Unless you have been living under a rock for the past year, you will be aware of the significant media attention surrounding a group of new medications known as GLP-1 agonists, often referred to in the press as “weight loss injections” or “skinny jags.”
I’ve been getting more and more questions about this topic lately, and I’ve even had the chance to share my thoughts on TV. So, let’s dive in and explore this interesting area of medicine together!
GLP-1 agonists are pretty fascinating! They work by mimicking a natural hormone called glucagon-like peptide 1 (GLP-1), which helps keep our blood sugar levels in check. When your blood sugar rises, GLP-1 signals your pancreas to release more insulin. That’s why these medications were originally created to help people with type 2 diabetes. But there’s more to the story! GLP-1 agonists also slow down how quickly food leaves your stomach, which helps you feel full for longer. Plus, they send signals to your brain to curb your appetite. This is great news if you’re trying to manage your weight! By making you feel satisfied and less hungry, these medications can help you eat less without feeling like you’re missing out. Many people who use them say they think about food less and find it easier to resist cravings.
This all sounds promising, doesn’t it? But like any medication, there are some side effects to keep in mind. The most common ones are generally not too serious but can still be uncomfortable. For example, you might experience stomach pain, indigestion, nausea, vomiting, diarrhoea, or even constipation as the movement of food through your digestive system slows down.
There are several serious side effects to consider, including gallbladder disorders, intestinal obstructions, acute pancreatitis (inflammation of the pancreas), kidney problems, and heart issues. Fortunately, these serious side effects are quite rare.
Additionally, we need to consider the cost and availability of these medications. They are not widely available on the NHS due to their high cost and are typically reserved for specialist (tier 3) weight loss services.
If we prescribed them to everyone who qualifies, it would blow the NHS budget! That’s why many people turn to sourcing them privately. While some find trustworthy sources, others may turn to less reliable online vendors or even the black market, which can be risky. I’ve seen patients buy these medications from their hairdressers, which doesn’t guarantee their safety. I have also had a patient with anorexia who managed to buy them online by giving false information about her weight. It’s crucial to be careful and informed when it comes to these medications!
Do they work?
Yes, they do. In my 20-year medical career, this is the first weight loss drug I have seen that truly works. Time and again, I hear patients describe it as “life-changing.” While people are successfully losing weight, one big question remains: What happens when it’s time to stop using these drugs? The current longest licensed use for one of these medications, Mounjaro, is two years. It’s not surprising that pharmaceutical companies are investing heavily in research for longer licensed uses; after all, the longer people stay on these drugs, the more revenue the companies generate. What is clear is that if individuals haven’t made lifestyle changes—such as improving their diet and becoming more active—or addressing the emotional triggers behind their eating habits, they are likely to regain weight once they stop the injections. In some cases, they may even gain back more weight than before. That’s because weight loss from these injections can lead to muscle loss if one does not engage in intentional muscle-building exercises. Since muscle is a calorie-hungry tissue that burns a lot of energy, losing muscle during treatment with GLP-1 agonists can decrease metabolism, making weight gain even more likely once the medications are discontinued.
Taking everything into account, I’d like to share my thoughts on these medications.
For many people, they can be a helpful tool in making positive lifestyle changes, but they aren’t the complete solution on their own. If you use them without addressing things like what you eat, how much you move, how you manage stress, your sleep quality, and your emotional well-being, you might find yourself gaining weight back when you stop them.
These medications must be used as a part of a program that understands the complex nature of obesity. Treatment should support people in recognising what led them to become obese and how to navigate the challenging obesogenic world we live in.
One aspect that has always troubled me about the weight loss industry is its impact on self-worth. The notion that a person’s value is tied to their appearance and body aesthetic is fundamentally wrong. Each of us is unique, and a one-body size-fits-all should not apply!
Whilst body positivity is important, clinical obesity is a disease, and it now appears we have a family of drugs that can help manage it. We don’t hesitate to use medications to treat high blood pressure or type 2 diabetes, both of which can develop due to unhealthy lifestyle choices. So why should we have a problem with using GLP-1 agonists to treat clinical obesity?
It’s important to remember that there are various ways to lose weight; medication is not the only option. However, making sustainable behavioural changes can be challenging and takes time. This is one reason I founded Maldod Life: to assist people in making comprehensive behaviour changes, regardless of their goals. If you choose to use weight loss injections to aid in your weight loss journey, ensure that you are also following a behavioral and lifestyle change program alongside the medication. This is something I can help you with at Maldod Life.
