Weight loss drugs
Are weight loss drugs the remedy for obesity?
Read on for my views on these and why I don’t believe we should be getting quite so excited about them. There are much better ways to sustainably lose weight, and improve health, for most people in my opinion.
Whilst these drugs can help with weight loss they don’t tackle the root cause of the weight gain in the first place. They can have some unpleasant side effects and would need to be taken in perpetuity to maintain the weight loss. It really is unrealistic to expect that excess weight will magically fall off, and stay off, without dietary change.
Changing your diet to be focused on real, lower carbohydrate, food, aligned to our biology, is a much better way to lose weight and can be sustained over the longer term.
One key reason we are overweight as a nation is, I believe, due to the flawed dietary guidelines and advice given to people – simply moving more and eating less being a classic example. I feel passionately we need to change the advice rather than trying to fix the resulting problem with drugs. The pharma companies making the drugs are already smelling the money with estimates of a billion people overweight or obese. That is a lot of potential sales to chase down!
What are the weight loss drugs everyone is talking about?
The new drugs on the block, developed to help with diabetes and obesity, that are currently very high profile with many celebrities using them and the latest jewels in the crown for several pharmaceutical companies are GLP-1 agonists, which I explain more about below. Commonly talked about in the media as weight loss or obesity drugs.
There are currently three main brands; Ozempic and Wegovy from Novo-Nordisk with the active ingredient being semaglutide and the more recent launch Mounjaro from Eli Lilly which contains tirzepatide.
They are taken as weekly injections and people have typically lost 15% of their body weight in clinical trials as a result of using them. Which sounds great and highly seductive for people wanting to lose weight ‘easily’ without changing anything else about how they live and eat.
They are licenced in the UK to help with the management of type 2 diabetes and also obesity for those with a BMI over 30. And they currently cost a cool £160 a month or just under two grand a year, which would be a hefty addition to the NHS drugs bills if every overweight person in Britain was prescribed them….
How do they work?
GLP stands for ‘glucagon like peptide’ which is a hormone we release after eating to supress appetite, stimulate insulin production and stop the liver producing glucose to help manage our blood sugar levels. The new class of prescription drugs mimic the effect of this hormone, leading to reduced appetite and a slower movement of food through the gut so people feel fuller for longer and eat less overall.
I found this quote about Ozempic from Tracy Morgan amusing and also depressing in equal measure as just eating less food, particularly junk food, is not the best way to go about losing weight for most people. Eating half a bag of Doritos is still not great and won’t nourish your body.
The downsides
All drugs have side effects so a careful assessment of the benefits against the potential problems should always be done before taking any drug, in conjunction with healthcare professionals who know your medical history.
So what are the potential downsides of these new weight loss drugs? There are a few with the most notable ones currently known about below – as yet we have no understanding of any long term risks for these drugs.
The other aspect to consider is that you need to keep having the injections to keep the benefits. If you stop having them you are likely to regain the weight you lost. This doesn’t sound great to me and no wonder the pharma companies financial values are sky rocketing and they are rubbing their hands with glee! 1 billion people is a lot of overweight people to get into the habit of a weekly injection….
There are better ways to lose weight!
Like Prof. Roy Taylor, a leading diabetes and weight loss expert at Newcastle University, said, I believe ‘we can’t drug ourselves out of Britain’s obesity crisis’ but need to go back to some basics and focus on dietary change.
We started to become overweight as a nation when we introduced dietary guidelines demonising fat and encouraging people to have half of their plate made up of refined carbohydrates. This has not served us well as many people are carbohydrate intolerant and putting on weight, especially around the middle of our bodies, is a key signal of this. Cutting down on the carbs, ditching the sugar and reducing your frequency of eating can all have a big impact on weight without relying on the need for weight loss drugs.
Other healthcare breakthroughs, such as CGMs, can be really powerful tools to help people figure out how carbohydrate intolerant they are and identify when and what to eat to minimise the blood sugar spikes that can lead to weight gain.
More and more of my clients self experiment with a trial of these devices, with my coaching support, to help them figure out how to interpret and act on their data. They provide a truly personalised response that gives a window into your own biology that can be a game changer for weight loss.
CGMs cost a lot less than £160 a month and you won’t need them for ever to keep the weight off!
Contact me to arrange a chat if you struggle to sustain a healthy weight and want to see what you could achieve with dietary changes that fit with your lifestyle, helping you improve your long term health.