GLP-1’s and type 1 Diabetes – my off-label prescription

Welcome to the latest episode in our My Health Focus GLP-1 series, co-hosted with personal trainer Becky Lever. In this conversation, we’re joined by Sally, who shares her honest and powerful experience of using a GLP-1 medication as a Type 1 diabetic, an off-label prescription that has significantly changed her relationship with food, weight, and exercise.

This episode goes beyond weight loss. It explores food noise, muscle loss, perimenopause, strength training, and the importance of proper support when starting GLP-1 medication.

Top 5 highlights from the conversation

1. GLP-1 Use in Type 1 Diabetes Is Not Straightforward

Sally was not expecting to be offered a GLP-1 medication. In fact, it’s not routinely prescribed for Type 1 diabetes and is considered off-label at the time of this interview.

Her diabetes team suggested it after she described:

  • Struggles with weight gain linked to insulin use

  • Increasing “food noise”

  • Emotional reliance on food during stressful life events

  • A spiralling cycle between weight gain and diabetes management

This wasn’t a cosmetic decision; it was about improving metabolic control and long-term health.

2. The “Food Noise” Shift Can Be Life-Changing

One of the most powerful parts of Sally’s story is her description of food noise:

“Food has always been my go to – happy, sad, stressed.”

After starting GLP-1, that background noise significantly reduced. However, when she delayed a dose, she noticed:

  • Hunger returning quickly

  • Increased portion sizes

  • More subconscious snacking

  • The mental pull toward food resurfacing

This gave her insight into how deeply ingrained those patterns were — and why stopping medication feels complex.

3. NHS Support Was Minimal

Despite being prescribed through the NHS, Sally received:

  • No structured dietary guidance

  • No exercise advice

  • No detailed discussion of side effects

  • No written support materials

She had to research independently to understand issues like:

  • Hair shedding after rapid weight loss

  • Insulin adjustments

  • Nutritional considerations

  • Muscle loss risks

This highlights why informed, professional support is critical when starting GLP-1 therapy.

4. Resistance Training Is Essential on GLP-1

Becky emphasises a key point often missed in public discussion:

Weight loss on GLP-1 includes muscle loss unless resistance training is introduced.

In perimenopausal women especially, muscle mass is vital for:

  • Metabolic health

  • Blood sugar control

  • Bone density

  • Strength in later life

  • Injury prevention

Sally began strength training weekly with Becky and gradually built confidence using weights and machines something she previously found intimidating.

Now she can:

  • Train independently in the gym

  • Progressively overload safely

  • Maintain muscle while losing weight

Government guidance now recommends 2–3 resistance sessions per week, particularly in midlife women.

5. The “Forever Medication” Question Is Complicated

Sally was told she would likely be on GLP-1 long-term.

That raised important questions:

  • Is this a lifetime medication?

  • What happens when you stop?

  • Will the food noise return permanently?

  • Can lifestyle changes sustain results?

When she delayed doses, hunger and patterns returned quickly, which makes the decision emotionally complex.

There isn’t a simple answer. It requires:

  • Ongoing monitoring

  • Lifestyle support

  • Psychological awareness

  • Individualised medical advice

Sally’s journey reminds us:

  • GLP-1 can be a powerful tool

  • It is not a magic solution

  • Support systems matter

  • Muscle matters

  • Honest conversations reduce stigma

And perhaps most importantly:

Being open about your journey helps others feel less alone.

If you’re considering GLP-1 medication or currently using it, always speak with your GP, diabetes team, or specialist clinician before making changes to medication or exercise.

We’ll be continuing this series with deeper dives into food noise, long-term maintenance, and sustainable health.

About the Expert

Becky Lever is a qualified personal trainer with experience supporting clients who are using GLP-1 medications alongside exercise and lifestyle changes.

I’m Becky, I started Believe Fitness & Nutrition in 2022, I am a qualified PT, online health and nutrition coach and qualified menopause specialist. I recently completed training to enhance my support for clients using GLP-1 medications. I have always had a keen interest in sport, nutrition and fitness. As a youngster, I competed in ten-pin bowling for my country worldwide and can attest to the value of staying active and healthy.

I live in Hampshire. I enjoy walking, strength training, kyaking and cycling.

I have helped numerous men and women understand how to make better nutrition choices, learn how to exercise to achieve their goals and change habits and behaviours for a happier, healthier life.

Medical disclaimer

This content is for general information only and is not a substitute for professional medical advice. Always consult your GP or a qualified healthcare professional if you have any concerns about your health.