Weight-loss drugs, like Ozempic, aren’t for everyone
Weight-loss medications, like Ozempic, Wegovy and Mounjaro have been hitting the headlines again as the stars of stage and screen graced award-season red carpets with noticeably thinner frames. As the media questions whether their dramatic weight loss is a result of taking GLP-1 receptor agonists medications, there’s growing concern that these drugs are being widely used for weight-loss alone.
We know, that for patients who need weight-loss medications, those with type 2 diabetes, obesity, insulin resistance, metabolic disorders and PCOS, the treatment can be transformative. These patients will have struggled for years, decades even, with their weight, and in our clinic at least, are medically prescribed the drugs, monitored whilst on them, and helped to come off them. They’re also given nutritional advice and suggested changes to their exercise regimes and lifestyle habits. This medicalised and holistic approach is key. Yet, growing numbers are self-prescribing, sometimes with life-changing consequences.
A recent study showed that 85% of people who stopped this type of treatment for obesity put the weight back on. The figure was slightly less for diabetics, but still a poor end stage result. This shows that without changing eating habits, and making psychological and lifestyle adjustments, these weight-loss medications can be a useless and sometimes dangerous option.
So, what are the issues?
Serious side effects when self-prescribing
These drugs are a relatively new treatment option and as such we don’t know the long-term effects of taking them. Serious side effects are rare for people who need them, and are under medical supervision, but patients report nausea and fatigue, constipation and other issues. When self-prescribed, issues around mental health and even unplanned pregnancy have been reported. Yes, as they delay stomach emptying, oral medications aren’t always absorbed fully, which can make the contraceptive pill less effective. The medications also affect anaesthetics.
Those at the top of the medical profession have repeatedly voiced their concerns about GLP-1 receptor agonists being “inappropriately used.” And it is widely agreed that taking these drugs whilst not under medical supervision is extremely dangerous. Professor Stephen Powis, NHS England’s national medical director, warns, “these are powerful medications. They are absolutely not quick fixes for those who are otherwise healthy, who just want to lose a few pounds." A&E departments report growing numbers of patients suffering serious side-effects from medications bought online. “Sadly, we are seeing life-threatening complications,” explains consultant, Dr Vicky Price, “including inflammation of the pancreas gland and alterations in blood salt levels in patients who were not aware of the risk they were taking.”
Less motivated to exercise
Lack of movement may not sound like a serious issue, but it is. Research shows that whatever her age, a woman’s main objective when she exercises is aesthetics and weight loss. If a drug can achieve this, then what does that mean for women’s health? It means we could be walking into a global health crisis. That may sound extreme, but we know that, as women age, working out becomes increasingly important. Whilst things like fitness, genetics, nutrition and alcohol consumption affect bone health, hormones are the main player. Oestrogen is most important for bone integrity and its decline at menopause means there’s less bone formation and more bone loss. And, as it also supports joints and soft tissue, we find more arthritis and joint inflammation. So, to counteract osteoporosis and sarcopenia in later life, women, from the age of forty, need to help themselves by ensuring they not only eat well and have sufficient Vitamin D, but also do adequate weight bearing exercise which itself stimulates bone growth.
If women choose a weight-loss pill, over working out, we are very likely to see an even greater rise in falls, fractures, and even deaths from these injuries in the over sixty-fives. Add to that issues around rapid, unhealthy weight loss and malnourishment and an even greater burden is placed on health systems globally.
The undoing of years of progress
We’ve taken small steps towards body acceptance and positivity over the past decades, but today’s focus on weight loss represents a huge leap backwards. By even commenting on a celebrity’s ‘svelte-like’ appearance, we are once again promoting the fact that slimmer is better and even healthier, which is simply not the case. We are reinforcing unrealistic role models to the most vulnerable, and in doing so, undermining years of progress.
And there’s yet another issue with the glamourisation of slimmed-down celebrities walking red carpets with frames akin to the supermodels of the nineties and that is the promotion of under-fuelling. These drugs are appetite suppressants and, when self-prescribed, can result in people becoming nutrient deficient. This lack of macro and micronutrients can have a widespread and long-lasting impact on the body affecting fertility, mental health and long-term disease risk.
So, with all this in mind, we repeat what we have always said… GLP-1 receptor agonists should never be solely used for weight-loss. They should always be medically prescribed, and patients should be monitored throughout their time on the medication, and when they stop taking it. Glamourising this form of treatment is frankly dangerous and is undermining years of progress in women’s health.
At London Hormone Clinic we are experienced at prescribing these medications to patients who really need them. Alongside the treatment, we provide nutritional advice, life coaching and psychological support and in doing so achieve excellent long-term results, reversing insulin resistance, reducing the risk of diabetes and heart disease and improving overall health.
