Why This Matters
If you’re navigating fertility, pregnancy, or postpartum and feeling overwhelmed by all the talk about GLP-1s, you’re not alone. It can feel like everywhere you turn, someone’s praising or questioning these meds. It’s hard to know what to believe. Thin is back in, and the days of #bodypositivity feel like a fever dream. Some of the biggest questions I hear from my perinatal clients are about GLP-1 use in pregnancy, postpartum and fertility. Is it safe, helpful, or harmful?
The rise in use of GLP-1 medications like Ozempic, Wegovy, and Mounjaro has been accompanied by a rise in online discourse around what it means to use them. Does taking a GLP-1 mean you are taking the “easy way out?” or triggering an eating disorder? Are you supercharging your health or risking life-altering side effects? MANY people are asking about the safety and benefit of GLP-1 medications – even while taking them.
It’s my hope that this blog will offer some clarity and needed nuance around GLP-1s from a weight-neutral lens. Particularly for those who are trying to conceive, pregnant and postpartum.
What Are GLP‑1 Medications?
Before diving in to GLP-1s and pregnancy, let’s first talk about what GLP-1 medications are and how they work. GLP-1s (glucagon-like-peptide-1 receptor agonists) mimic a natural hormone in the body that helps regulate blood sugar and appetite. GLP-1s were originally developed to help manage Type 2 diabetes, but they are now commonly prescribed for weight loss. You may recognize brand names such as Ozempic, Wegovy, Mounjaro and Zepbound.
How do they work?
GLP-1 medications work by:
- Slowing gastric emptying, which keeps you feeling full for longer
- Increasing insulin production from the pancreas and increasing insulin sensitivity in various tissues in the body
- Reducing appetite by acting on hunger centers in the brain
- Suppressing glucagon, a hormone that raises blood sugar
To support informed decision-making, it’s also worth distinguishing between the current FDA-approved uses of GLP-1 meds and off-label applications. GLP-1s like Ozempic, Victoza, Trulicity and Mounjaro are approved for blood sugar management in adults with Type 2 diabetes. Additionally, some GLP-1s are approved for “weight management” in adults who meet BMI criteria with or without another metabolic dysfunction (like high blood pressure, diabetes, or high cholesterol). In both cases, these medications are intended to be used long-term in combination with lifestyle interventions to support overall wellbeing.
Two GLP-1s (Saxenda and Wegovy) are currently approved for use in adolescents ages 12 and up. Ozempic, Mounjaro and Zepbound are not approved for any pediatric use. (This blog is not where I’m going to discuss the nuance and potential harm of prescribing GLP-1s to teens. But boy oh boy, could I write one!)
This contrasts with various off-label uses of these medications, where GLP-1s are prescribed to treat conditions that the FDA has not fully approved. This is legal and common in medicine but should be guided by evidence and shared decision-making.
Common Off-Label Uses
Polycystic Ovary Syndrome (PCOS)
- Some providers prescribe GLP-1s to improve insulin resistance, weight-related symptoms, and menstrual regularity
- Small studies show potential benefits
Infertility / Preconception Support
- Off-label use in people trying to conceive (especially those with an elevated BMI and/or insulin resistance).
- Some studies show improved fertility outcomes. However there is no established safety profile for GLP-1 in pregnancy and experts recommend discontinuing 1-2 months before conception.
Pre-diabetes or Insulin Resistance (without T2D)
- Used to improve metabolic markers in high-risk individuals, though not officially approved for prediabetes alone.
Postpartum Weight Management
- Some are prescribed off-label in the postpartum period, though safety while breastfeeding has not been established and is generally not recommended.
Key note: GLP-1s are not approved for treatment of Type 1 diabetes, or for weight loss in individuals with a BMI <27 without complications. GLP-1 and pregnancy or lactation are not recommended.
GLP‑1s & Fertility: What We Know
Now that we have a basic understanding of what GLP-1s are and why they’re most commonly prescribed, let’s talk about their use during the preconception period. If you’re struggling with fertility (or expect you might, especially if providers have pointed to your BMI as a barrier), you may be wondering whether a GLP-1 could help.
In the fertility space, it’s often repeated that losing weight can improve outcomes for individuals with a BMI above “normal.” But this advice isn’t always helpful, or even rooted in full-body health.
Here’s why:
- “Weight loss” isn’t a behavior. It’s a possible outcome. One that can vary wildly depending on the person, the context, and the method. There’s no universal formula that guarantees weight loss leads to improved fertility. Many behaviors pursued in the name of weight loss may not be supportive of reproductive health at all.
- The “calories in / calories out” model oversimplifies what’s actually a complex and sensitive system. If you’re eating less and moving more in pursuit of weight loss, or if a medication like a GLP-1 is suppressing your appetite to reduce intake, your body may interpret that as stress. In response, it often lowers your metabolic rate to preserve energy. This can actually work against your hormonal and reproductive health.
- Your body needs adequate nourishment to regulate hormones, support ovulation, and prepare for pregnancy. Many people who pursue weight loss through restriction end up undernourished. They may develop nutrient deficiencies, hormone disruptions, and elevated stress levels, all of which can negatively affect fertility.
- And let’s not ignore the impact of weight stigma in healthcare. If a provider told you to “just lose weight” before trying to conceive without asking about your eating patterns, your cycle, or your relationship with food (and don’t get me started on the lack of eating disorder screening), that’s not evidence-based care. That’s bias. And it’s harmful. You are not imagining things if you feel ashamed, angry, or like your body is broken after that kind of appointment.
Lifestyle changes can absolutely support fertility, and some may result in weight loss. But that doesn’t mean weight loss should be the goal, or that medications meant to suppress appetite are always a helpful first step.
How GLP-1s are Currently Used
That said, GLP-1s are currently being prescribed off-label to support fertility, particularly for those with PCOS. There’s some promising research showing they may help improve insulin sensitivity, restore more regular menstrual cycles, and support spontaneous ovulation. The female reproductive system is highly responsive to changes in insulin, which is why PCOS (a condition often marked by insulin resistance) can so strongly affect ovulation. GLP-1s appear to improve insulin signaling across the hypothalamic-pituitary-gonadal axis, which could explain these benefits. What’s less clear is how GLP-1s might affect fertility in those without PCOS.
There’s also a major caveat here: GLP-1s are considered a pregnancy category C medication. This means the safety of GLP-1 in pregnancy hasn’t been established. It’s recommended that they be discontinued at least two months before trying to conceive.
There’s also the question of long-term safety. GLP-1s are still relatively new in the way they’re being used now, and we simply don’t have enough data to understand their full impact over time – especially in younger populations or those using them off-label.
And finally, we have to talk about disordered eating. GLP-1s are powerful appetite suppressants, and for individuals with a history of restriction, bingeing, purging, or body image struggles, they can be destabilizing. It’s incredibly concerning that most prescribers are not screening for eating disorders before starting these medications. If you are in eating disorder recovery, GLP-1s are not a safe choice. Period.
GLP-1 and Pregnancy: What We Know
If you’re curious about GLP-1 and pregnancy, know that the research is still emerging. GLP-1 medications are considered pregnancy category C, which means their safety during pregnancy has not been firmly established. Most current guidelines recommend stopping GLP-1s at least two months before trying to conceive, especially because some of these medications stay in the body for weeks after the last dose.
Animal studies have shown concerns like reduced fetal growth, developmental abnormalities, and pregnancy loss at doses similar to those used in humans. However, emerging human data have not shown an increased risk of major birth defects when GLP-1s were used during early pregnancy. That said, these studies are still limited. Most were not designed to evaluate long-term outcomes in children exposed to these medications in-utero.
If you are worried about using a GLP-1 during pregnancy and are managing type 2 diabetes or another medical condition, it is important to have an open conversation with your healthcare provider about whether it makes sense to continue or switch medications during pregnancy. For some individuals, the risks of stopping abruptly may outweigh the potential risks of continuing.
But for those using GLP-1s for weight loss or weight management alone, pregnancy is not the time to begin or resume one. Nutrient needs are high, appetite naturally increases, and weight gain is not only expected, it’s necessary for the health of both you and your baby. GLP-1s work by suppressing appetite and slowing digestion, which directly conflicts with what your body needs to support a growing pregnancy.
GLP-1 Use in the Postpartum Period: What to Consider
Since GLP-1 and pregnancy are often discussed with caution, many individuals may wonder when it is safe to resume (or start using) these medications after giving birth.
First of all, I deeply understand the desire to return to your “pre-baby body” after having kids. Motherhood is a profound identity shift, and it is natural to long for a sense of familiarity and control. When your body has changed, grown, and softened through pregnancy, it can be incredibly difficult to accept that this new body is your home (and your baby’s) without rushing to change it.
If you are considering a GLP-1 medication in the postpartum period, here are some important things to know.
What About Breastfeeding?
GLP-1s are not currently recommended during breastfeeding. One reason is that it remains unclear whether these medications are transferred into breast milk. A very small study of eight breastfeeding individuals did not detect significant levels of GLP-1 in milk. However, animal studies have shown that transfer can occur, and the long-term effects of exposure through breast milk are still unknown. While there is currently no strong evidence that GLP-1s are harmful to breastfeeding infants, much more research is needed before these medications can be considered safe during lactation.
Another consideration is milk supply. Adequate nourishment is one of the most important factors in maintaining a healthy supply. This includes not only eating enough calories but also ensuring consistent intake of protein, carbohydrates, fats, fluids, and key micronutrients. GLP-1s are well known for reducing appetite, and this can make it more difficult for a new mom to meet her nutrition needs. While everyone responds differently, there is reason to be cautious about how these medications might impact milk production and overall postpartum recovery.
What If You Are Not Breastfeeding?
Even if you are not breastfeeding, there are still meaningful considerations when it comes to using GLP-1s after pregnancy. The postpartum period is a time of major physical and emotional change. Hormones are fluctuating, sleep is often disrupted, and the demands of caring for a newborn can feel overwhelming. These factors alone make this a high-risk period for the return or development of disordered eating and body image distress.
GLP-1s work in part by suppressing appetite. For someone who is already feeling disconnected from their body or struggling with how it looks, using a medication that reduces hunger cues can create a slippery slope to intentional restriction, guilt, and shame around eating.
There is also the deeper issue of how we, as a society, respond to postpartum bodies. The pressure to “bounce back” can be relentless, and that pressure often gets internalized. But healing from birth is not something that should be rushed. Your worth is not defined by how quickly you can shrink your body. Weight changes after pregnancy are normal, expected, and not something that needs to be “fixed” with medication.
So What Can You Do Instead?
If you are feeling uncomfortable in your postpartum body, you are not alone. It is absolutely valid to want to feel more like yourself again. But there are ways to support your health that do not require silencing your body’s needs. Regular meals and snacks, flexible movement when you are ready, adequate rest, connection with others, and mental health support can all play a role in helping you feel more at home in your body.
And if your relationship with food or your body feels overwhelming right now, please know there is help available. You do not have to go through this alone.
The Bottom Line
Whether or not you are breastfeeding, using a GLP-1 medication in the postpartum period is a personal decision that deserves careful consideration. Before starting or restarting one of these medications, I encourage you to look beyond the promise of weight loss and consider the full picture: your mental health, your relationship with food, your energy levels, and your values.
A Weight‑Neutral Perspective
So, what is my opinion about GLP-1s as a weight neutral provider? Like most things in nutrition and healthcare, it’s nuanced – and my perspective has evolved as these medications have become more widely used.
What hasn’t changed is this: prescribing a GLP-1 for weight loss is, at its core, not all that different from prescribing a diet. Yes, these medications do more than just reduce food intake. They can lead to real metabolic improvements, especially for people with insulin resistance. But maintaining the body changes that happen while using GLP-1s often requires staying on the medication long-term — potentially for life. And we still don’t fully understand the long-term effects of chronic GLP-1 use.
It’s also important to underscore that eating less means taking in fewer nutrients. Your body needs consistent energy and micronutrients to support a functioning metabolism, immune system, bone strength, muscle maintenance, cognitive function, and heart health. Many people prescribed GLP-1s for weight loss report GI side effects and a drastically reduced appetite, which can make it incredibly difficult to eat enough to meet basic needs – let alone thrive.
And I cannot overstate the slippery slope GLP-1s create for those with a history of disordered eating or body image struggles (and let’s be honest — that’s a lot of the people who feel drawn to these medications). Eating disorders affect people in all body sizes, and those in larger bodies are especially vulnerable to being overlooked or actively harmed by a medical system that overemphasizes weight loss. For many, GLP-1s can deepen disconnection from hunger cues, reinforce fear of weight gain, and make recovery feel even further out of reach.
Some hard truths:
- GLP-1s are not making our society more body-positive or body-accepting.
- Experiencing less “food noise” does not mean your relationship with food is healed.
- Feeling okay in your body only when it’s smaller is not the same as resilient body image.
- Restriction is restriction — whether it comes from willpower or from a medication that shuts down your hunger.
And still… I do not blame or shame anyone for being curious about or starting a GLP-1. Whether it’s been prescribed by a doctor or discovered through social media, the appeal of losing weight without “trying” is incredibly strong – especially in a world that celebrates thinness and makes it harder to live in a larger body. The truth is, life can feel easier in many ways when your body is smaller, and that’s not your fault – that’s weight stigma.
What I advocate for is informed consent. That means having real conversations about side effects, emotional impact, disordered eating risk, and long-term consequences – including a proper eating disorder screening. Everyone deserves care that is holistic, respectful, and tailored to their full lived experience.
I know there are people who feel genuinely better while taking a GLP-1, and I don’t want to minimize that. My hope is to simply add some necessary nuance to the otherwise “sunshine and rainbows” messaging that often surrounds these medications in weight-loss spaces.
Supporting Clients Through These Questions
For many of my clients, conversations about GLP-1s don’t come out of nowhere. They come from real struggles. Feeling stuck in a body that’s changed. Managing insulin resistance, PCOS, or a history of restrictive eating. Wanting to feel at home in their skin again after pregnancy. It’s all valid. My role is to help you navigate these questions with compassion, clarity, and context.
If you’re wondering whether a GLP-1 is right for you, here’s how I can support you:
We will get clear on your goals and where they’re coming from.
Together, we unpack the “why” behind your interest in weight loss or GLP-1 use. Are you looking for more energy? Relief from food obsession? Control in a world that feels unpredictable? This helps us figure out what you’re really hoping to feel, and whether a GLP-1 is likely to help in a sustainable, meaningful way.
We will center nourishment, not numbers.
Whether you’re trying to conceive, pregnant, or postpartum, your body needs fuel. Not just to function, but to thrive. I help you reconnect with hunger and fullness, plan realistic meals (even when you’re exhausted), and meet your nutrient needs without restriction.
We will name body grief and the pressure to “get your body back.”
Pregnancy and postpartum often reshape your body and identity in ways that can feel disorienting or even distressing. I hold space for those feelings, and help you build body respect even if body positivity feels out of reach. We talk honestly about what’s driving the desire for weight loss and offer sustainable, shame-free ways to care for your body in its current form.
We will screen for disordered eating and support full recovery.
If GLP-1s are being considered and there’s a history of restriction, bingeing, purging, or body image distress, we don’t ignore it. We name it, explore it, and build support systems that put your mental and physical health first.
We will collaborate with your care team.
I work alongside prescribers, OBs/midwives, and mental health providers to make sure your care is truly integrated and aligned. You deserve a team that talks to each other and puts your full well-being at the center.
There is room for nuance, and there is space for you.
You deserve full-spectrum support without shame, shortcuts, or silence. Whether you’re using a GLP-1, considering it, or trying to understand your options in a weight-focused world, I’m here to help you navigate it with care, curiosity, and evidence-based guidance.
If you’re weighing the risks and benefits of GLP-1 and pregnancy, postpartum use, or fertility support, or just need a safe space to talk through your options, I invite you to book a free Clarity Call. We’ll explore your goals, your questions, and how I can support you in finding a path forward that prioritizes your full wellbeing.
You don’t have to figure this out alone. Let’s talk.
