The talk around weight loss injections is as loud as the conversations about food noise right now (more on that later). From mainstream news and social media to whispers in coffee shops, these medications are probably the most asked-about topic I hear, second only to back pain.
1139 words (approx), 5 minutes read
Side note: for readers elsewhere in the world, as a UK osteopath, I do not have prescribing rights. However, understanding medication is essential to supporting my patients’ overall wellbeing, as is recognising the complexities of health and wellness.
This is a big topic, split into two parts, so let’s dive in. Here’s the inside scoop on what these medications do, who they’re intended for, and what to watch out for.
Introduction
It goes without saying that obesity is a serious, growing, and complex health issue across the UK and around the world. The causes are multifactorial and influenced by genetics, environment, lifestyle, culture, and more. There is no single solution that fits everyone. As a result, more people are turning to medical options to support their weight and overall health.
One class of medication in particular is generating huge interest and reshaping how we approach not only obesity but also type 2 diabetes, certain inflammatory conditions, liver disease, and even addictions. Fewer people are opting for gastric surgery. Instead, they’re choosing medical therapy to take more control of their weight and health. While I have some concerns from a purely clinical perspective, it’s an encouraging and empowering trend.
What Are Weight Loss Injections?
Weight loss injections are prescription-only medications that mimic a hormone called glucagon-like peptide 1 (GLP-1), which helps regulate appetite and blood sugar levels. These drugs, known as GLP-1 receptor agonists (often shortened to GLP-1 medications), work by slowing stomach emptying and increasing feelings of fullness.
Initially developed for type 2 diabetes, they are now prescribed under medical supervision more widely to support weight loss. While injections are the most common method, some GLP-1 medications are also available in tablet form. However, these are less widely used for weight management.
Who Can Take Them?
Typically, they are prescribed to people with a BMI over 30, or those with a BMI over 27 if they have related health conditions such as:
- Type 2 diabetes
- High blood pressure
- Prediabetes
- Metabolic syndrome
Because this is not a decision to be taken lightly, your prescriber, whether a pharmacist or a doctor, will usually ask for your GP’s details. As with any prescription medication, a complete health review is necessary before starting to help create a full picture of your health. It ensures your treatment can be monitored safely and effectively.
Successful weight management often requires addressing not only physical but also emotional and psychological aspects; therefore, support in these areas is crucial alongside medical treatment.
Who Should Not Take Them?
They are not suitable for everyone. People with a history of thyroid cancer, pancreatitis, gallbladder issues, eating disorders, or who are pregnant or breastfeeding should not take them.
A Quick History of GLP-1s
The science behind these injections is intriguing. It apparently started with diabetes research and a surprising discovery in the saliva of a lizard.
- In the 1970s and 80s, researchers identified gut hormones that helped regulate insulin after meals.
- In 1992, a substance in the saliva of the Gila monster, a desert-dwelling lizard (photo below), was discovered to mimic GLP-1 and remain active in the body for a more extended period.
- The first GLP-1 drug, Byetta, was approved in 2005.
- Later medications, such as Victoza and Ozempic, offered longer-lasting effects.
- Saxenda was approved in 2014 specifically for weight management.
- Wegovy followed, showing 15 to 20 per cent weight loss over a year.
- Mounjaro, approved in 2022, works by targeting two hormones: GLP-1 and GIP. GIP, or Glucose-dependent Insulinotropic Polypeptide, is released by the small intestine after eating and helps stimulate insulin release to regulate blood sugar levels. It also plays a role in fat metabolism and appetite control. Because Mounjaro acts on both GLP-1 and GIP, it may offer more potent effects on weight loss and blood sugar management than medications that target GLP-1 alone.
Key Benefits
When combined with healthy lifestyle habits, GLP-1 medications can offer:
- Weight loss of 10 to 20 per cent over 12 to 18 months
- Better blood sugar control
- Lower appetite and reduced food noise (the constant mental chatter about food)
- Reduced inflammation
- Lower risk of heart disease
- Possible brain health benefits, including protection against Alzheimer’s and Parkinson’s
What Is Food Noise?
Food noise is the constant mental chatter about food, even when you are not hungry. These medications help reduce that persistent chatter or noise, making it easier to hear and respond to your natural hunger and fullness cues.
Emerging Research: GLP-1s and Addiction
One area of growing interest is how these medications might affect addictive behaviours. While research is still in the early stages, studies suggest that GLP-1 drugs may help reduce cravings not just for food, but also for substances like alcohol, nicotine, and even opioids. There are also reports of them helping with behavioural addictions such as gambling and compulsive shopping.
This appears to be linked to how GLP-1s act on the brain’s reward pathways, helping to regulate impulse control and reduce the mental pull toward certain behaviours. It’s early days, and these medications aren’t currently licensed for treating addiction, but the science is promising. Some researchers are now exploring their potential in managing alcohol use disorders, binge eating, and other compulsive patterns.
For now, it’s another reminder of how metabolic health, brain chemistry, and behaviour are more connected than we’ve often been taught.
Myth Busting
There is a lot of misinformation floating around, along with some harsh judgments. Here are just a few:
- “It’s a magic fix.” Sadly, no. These medications reduce appetite but do not replace the need for healthy lifestyle changes, such as a balanced diet and regular exercise.
- “It’s cheating.” Not at all. Using these drugs is like using nicotine patches to quit smoking.
- “Only celebrities and influencers use them.” False. These medications are prescribed by NHS services and specialist private clinics for individuals aged 18 years and above with genuine health needs.
- “You don’t have to change your habits.” Nope, this is a misconception. Medication works best when combined with lasting lifestyle changes, including regular exercise, a balanced diet, and emotional support to address your underlying issue with food.
- “Weight loss happens quickly and automatically.” Sadly, this is not true either. Weight loss with these injections is typically gradual and sustainable over several months, rather than instant or extreme.
These medications are reshaping treatment approaches, but there’s a lot more to consider beyond just how they work.
In Part 2, we’ll explore the risks, access routes, and how to use them safely, as well as how healthcare professionals like me can support you along the way. Read part 2 here
