In a Cylinder-hosted webinar, experts from Lyra Health and Cylinder shared how digestive care improves adherence, delivers better results, and protects ROI. Here’s a recap of the key insights.
Q: What are GLP-1s and why are they making headlines?
A (Dr. Hau Liu, Chief Medical Officer at Cylinder): GLP-1s are powerful medications originally used for diabetes. Now, they’re widely used for weight loss and to manage conditions like heart and liver disease. They work by regulating appetite, slowing digestion, and keeping blood sugar steady, which makes them a really effective tool, both for metabolic health and cardiovascular health. Their effectiveness is fueling a lot of excitement. But for many people, GI side effects, like nausea, bloating, and chronic diarrhea are common.
Q: How common are digestive side effects?
A (Yael Horwitz, Clinical Programs Manager at Cylinder): In Cylinder’s Harris Poll, 86% of GLP-1 users reported GI symptoms like nausea, constipation, diarrhea, or abdominal pain. Over half (55%) had unmanaged GI issues before starting the medication, making them more vulnerable to side effects.
Q: Why do GLP-1s cause GI issues?
A (Dr. Liu): GLP-1 drugs reduce hunger and increase satiety by acting on the brain, boost insulin production in the pancreas to help manage diabetes, and slow gastric emptying in the stomach. While these mechanisms drive benefits, slowed digestion can also cause common GI side effects such as bloating, nausea, vomiting, abdominal pain, and gastroparesis, especially if doses are increased quickly, meals aren’t timed well, or diet isn’t adjusted.
A (Dr. Bravata, Lyra Health Co-Founder): These drugs mimic naturally occurring gut hormones, so GI symptoms are expected. With the right dietary and dosing support, they’re often manageable.
Q: How can digestive care improve tolerance?
A (Dr. Bravata): It all comes down to personalization. That means starting slowly with the right dose, adjusting your diet to avoid trigger foods, staying hydrated, and timing meals in a way that works with the medication. When people know what to expect upfront, they’re more likely to feel better and stay on track.
A (Dr. Liu): The earlier we step in with the right support, the more likely someone is to stay on their medication and see real results.
Q: What’s the risk if GI side effects go unmanaged?
A (Dr. Liu): When side effects aren’t addressed, people often stop the medication too soon. That means they lose the progress they’ve made and many regain the weight, sometimes ending up in a worse spot than before.
A (Dr. Bravata): If someone reaches their goal and then stops, that’s okay, but they need a plan. Lifestyle changes or other medications can help maintain the benefits long term.
Employer impact
For HR and benefits leaders, early discontinuation isn’t just a health issue, it’s a business one. GLP-1s are among the costliest drugs on the market, and every member who stops therapy represents wasted pharmacy spend. Add in the productivity impact of unmanaged symptoms, and the stakes get even higher.
Q: Why is adherence so hard and how does Cylinder make a difference?
A (Dr. Liu): Across the country, a lot of people stop taking GLP-1s because of side effects and not enough support. At Cylinder, we see the opposite: 87% of our members say they plan to stay on therapy because we give them the right support from day one. We focus on:
- Smart dose management (slow, steady escalation).
- Clear education (what to expect, how to stay ahead of symptoms).
- Targeted digestive support (food tweaks, hydration, fiber, meal timing).
Employer impact
That means more of your investment in GLP-1s translates into sustained health improvements, reduced pharmacy waste, and healthier, more productive employees.
Q: What role does stigma play?
A (Dr. Bravata): People with chronic digestive disorders already face stigma due to symptoms like nausea, diarrhea, or dietary restrictions. Adding GLP-1 treatment can compound this. Patients may feel singled out if the drugs don’t work for them, while also facing societal stigma around obesity, weight-loss medications, and the misconception that weight should be managed through willpower alone.
This underscores the need for empathic, personalized care that acknowledges these burdens. Compassionate, personalized care helps address both physical and emotional challenges.
Q: How does the rise of compounded and oral GLP-1s change the landscape?
A (Yael Horwitz): Many users (40% in our member survey) take compounded GLP-1s, which often don’t appear in claims data, which makes it harder for employers and plans to track ROI or manage spend effectively.
A (Dr. Liu): We’re also seeing more interest in oral GLP-1s. They may not be quite as effective as injectables, but they often come with fewer side effects, so more people can stick with them.
A (Dr. Bravata): And the truth is, not everyone needs the highest dose. Lower doses or other medications can still help people hit their goals, especially when paired with the right support.
Q: If insurance doesn’t cover GLP-1s, what are the options?
A (Dr. Bravata): There are still options. Some drugmakers offer patient-assistance programs that lower the cost. Compounded versions and other weight-loss medications may also be available at a lower price. And for eligible members, Medicare and Medicaid often have reduced-rate programs. The key is helping people find a path that works—for their health and their budget.
Key GLP-1 takeaways
GLP-1s can be transformative, but success takes more than a prescription. Without wraparound support, employers risk:
- High drug spend with little return when members discontinue early.
- Lost productivity from employees sidelined by GI side effects.
- Benefit fragmentation and admin burden trying to piece together solutions.
We work alongside members’ prescribing providers to manage digestive side effects, improve GLP-1 tolerance, and keep more people on track to reach their goals. This results in better outcomes, less wasted spend, and a stronger return on your investment.
If you missed the live session, watch the on-demand recording.
Watch the recap or let us know if you want to talk about how our approach can support your population.
