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In recent years, weight-loss and diabetes drugs have become widely used around the world. They help people shed extra pounds and manage blood sugar.
Our bodies make natural versions of those drugs: gut hormones called incretins. Christopher Damman, a gastroenterologist and researcher at the University of Washington, studies how food and the gut microbiome affect human health.
It’s not surprising that nutrients from our diet influence these hormones. But the most striking part is that the trillions of bacteria in our gut play a central role in running this system, Damman says.
How It Works
Certain bacteria in the lower intestine ferment parts of food we can’t digest—fiber and polyphenols, for example. They convert those compounds into molecules that trigger hormones controlling appetite and metabolism.
Two of those hormones are GLP-1 and PYY. They help regulate blood sugar by acting on the pancreas. They also tell the brain when you’re full and slow the movement of food through the stomach and intestines to aid digestion. This mechanism is sometimes called the colonic brake.
Before modern processed foods became common, metabolic regulation was largely governed by a diverse, healthy gut microbiome that used those hormones to balance appetite and metabolism. Industrial food processing, which extends shelf life and boosts flavor, strips out many bioactive compounds—especially fiber and polyphenols—that help regulate this system.
Losing those dietary components—and the drop in microbiome diversity that follows—may be a major factor in rising obesity and diabetes.
Miracle Drugs Aren’t So Miraculous
These weight-loss and diabetes drugs boost colon activity after meals and act on pathways similar to GLP-1. Studies have shown they can be effective for weight loss and blood sugar control, as reported by Science Alert.
Despite their success, current prescribing practices have drawn skepticism.
Experts have flagged common side effects—nausea, vomiting, diarrhea, and constipation—which reflect slowed gastrointestinal motility. More serious risks include pancreatitis and, in rare cases, gastric paralysis.
These drugs can also lead to loss of lean muscle mass, especially if people don’t exercise. Many patients regain significant weight after stopping the medication, which raises questions about long-term effectiveness.
All Roads Lead to a Healthy Lifestyle
Damman says a healthy lifestyle is still the best way to prevent and manage metabolic disease. That means regular exercise, managing stress, getting quality sleep, walking outdoors, and eating a balanced diet.
For most people without obesity or diabetes, he advises relying on the gut’s built-in appetite and metabolism control.
Build a diet around minimally processed foods—especially those high in fiber and polyphenols, like flavonoids and carotenoids—to help prevent obesity and metabolic disease.
