist. It's how they're being talked about. There's very little nuance. Right, it's either this drug is amazing, or this drug is horrible, and neither of those extremes are helpful. Yeah, exactly. These medications have legitimate medical uses. They've helped people with type two diabetes significantly, but the way they're being prescribed and discussed now, that's where things get messy. Okay. Let's start with the basics. When someone hears GLP one, what are we actually talking about? GLP one stands for glucagon-like peptide one. It's a hormone your body already makes, primarily in your gut, and its job is to help regulate blood sugar, appetite, and insulin response to food. So it's something that you're already producing. So sort of GLP one medications are agonists, so they aren't the hormone itself. Drugs like semaglutide essentially amplify the signal. So that's why people feel less hungry? Yes, these drugs slow gastric emptying. Uh, so food stays in your stomach longer and they increase satiety signals in the brain so people feel full faster and they stay full longer. Well, and that all sounds great on the surface. It does. And for people with uncontrolled blood sugar, that mechanism can be life changing. So originally these drugs were for diabetes, correct. Yes, type two diabetes specifically. And in that context, they can lower blood sugar, reduce cardiovascular risk, and improve markers like fatty liver disease. But now they're everywhere primarily for weight loss. I know I see them all over my feed. Yeah, exactly. And here's where it's important to understand how they work. Weight loss happens because appetite is suppressed. That's not inherently bad, but appetite suppression without education, nutrition support, or muscle preservation strategies is a problem. And I would say especially in midlife. Yeah, especially in midlife, we already lose muscle mass naturally as we age. And these drugs can accelerate that loss. If we're not taking measures to combat that. And this part shocked me when you first explained it to me. Yeah. A randomized controlled trial showed that about 40% of the weight lost on GLP one drugs was lean muscle mass. Seriously, 40%. Yeah, and we'll talk more about side effects in a minute, but one of them is reduced appetite. So what's happening is people aren't eating as much and they're not eating enough protein among other macronutrients and micronutrients, but that's why they're losing so much muscle mass, which is definitely a problem. Muscle is metabolic insurance. It protects blood sugar regulation, bone density, longevity, and independence as we age. Yet the conversation is about weight and what the scale says. Yeah, because unfortunately, culturally thinness still gets more attention than strength or long-term health. Okay. Let's talk about side effects, because they're often brushed off, it feels like people put more importance on losing weight and kind of ignore any potential negative effects that this drug may have. Right, and not everyone has side effects or negative effects, but common ones include nausea, vomiting, constipation, severe diarrhea, dizziness, headaches, fatigue and appetite loss like we've talked about. And I think that some people can look at those and say, those are inconvenient. Sure. But the payoff is worth it. Yeah, it's really unfortunate and that normalization definitely worries me. I was, uh, doing wellness coaching with a college student and she was telling me about her roommate. Her roommate had PCOS and she was overweight. She was trying to get on track with her health and trying to work on getting to a healthy weight, and so she was starting to work out. She was starting to eat healthier, but then she went to her doctor, and her doctor prescribed her GLP one and said nothing about lifestyle, mind you. So what happened was the medication was making her vomit. So in her mind she was thinking, I don't wanna spend all this time and money making a healthy meal that I'm just gonna throw up. So instead of making those healthy meals, she started eating fast food instead. And so her healthy lifestyle that she had started working on before going on the medication went out the window because she just felt like it wasn't worth it since she was just throwing up anyway, which breaks my heart on so many levels. Like talk about, uh, starting such an unhealthy behavior at that age and you know, like your relationship with food in general, which a lot of people already struggle with starting at that age to have that, you know, really unhealthy relationship with food and just thinking, oh, well, it's just, you know. Forget the healthy lifestyle. This is, you know, I'll just rely on the medication to get me where I need to go. And long-term, it's just, that's such a, it's heartbreaking, really. Yeah, for sure. You know, we should especially be encouraging a healthy lifestyle to our youth so they don't grow up with all these health issues that come with an unhealthy lifestyle. I mean, I could not agree more, but digestive issues and appetite loss aren't the only side effects of these medications. There are also more serious risks like pancreatitis, gastroparesis, bowel obstruction, kidney injury, increased sympathetic nervous system activity, which we already talk a lot about, how that's already a problem in midlife. Gallbladder problems. And there's new research showing vision problems like blurred vision, visual impairment and retinopathy, some of which occurred as early as 10 days after initiating treatment. So these drugs can have some serious effects and they are still relatively new drugs, so we don't know the full long-term use picture just yet. Yeah, and those are nothing to take lightly. Exactly. They should certainly be discussed before beginning these medications, but I know that often they are not. No, this drug is definitely glamorized. Yeah, and really my biggest concern is that they aren't being used in conjunction with lifestyle changes, which is how they were intended to be used. And you know, I, again, I don't want to make it sound like I'm against these drugs because they can have a lot of really beneficial uses for certain people, but they should not be used as a replacement for healthy lifestyle practices. And unfortunately, they are. And. There just cannot be a good long-term outcome from continuing to eat ultra processed food and remain sedentary. Right. And I'm not, like I said, I'm not denying that there's definite upsides to these drugs, but which we'll touch on in a minute. But I just don't like the casual use of them and that they're often not being used in conjunction with those lifestyle changes. Right. And like I said before. Ozempic GLP ones, you know, these are all over my feed and seeing them on social media and I hear people talk about and mention having a ozempic face, um, or, you know, a GLP one, but they just say Ozempic face. Let's talk about that. What does that look like? So rapid weight loss, especially when muscle and fat are lost quickly, can lead to facial volume loss. And that causes sagging skin and an aged appearance. So there's a hollowed look to the face. There's more wrinkles, sunken eyes, and sagging jowls, you know? And the irony is that people then seek cosmetic procedures to fix the effects of the drug they took to look better. It's ironic, and in case it's not obvious, it's not just ozempic that can have that effect. Any med that causes you to lose weight quickly like that can have that effect. I mean, I definitely think celebrities have had a lot of influence over the popularity of these drugs too. Would you agree on that? Oh yeah, I, yeah, I agree. When famous people talk about it casually or are visibly shrinking, there's an implied message that this is easy, this is normal, this is the solution. Right. And that trickles down to us common folks and to the people that look up to the celebrities. Mm-hmm. Especially to women who already feel pressure to control their bodies at all costs. Oh, and what about hair loss? Is that something that these medications can cause too? So rapid weight loss in combination with potential nutrient deficiency, because remember, our appetite is reduced with these medications can definitely cause that for people on these drugs. It's not specifically caused from the drug itself, but the fact that these meds cause a loss of appetite and people often aren't eating enough protein or getting adequate vitamins and minerals in their diet as a result. So that lack of nutrition is part of what's causing the hair loss here. Okay, so what happens when you stop? Well, the data is clear when people stop GLP ones without sustaining lifestyle changes, and that's the key. Weight is regained and blood sugar rises again. So it's not a permanent fix? No, it, the drug itself is not a permanent fix. Diabetes and metabolic dysfunction are lifestyle driven. So if the root cause isn't addressed, the outcome isn't gonna stick. Right. Okay. So up to this point, we've talked a lot about concerns, risks, and culture, but I really wanna make sure we're being fair here because clearly these medications do have benefits and people aren't imagining that. Absolutely. There definitely are benefits to these meds. So let's talk about the upsides. What do these medications actually do? Well. First and foremost, they can be incredibly effective for blood sugar regulation, especially for people with type two diabetes. GLP one medications improve insulin sensitivity, reduce post-meal blood sugar spikes, and help stabilize glucose levels overall. Which for someone who struggled with that per years can feel life changing, I'm sure. Definitely more stable blood sugar often means better energy, fewer crashes, improved mood, and less of that constant mental obsession with food too. That alone explains why people feel so different on them. Exactly. Another benefit is appetite regulation. These medications reduce appetite in a way that feels almost effortless for many people. That constant food noise, thinking about what you're going to eat next, feeling out of control around food that often quiets down, and I can see how that would feel like relief, especially for women who've spent decades dieting. Yes. There's also evidence showing improvements in cardiovascular risk factors. We see reductions in blood pressure, improvements in cholesterol markers, and a reduced risk of heart disease in certain populations. And that part doesn't get talked about as much on social media where I've been hearing all of this noise about it. Right. No, it does not. There's also data showing improvement in fatty liver disease, which is becoming incredibly common. So from a metabolic standpoint, there are real wins here. There are, and for some people, especially those with significant insulin resistance or longstanding metabolic dysfunction, these medications can create enough stability to finally make lifestyle changes feel possible. I think that's a really important distinction. Yes, when used as a tool, not as a replacement for the right person under the right supervision with lifestyle support, layered in GLP ones can absolutely play a positive role. So the problem isn't that these medications exist, not at all. The problem is when the benefits are oversimplified, glamorized, or treated like a permanent solution without talking about what it takes to maintain long-term health. Or when weight loss becomes the only benefit anyone cares about. Yeah, exactly. Which is definitely the focus for a lot of people with what we're seeing. The real benefits are metabolic stability, reduced risk for some diseases, and improved quality of life, not just a smaller body. Okay. So are there any natural alternatives to this drug? Well, yes and no. Nothing natural will replicate pharmaceutical levels. Right, but there are ways to support GLP one naturally. Yes, protein, healthy fats and fiber are GLP one agonists. Foods like eggs, nuts, avocados, for example. And then certain herbs and compounds like berberine, curcumin, cinnamon, rosemary, and yerba mate can stimulate GLP one as well. Probiotics? Yes. Specifically a probiotic called Akkermansia Muciniphila, which supports GLP one and Metabolic Health. That was a mouthful. It was. Okay, so this feels more aligned with sustainability? Yeah, because it is, right. These approaches work with the body. They're just more wholesome and supportive of natural overall long-term health. And I wanna be really clear, like I said, we're not anti-medication, but we are anti shortcut culture that ignores long-term health, muscle health, nervous system regulation, and self-trust and anti the idea that your body is something to override instead of support. That is the key here, right? There are real benefits from these medications. As with any medication or supplement, they should always be used in conjunction with healthy lifestyle practices, not as a replacement for. If you found this helpful, please share it with a friend who's been wondering about GLP ones but hasn't heard the full picture. If you haven't already, leave us a review. It helps this podcast reach more women who deserve thoughtful, grounded conversations about their health. Thanks for listening and thanks for being here, and we'll see you next week on Midlife and Glowing.