Your Genes May Predict How Your Body Reacts To Glp-1s, Ne…
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October 23, 2026
Assistant Health Editor
Assistant Health Editor
Sela Breen is the Assistant Health Editor at mindbodygreen. She is a graduate of the Medill School of Journalism at Northwestern University, where she studied journalism, international studies, and theatre.
Image by Milles Team
October 23, 2026
If you’ve ever scrolled through social media and wonder why everyone else seems to be losing 40 pounds on GLP-1s while you’re struggling to see a difference, you’re not imagining things. The difference might actually be written in your DNA.
A new large-scale study published in Nature has identified specific gene variants that may predict how much weight you’ll lose on GLP-1 medications semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro, Zepbound), and whether you’ll experience side effects nausea and vomiting along the way.
What the research found
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Researchers at 23andMe surveyed nearly 28,000 people taking GLP-1 medications and conducted a study to identify genetic factors linked to treatment response. The participants were mostly female (82.4%), with a median age of 52, and had been on their medication for a median of 8.3 months. Participants lost about 25 pounds on average, which amounts to approximately 11.7% of their pre-treatment weight.
Most notably, the researchers identified a specific variant in the GLP1R gene (the gene that encodes the receptor these drugs target) that was associated with greater weight loss.
People who carried this variant (called rs10305420) lost an additional 1.67 lbs per copy of the variant allele. The finding was significant enough to replicate in a separate cohort of 4,855 people from the All of Us research program, which gives research confidence this genetic link is legitimate.
The discovery of this genetic variant may help explain some of the differences in drug efficacy observed across populations.The variant was most common in people of European (40%) and Middle Eastern (38%) ancestry, and least common in those of African ancestry (7%).
The genetics of GLP-1 side effects
If you’ve experienced nausea or vomiting on a GLP-1 medication, you might have wondered if it means the drug is “working.” According to this research, there may be some truth to this theory.
The same GLP1R varaint linked to greater weight loss was also associated with a higher lihood of experiencing nausea and vomiting. The researchers found that these signals ly the same underlying genetic cause, suggesting that side effects and efficacy may be biologically connected.
For people taking tirzepatide specifically, there’s another gene in play: GIPR. Tirzepatide is a dual agonist, meaning it targets both the GLP-1 and GIP receptors. The study identified a variant in the GIPR gene (rs1800437) that was linked to vomiting risk, but only in tirzepatide users, not those on semaglutide. People who carried the genetic varaints at both the GLP1R and GIPR genes had a 14.8-fold increased odds of experiencing vomiting on tirzepatide compared to those without these variants.
RELATED READ: New Research Suggests Overlooked Effect Of GLP-1s On Bone Health
Why your results may differ from others
Genetics isn’t the whole story. The researchers also built models incorporating non-genetic factors and found that variables sex, drug type, dosage, and time on treatment explained about 21% of the variance in weight loss.
Here are some more of their key findings:
- Women tended to lose more weight than men (12.2% vs. 10.0% BMI reduction)
- Tirzepatide users lost more weight than semaglutide users, despite similar treatment durations
- People with type 2 diabetes lost less weight, about 2.87 percentage points less than those without the condition
- Ancestry played a role, with GLP-1 medications appearing most effective in people of European ancestry, ed by Latino ancestry, and least effective in people of African American ancestry
When the researchers combined genetic and non-genetic factors into a single model, they could explain about 25% of the variance in weight loss outcomes.
What this means for the future of GLP-1 treatment
This research lays the groundwork for what scientists call pharmacogenetics, a field where doctors examine your genetic profile to predict how you’ll respond to a medication before you even start taking it.
While genetic testing for GLP-1 response isn’t clinically available yet, these findings suggest it could be on the horizon. This means people may be able to know ahead of time whether they’re ly to respond well to semaglutide, or whether tirzepatide might come with a higher risk of nausea.
For now, the study reinforces what many people on these medications already sense: individual response varies widely. Plus, this variation isn’t random: it’s at least partly biological.
RELATED READ: Why It’s Dangerous To Buy Peptides Online, From A Longevity Expert
The takeaway
Precision medicine for obesity is still in its early stages, but this study brings us one step closer to understanding why GLP-1 medications work differently for different people. And eventually, this research could lead to the ability to tailoring treatment to each patient’s unique biology.
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