ASGE Annual GI Advanced Practice Provider Course (Virtual) (Day One) | March 2026-SESSION B: GLP-1 Therapies- GI Implications and Patient Management

SESSION B: GLP-1 Therapies- GI Implications and Patient Management

Video Transcription

Video Summary

The speaker reviews GLP-1 receptor agonists for obesity and diabetes, emphasizing obesity as a complex, chronic, relapsing disease requiring individualized care. GLP-1 therapies (e.g., semaglutide, tirzepatide; injectable and oral forms) promote weight loss by increasing satiety via brain pathways and slowing gastric emptying and gut motility. Because of this, gastrointestinal adverse effects are common (up to 40–70%), especially during initiation and dose escalation, including nausea, vomiting, constipation, diarrhea, bloating, and reflux. Management focuses on “start low, go slow,” maintaining the lowest effective dose, addressing baseline constipation before treatment, dietary strategies (small frequent meals; avoid fatty foods), and close follow-up for accountability and symptom monitoring. The talk highlights contraindications (MEN-2/medullary thyroid cancer; pregnancy; caution with prior pancreatitis, gastroparesis, severe GERD/Barrett’s) and stresses evaluating alternate causes of symptoms (e.g., C. difficile). Discontinuation is common due to cost and tolerability.

Asset Subtitle

Sarah Kosinski, DNP, APRN, FNP-BC

Keywords

GLP-1 receptor agonists

semaglutide

tirzepatide

obesity management

gastrointestinal adverse effects

dose titration (start low, go slow)