Over the past year, I’ve had several patients quietly admit something to me: they weren’t sure whether they should come back because they had started taking Ozempic, Wegovy, Mounjaro, or another GLP-1 medication used to support blood sugar or weight management.

Some felt embarrassed. Others weren’t sure how I would feel about their decision. Some assumed there wasn’t much a naturopathic doctor could offer once medication entered the picture.

After hearing variations of this conversation again and again, I realized there are probably many more people wondering the same thing.

So I want to say this as clearly as I can:

You don’t have to choose between medication and naturopathic care.

My job has never been to judge your decisions. My job is to help you move forward from wherever you are in your health journey.

Whether you’ve started a GLP-1 medication, you’re considering one, you’ve decided it isn’t right for you, or you’ve experienced weight regain after stopping one – you are welcome here.

In fact, this is often when it is especially helpful to have someone looking at the bigger picture.

What are GLP-1 medications?

GLP-1 stands for glucagon-like peptide-1, a hormone released primarily by the gut after eating. It helps regulate blood sugar, appetite, and digestion.

Medications such as semaglutide – sold under brand names including Ozempic and Wegovy – act on the GLP-1 receptor. Tirzepatide, sold as Mounjaro or Zepbound, acts on both GLP-1 and another hormone pathway called GIP.

Depending on the medication and the person’s health history, these prescriptions may be used to treat type 2 diabetes, obesity, or certain weight-related health risks. They are also sometimes prescribed off-label for polyendocrine metabolic ovarian syndrome (PMOS, formerly known as PCOS), particularly when insulin resistance and metabolic concerns are part of the picture.

GLP-1 medications can be incredibly effective

These medications have changed many people’s lives.

For some people living with obesity, insulin resistance, type 2 diabetes, PCOS, or weight that has not responded adequately to lifestyle changes alone, they can be valuable tools. They may reduce appetite, improve blood sugar regulation, and lead to meaningful weight loss. Certain medications in this category have also demonstrated cardiovascular benefits in specific populations.

That is worth acknowledging.

Using medication does not mean you have failed. It does not mean you have “taken the easy way out.” And it certainly does not mean you should stop caring about the rest of your health.

Not everyone has a dramatic response

GLP-1 medications do not work equally well for everyone. In a major trial of semaglutide 2.4 mg, approximately 86% of participants lost at least 5% of their starting weight – which also means that roughly 14% did not reach that threshold. About 69% lost at least 10%, and approximately half lost at least 15%.

These numbers also help put expectations into perspective. A person does not need to lose 20% or 25% of their body weight for treatment to be meaningful. A 10% reduction would be 20 pounds for someone beginning at 200 pounds, and that degree of change may still produce important metabolic and functional benefits.

At the same time, some people experience very little change despite taking the medication appropriately. Others cannot reach or remain at the intended dose because of side effects or cost. Response can also differ depending on the medication, dose, treatment duration, diabetes status, other medications, sleep, underlying health conditions, and individual biology.

If results are more modest than expected, that does not automatically mean the person has failed. It means the plan deserves a thoughtful review: Is the medication helping in ways beyond weight (metabolic markers such as A1C, fasting glucose, blood pressure, waist circumference, triglycerides and other lipid measures)? Has there been enough time at a therapeutic dose? Are side effects limiting treatment? Is another medical or lifestyle factor affecting the response? And is this still the right tool for this particular person?

Medication doesn’t answer every question

This is where naturopathic care can fit naturally – not as an alternative to medication, but as a complement to it.

As appetite changes and weight begins to shift, there are still important questions to consider:

• How can you preserve muscle while losing weight?
• Are you getting enough protein, fibre, and micronutrients while eating less?
• Are symptoms such as nausea, constipation, reflux, fatigue, or hair shedding emerging?
• Are there underlying health concerns that still need their own assessment and treatment, rather than assuming the medication will address everything (e.g. iron deficiency, PCOS, hypothyroidism)?
• How can you protect your bone health and physical strength?
• What habits will continue supporting you if your medication is discontinued?

Successful treatment is not only about seeing a smaller number on the scale. It’s about protecting your muscle mass, physical strength, energy, and long-term health along the way.

Where naturopathic care may help while you’re taking a GLP-1 medication

Every person is different, but these are some of the areas I commonly consider with patients using these medications.

Preserving muscle – not simply losing weight

When body weight decreases, some lean tissue may be lost along with body fat. That matters because muscle supports strength, mobility, balance, blood sugar regulation, metabolism, and healthy aging.

We can assess whether your plan includes enough protein, appropriate resistance training, adequate recovery, and realistic strategies you can maintain. The goal is not to optimize everything at once. It is to identify what will make the greatest difference for you right now.

Making sure your nutrition keeps up

When appetite drops, total intake often drops too. That can make it harder to consume enough protein, fibre, vitamins, and minerals.

Over time, symptoms such as fatigue, hair shedding, constipation, weakness, or poor recovery may deserve a closer look. Sometimes the answer is adjusting how meals are structured. Sometimes further assessment or laboratory testing is appropriate.

When clinically indicated, naturopathic doctors in Saskatchewan can also requisition certain laboratory tests privately through LifeLabs. Testing should be selected purposefully, based on your health history and on whether the result is likely to change your treatment plan.

Managing side effects

Nausea, constipation, reflux, bloating, fatigue, and hair shedding are some of the concerns patients may experience during treatment.

These symptoms should not simply be ignored. There are often practical, evidence-informed strategies that can help make treatment more tolerable. Depending on the person and the symptom, this might include adjusting meal size or timing, improving hydration or fibre intake, addressing nutritional deficiencies, or using supportive treatments such as ginger or acupuncture for nausea.

Continuing to investigate the bigger picture

A GLP-1 medication can be effective while other parts of the metabolic picture still deserve attention. Reducing appetite may help create meaningful change, but it does not necessarily explain what made weight regulation difficult in the first place – or address every factor that may still be affecting your health.

Together, we may continue asking questions such as:

• What factors made weight regulation difficult in the first place, and which of them still need attention?
• Has insulin resistance developed, and what may be contributing to it?
• Are polyendocrine metabolic ovarian syndrome (PMOS, formerly PCOS), hypothyroidism, perimenopause, or another hormonal condition part of the picture?
• Are poor sleep, sleep apnea, chronic stress, pain, or fatigue affecting appetite, blood sugar regulation, recovery, or the ability to be physically active?
• Could another medication be contributing to weight gain or making weight management more difficult?
• Are environmental, financial, emotional, or time-related barriers influencing food choices, movement, sleep, or access to care?
• What will help support metabolic health beyond appetite suppression?

Medication and root-cause care are not competing approaches. They can address different parts of the same problem.

Sometimes medication creates the momentum – and the physical and mental capacity – to address concerns that previously felt impossible to manage. That is one of my favourite ways to practise: using the tools that help now while continuing to understand and support the bigger picture.

What if a GLP-1 medication isn’t working as expected?

Not everyone responds to these medications in the same way. Some people experience substantial changes, while others lose less weight than expected, have side effects that limit dose increases, or find that the medication does not feel sustainable.

That does not automatically mean the person has done something wrong.

Response may be influenced by the specific medication and dose, length of treatment, other medications, sleep, hormonal or metabolic conditions, nutritional intake, activity, and individual biology. It is also important to clarify what “working” means: changes in blood sugar, appetite, cardiovascular risk, symptoms, and body weight are related, but they are not identical outcomes.

If your response is limited, we can take a closer look at what may be getting in the way, identify what we can address together, and coordinate with your prescribing clinician if medication changes need to be considered.

What happens if you eventually stop?

Ideally, this conversation begins before the medication is even started – not when someone is already preparing to stop it.

Weight regain is common after stopping GLP-1 treatment, although individual experiences vary. In an extension of the STEP 1 trial, participants regained, on average, approximately two-thirds of the weight they had lost within one year after semaglutide and the study’s lifestyle intervention were withdrawn. This does not mean every person will have the same result, and it does not indicate a failure of motivation. Appetite often increases again, digestion returns toward its pretreatment pattern, and the body may now burn fewer calories at rest. This is one reason preserving muscle and planning for the transition matters.

That is exactly why ongoing support matters. These medications work through a pathway your body already has: your gut naturally produces GLP-1 in response to food. One pattern I have observed repeatedly in practice is that when digestive health improves, many patients report fewer food cravings and a steadier, more regulated appetite.

There are several biologically plausible reasons this may happen. Gut bacteria produce metabolites, including short-chain fatty acids, that interact with the intestinal cells responsible for releasing appetite-regulating hormones such as GLP-1 and PYY. The microbiome also communicates with the brain through immune, metabolic, hormonal, and neural pathways that may influence hunger, fullness, and food reward.

This does not mean that healing the gut reliably causes weight loss or naturally reproduces the effect of a GLP-1 medication. Human research is still developing, and the microbiome is only one part of appetite regulation. However, it helps explain why gut health may be relevant to much more than digestion – and why supporting it may be one valuable part of a broader metabolic plan.

Rather than waiting until after a medication is stopped, we can use the time while it is helping to strengthen the foundations that will continue supporting your health. Depending on the person, that may include:

• preserving muscle through adequate nutrition and resistance training
• improving sleep and addressing possible sleep disorders
• supporting blood sugar regulation
• correcting clinically relevant nutrient deficiencies
• addressing conditions such as PMOS (formerly PCOS)
• creating satisfying, sustainable eating patterns
• planning collaboratively with the prescriber for any medication transition and considering whether targeted supports – such as berberine or inositol – may play a role in blood sugar regulation after the medication is discontinued

For some people, long-term treatment may be appropriate. Others may need to stop because of side effects, cost, pregnancy plans, access, personal preference, or a change in health status. The plan should be individualized rather than built around the assumption that everyone must follow the same path.

Medication may be a powerful part of the journey, but it cannot address every part of your health on its own.

Here’s why I still get excited to work with patients taking GLP-1 medications

One of the reasons I enjoy working with patients taking GLP-1 medications is that there is so much more happening beneath the surface than simply eating less. Research continues to uncover fascinating ways that nutrition, sleep, gut health, inflammation, and physical activity influence metabolism – and these are all areas we can work on together.

🥩 Protein matters for more than muscle. Protein and individual amino acids can stimulate your body’s own GLP-1 and PYY release, helping support fullness and blood sugar regulation. Adequate protein is also essential for preserving muscle during weight loss.

🌿 Your gut bacteria may help regulate appetite. Gut bacteria ferment fibre into short-chain fatty acids, which can signal intestinal L-cells involved in releasing GLP-1 and PYY. This is one reason supporting digestive and microbiome health may influence much more than digestion, although human research is still developing.

🏋️ Exercise does more than burn calories. Exercise may not dramatically increase GLP-1 production itself, but it can improve insulin sensitivity, appetite regulation, physical function, and possibly the body’s responsiveness to GLP-1 signalling. It is also one of our most important tools for protecting muscle and strength.

😴 Sleep affects the entire appetite-regulation system. Inadequate or disrupted sleep can alter hunger and fullness signals, worsen insulin sensitivity, and increase cravings and food intake. Improving sleep does not simply make healthy choices easier – it changes the physiology influencing those choices.

🔥 Inflammation affects metabolism too. Chronic inflammation does not only affect pain or digestion. It can also influence insulin sensitivity, blood sugar regulation, appetite signalling, and overall metabolic health.

🍽️ Meal order may matter. Eating vegetables, protein, or fat before carbohydrate-containing foods may improve the post-meal glucose response and influence the release of hormones such as GLP-1. It is a small, practical strategy that may be useful for some people without requiring an entirely different meal.

What about supplements such as berberine?

GLP-1 medications aren’t the right choice for everyone.

Some people simply aren’t interested in taking medication. Others experience side effects, face cost or insurance barriers, are trying to conceive, or want to explore other options first.

The good news is that we still have tools.

One of the supplements I discuss most often in practice is berberine. It has been studied for its effects on blood sugar regulation, insulin resistance, metabolic syndrome, cholesterol, and weight management. It is not intended to replace a GLP-1 medication, but for the right person, it can be an incredibly valuable tool for supporting metabolic health.

I have also seen some patients experience a striking reduction in evening cravings or “food noise” while taking berberine. Others notice no change in appetite, and some cannot continue taking it because of digestive side effects. That variability is important: berberine is not a predictable appetite suppressant, but individual responses can be meaningful.

What I find particularly interesting is that berberine does not work through only one pathway. Research suggests it may improve insulin sensitivity, influence the gut microbiome and inflammatory signalling, and activate AMPK – a key cellular energy-sensing pathway. Early mechanistic research also suggests it may influence the body’s own GLP-1 production or signalling, although we do not yet know how clinically significant that effect is in humans.

The key is knowing who is most likely to benefit, how to use it safely, how it may interact with medications, and what other pieces of the metabolic picture still need attention. It should not be used during pregnancy or breastfeeding, and it may not be appropriate for everyone.

That is where personalized care matters.

You don’t have to pick sides

Natural or conventional.

Medication or supplements.

Lifestyle or prescriptions.

Health is rarely that simple.

Most of the time, good care means using the right tools at the right time – and recognizing when the plan needs to evolve.

Your health changes. Your life changes. Your treatment plan should be able to change with you.

Treating symptoms while still asking why

One thing I find interesting is that we don’t believe the dramatic rise in obesity over the past several decades occurred because people suddenly became “GLP-1 deficient.”

These medications can be incredibly effective because they act on one of the body’s natural appetite and blood sugar regulating pathways. But they do not erase all the other biological, psychological, social, and environmental factors that influence metabolism, weight, and long-term health.

That is why I don’t see medication and root-cause medicine as competing approaches. They are often working on different parts of the same problem.

Sometimes reducing appetite, quieting food noise, or improving blood sugar creates the momentum – and the capacity – to address concerns that previously felt impossible to manage.

And that is one of my favourite ways to practise: using the tools that help now while continuing to understand and support the bigger picture.

If you’ve been wondering whether you still belong here

The answer is yes.

If you have been hesitant to book because you weren’t sure how I would respond to your decision, I hope this article reassures you.

You do not have to apologize for taking medication. You do not have to defend your choices. And you do not have to figure out every part of this alone.

One of the biggest mistakes I see is trying to optimize everything at once. My approach is different: we determine what is most important for your body right now.

For one person, that might mean preserving muscle. For another, it could mean investigating fatigue or correcting an iron deficiency. For someone else, it may mean getting constipation under control.

We start with what matters most, then build from there.

If you would like support navigating your treatment, managing side effects, protecting your long-term health, or creating a realistic plan that fits your life, I would be happy to help.

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This article is for general educational purposes and is not a substitute for individualized medical advice. Do not start, stop, or change the dose of a prescription medication without consulting the prescribing clinician.