From the Guidelines
GLP-1 receptor agonists like semaglutide and liraglutide do not appear to increase the number of fat cells in the body, but rather reduce fat mass through multiple mechanisms, including decreased appetite, delayed gastric emptying, and improved insulin sensitivity, as supported by recent studies 1. The primary mechanism of action of GLP-1 receptor agonists is to promote weight loss by decreasing appetite and food intake through their effects on the brain's hunger and satiety centers, as well as slowing gastric emptying, which helps patients feel fuller longer after meals 1. At the cellular level, GLP-1 agonists may actually reduce adipogenesis (the formation of new fat cells) and can promote lipolysis (the breakdown of fat), as suggested by recent research 1. These medications also improve insulin sensitivity and reduce inflammation, which can help prevent fat accumulation, and may even shift fat distribution from visceral (around organs) to subcutaneous (under the skin) fat, which is metabolically healthier, as reported in a recent study 1. Key benefits of GLP-1 receptor agonists include:
- Reduced risk of cardiovascular events, as demonstrated in the SELECT study 1
- Improved weight-related comorbidities, such as reduced blood pressure and improved lipid profiles, as reported in a recent review 1
- Increased pancreatic β-cell growth, which can help improve glucose regulation, as suggested by recent research 1 If you're concerned about fat cell proliferation while using these medications, current evidence suggests this is not a significant concern, and the overall effect is a reduction in total body fat through decreased caloric intake and improved metabolic function, as supported by recent studies 1. In fact, the most recent guidelines recommend prioritizing the use of glucose-lowering medications with a beneficial effect on weight, such as GLP-1 receptor agonists, for people with type 2 diabetes and overweight or obesity, as stated in the 2025 standards of care in diabetes 1. Overall, the use of GLP-1 receptor agonists like semaglutide and liraglutide can be an effective and safe way to manage weight and improve metabolic health, as supported by recent studies and guidelines 1.
From the Research
GLP-1 and Fat Cells
- The relationship between GLP-1 and the number of fat cells is complex and has been studied in various contexts, including weight loss and type 2 diabetes management 2, 3, 4, 5, 6.
- GLP-1 receptor agonists (GLP-1RAs) have been shown to induce weight loss and reduce adipose tissue in patients with type 2 diabetes 2, 3, 4, 5, 6.
- Studies have demonstrated that GLP-1RAs can decrease fat thickness at various sites, including subcutaneous and deep fat deposits 6.
- The effects of GLP-1RAs on fat distribution and the number of fat cells are not fully understood and require further research 2, 3, 4, 5, 6.
Mechanism of Action
- GLP-1RAs work by mimicking the action of the hormone glucagon-like peptide-1, which helps to regulate blood sugar and appetite 2, 3, 4, 5.
- The mechanism of action of GLP-1RAs involves the promotion of glucose-dependent insulin secretion, suppression of glucagon secretion, and delay of gastric emptying 2, 3, 4, 5.
- GLP-1RAs have also been shown to have beneficial effects on cardiovascular risk factors, including weight loss and improvements in blood pressure and lipid profiles 2, 3, 4, 5.
Clinical Implications
- The use of GLP-1RAs for weight loss and type 2 diabetes management has been associated with significant improvements in glycemic control and weight loss 2, 3, 4, 5.
- However, the use of GLP-1RAs has also been associated with gastrointestinal side effects, including nausea and diarrhea 2, 3, 4, 5.
- Further research is needed to fully understand the effects of GLP-1RAs on fat cells and to determine the optimal dosing and treatment regimens for patients with type 2 diabetes and obesity 2, 3, 4, 5, 6.