GLP-1s and GI care: The missing link in long-term outcomes

Authored by Dr. Hau Liu and Yael Horwitz,

GLP-1 medications like Ozempic, Wegovy, and Mounjaro have quickly become some of the most talked-about developments in health care. Originally developed to manage type 2 diabetes, they’re now widely used for weight loss and metabolic health. For the right patients, they can be life-changing.

But they’re not without tradeoffs and they’re not one-size-fits-all.

💡 GLP-1s: What you need to know

GLP-1s (glucagon-like peptide-1 receptor agonists) mimic a natural hormone in the body that helps:

• Regulate appetite

• Slow digestion

• Increase insulin secretion

By doing so, they help with weight loss, blood sugar control, and even reduce cardiovascular risk. Clinical trials show up to 15–20% body weight reduction, thus driving significant demand.

Many employers and health plans now offer access to GLP-1s, often through weight management programs. But access alone isn’t enough to drive real outcomes.

⚠️ The GI tradeoff

The most common (and disruptive) side effects of GLP-1 medications are related to  GI discomfort, including nausea, constipation, diarrhea, and abdominal pain. In a Cylinder conducted Harris Poll, 86% of GLP-1 users reported experiencing GI side effects. These symptoms can significantly impact quality of life and often make it difficult for individuals to continue treatment, contributing to high rates of discontinuation.

🔍 Why digestive health matters now

GLP-1 use is surging, but clinical support hasn’t kept up:

• 40% of users in our population are taking compounded versions—usually invisible to claims data

• Users may be prescribed GLP-1s online, by retail clinics or even in medical spas, with limited GI or behavioral support

• Rapid dose escalation, poor nutrition guidance, and unmanaged expectations amplify side effects

GLP-1s delay gastric emptying, which can trigger nausea, bloating, and constipation. These aren’t rare side effects, they’re expected pharmacologic responses. And for some, they escalate: A 2024 CDC-led study found that nearly 70% of GLP-1–related emergency department visits were due to gastrointestinal symptoms like nausea, vomiting, and abdominal pain. That’s why we view GI symptoms as the rule, not the exception.

✅ Cylinder’s clinical model: Digestive care that strengthens adherence

We don’t prescribe GLP-1s. But we’re a critical partner in making them work more effectively. Cylinder integrates digestive health support into the weight management journey, helping members:

• Manage side effects through evidence-based care

• Identify and address pre-existing GI conditions

• Get nutrition and behavioral guidance that reduces discomfort and improves adherence

With a care team that includes gastroenterologists, obesity experts, dietitians, and coaches, we help members stay on track safely and comfortably.

• Only 6% of Cylinder members on GLP-1s discontinue due to side effects

• Employers see up to 18% reductions in Med + Rx claims 

🩺 What this means for your population

Digestive care is the differentiator between a high-cost prescription and a high-value outcome.

• Fewer ED visits from unmanaged symptoms

• Higher adherence rates and sustained engagement

• Better long-term outcomes without bloated costs

• Happier, healthier employees who can show up and thrive

🌱 From prescription to personalization

Whether your members are on brand-name medications, compounded versions, or taking  GLP-1s for non-obesity conditions like cardiovascular or liver disease, the right digestive support changes everything.

We help you spot the high-risk cases early, intervene before costs spiral, and equip members with the tools to succeed.

📬 Want to see how it works in your population? Connect with us to learn more.