Cortisol, Stress, and GLP1 Medications: What Patients Should Know

GLP-1 Medications and Cortisol: What’s the Connection?

GLP-1 medications like Ozempic, Wegovy, Mounjaro, and Zepbound are making a big impact in the world of weight management and metabolic health. And while a lot of people are talking about the appetite suppression and weight loss benefits, there's something else worth paying attention to your stress hormone—cortisol.

At Blossom Family Medicine, we love helping you connect the dots between your body’s systems. So today, we’re diving into how these medications might influence your cortisol levels, what that means for you, and how to support your body through it all.

First, What Are GLP-1s?

GLP-1 stands for glucagon-like peptide-1, which is a natural hormone your gut makes after you eat. It tells your body, “Hey, we’ve got food—no need to keep hunting for more!” GLP-1 medications are designed to mimic this hormone and help with things like:

• Lowering blood sugar

• Slowing down digestion

• Reducing appetite and cravings

• Supporting weight loss

• Improving insulin sensitivity

In short: they help your metabolism run smoother and give your body a chance to reset.

Now Let’s Talk About Cortisol

Cortisol is often called the “stress hormone,” but it does a lot more than just react to stress. It helps regulate: blood sugar levels, blood pressure, inflammation, energy levels, and sleep-wake cycles.

When cortisol is in balance, you feel grounded, energetic, and clear-headed. But when it’s too high for too long (poor sleep, high stress, overexercising, or inflammation), it can lead to things like fatigue, trouble sleeping, weight gain (especially around the belly), mood swings, and brain fog.

How Do GLP-1s Affect Cortisol?

This is still an area of active research, but here’s what we’re learning—and what we’re seeing in real patients:

GLP-1s Might Help Lower Chronic Cortisol

Some studies suggest these medications might help bring down high cortisol levels—especially in people with insulin resistance or prediabetes. When your blood sugar stabilizes and your body isn’t in constant survival mode, your adrenal glands (which produce cortisol) get to relax a bit too.

Weight Loss = Less Cortisol Load

Carrying extra visceral fat (especially in the belly area) can drive up cortisol. So, as GLP-1s help reduce that type of fat, it may naturally help rebalance your cortisol as well.

But Rapid Shifts Can Be Stressful, Too

Some people feel a little “off” in the first few weeks—more tired, wired, or emotional than usual. That might be your body adjusting to a new rhythm, new eating patterns, and a whole new metabolic state. All of this can temporarily affect cortisol levels as your system recalibrates.

At Blossom, we take this seriously. We don’t just prescribe a med and send you off—we walk with you through the changes and check in regularly to make sure your body (and your mind) are adjusting well.

How to Support Your Cortisol While Using GLP-1s

Here’s what we recommend to help keep your stress system in balance while on these medications:

Don’t Skip Meals (Even If You’re Not Hungry)

It’s super common to lose your appetite on GLP-1s—but skipping too many meals can backfire and actually spike cortisol. Focus on protein, healthy fats, and colorful veggies to keep your body nourished, even if you’re eating smaller portions.

Get Good Sleep

Cortisol is tightly tied to your sleep-wake cycle. Poor sleep = higher cortisol the next day. We’re big fans of winding down without screens, keeping your room cool and dark, and getting sunlight early in the day.

Manage Stress Proactively

Whether it’s breathwork, therapy, gentle movement, or just setting boundaries—your stress toolkit matters. Lower stress = lower cortisol = better outcomes.

Cortisol Test?

Let’s talk a little more about cortisol levels—because here’s the truth: they can change from day to day based on how you’re living, sleeping, eating, and coping.

These everyday experiences have a real impact on your cortisol rhythm, and at Blossom, we take the time to explore all of that with you. Your labs are just one piece of the puzzle. We look at the whole picture—because it all matters.

Now, should everyone get their cortisol checked? Not necessarily. In fact, most people don’t need routine cortisol testing unless we’re specifically concerned about something like adrenal insufficiency. That’s a clinical decision we make based on symptoms, history, and what we see in your other labs—not just because you’re tired or feeling “off.”

Bottom line: we don’t just order labs to order labs. We take the time to make sure the testing—and the care plan—makes sense for you. That’s the Blossom way.

The Big Picture

GLP-1 medications are powerful tools, but they’re not magic bullets. Your hormones, your stress levels, your lifestyle—they all matter. And the good news? We can work with all of it.

At Blossom Family Medicine, we look at your whole picture. If you’re already on a GLP-1 or thinking about starting one, and you’re curious about how it could affect your energy, sleep, or stress—we’re here for that conversation (Learn more here) .

This is about more than weight loss. It’s about helping your body feel safe, supported, and well-regulated—so you can truly thrive.