Losing weight with medication: does it really work?

Struggling with excess kilos? You are in good company: most Dutch people are affected by it.

A growing pandemic in numbers [1,2]:

• 52.2% of adults in the Netherlands are overweight.

• 16% are living with obesity.

Those extra kilos are more than just a high number on the scales. Obesity increases the risk of, among other things:

• Cardiovascular disease

• Type 2 diabetes

• Some forms of cancer

• Sleep apnoea

• Lower back pain

It also reduces your quality of life [3]. And let’s be honest: in the end, don’t we all just want to feel good in our own skin and enjoy life?

In addition, people with overweight suffer from stigma, and it costs society a great deal of money in healthcare costs and reduced productivity, among other things: around €79 billion per year [4].

In other words: plenty of reasons to turn the tide on overweight.‍

You are trying to live more healthily. Eating less, moving more. Yet you hardly see any results, or the kilos simply come back over time. That is not down to a lack of discipline, but to your biology.

After weight loss, your metabolism slows down and the hunger hormone ghrelin rises [5]. This is a kind of survival mechanism, in which your body tries to bounce back to your old weight.

Weight-loss medicines can temporarily break through that biological mechanism. They support your brain and metabolism, so you feel less hungry and stay full for longer.

That is not a quick fix, but support for a sustainable lifestyle change. Think of eating more healthily, moving more and getting goodsleep.‍

Healthy eating, exercise and behavioural change are the foundation for achieving and maintaining a healthy weight.

Unfortunately, this is not made easy for you. We can safely say: the odds are stacked against you. Many people struggle with:

• An obesogenic environment (think of low prices for unhealthy products, sedentary jobs, fast food and sugary drinks available everywhere, and heavy marketing of calorie-rich food).

• Falling back into old habits.

• Psychosocial stress, poverty or limited health literacy.

That makes long-termweight lossdifficult. Weight-loss medicines, such asOzempic, are then not a luxury, but a necessary addition [6].

This also shows the complexity of obesity. It is about much more than ‘just eating healthily’. You are dealing with your biology, with supermarket aisles full of unhealthy temptations, with loud marketing from the food industry, social pressure, and countless other factors.

Most new medicines, such asOzempic,WegovyandSaxenda, are GLP-1 agonists: they mimic the natural appetite-suppressing hormone GLP-1. The medication makes you feel fuller and keeps your blood sugar levels stable, so you automatically eat less [7].

Some new medicines, such asMounjaro, even target two hormones at once (GLP-1 and GIP), for an extra powerful effect.

Please note:this weight-loss medication works best in combination with a healthy lifestyle. If you don’t adjust your lifestyle, the results are often temporary.

A doctor may consider prescribing weight-loss medication if you have:

• A BMI ≥ 30

• A BMI ≥ 27 with conditions such as high blood pressure or type 2 diabetes

Not everyone is eligible. Your doctor looks at your health, lifestyle, medical history and wishes. Pregnant or planning to become pregnant? Then weight-loss medication is not suitable. You also cannot use the medication if you are breastfeeding.

First of all, it is good to realise that you are using a medicine, not a supplement. Your body will need to get used to the medicine and you may experience side effects (you can read more about that below).

Weight-loss medication is built up gradually: you start with a low dose that is increased monthly, provided you tolerate the medicine well. This allows your body to get used to the medicine and helps you achieve sustainable results.

You will also notice over time that you feel less hungry and get full sooner. As a result, you automatically take in fewer calories. It is then extra important to eat healthily. After all, you have fewer opportunities to get all your essentialnutrients.

It is also important to get enough exercise, sleep well and minimise stress. This strengthens the effect of the medication, gives your weight-loss process a boost and optimises your health and energy levels.

How many kilos can you lose?

And of course what you most want to know: the results. Depending on the weight-loss medication you use and your lifestyle, up to 26% weight loss is possible [8]. This is the most favourable result.

One year of weight-loss medication results on average in 3-12% extra weight loss compared to lifestyle interventions alone [7]. And with just 5-10% weight loss you already achieve significant health gains [9]:

• Lower blood pressure

• Better blood sugar levels

• Less fat in the blood (triglycerides)

• Less strain on joints

• Improvement of sleep apnoea and other complaints

How long do you use weight-loss medication?

That varies from person to person. If you respond well to the medication, meaning you lose enough weight and have no unpleasant side effects, it is safe to use it long-term.

Is it not working well enough after 16 weeks on the maximum dose (less than 5% weight loss)? Then your doctor will look at other options together with you.

Please note:if you stop the medication, the weight often (partly) comes back. That is why it is important to work on lasting lifestyle changes.‍

Medicines can causeside effects. The most common ones are mild and temporary:

• Nausea

• Constipation or, conversely, diarrhoea

• Reduced appetite

Serious side effects are rare, but always discuss with your doctor whether a medicine is right for your situation.

Important tips:

• Always follow the advice of your doctor or medical specialist.

• Use the medication as an addition to, not a replacement for, ahealthy lifestyle.

• Always discuss which other medicines or supplements you are taking.

Below is an overview of the main weight-loss medications:

Wegovy / Ozempic

• Weekly injection

• Strong effect on satiety and appetite

• Up to 15% weight loss

Saxenda

• Daily injection

• Supports the feeling of fullness via GLP-1

• 5-10% weight loss

Mounjaro

• Newest generation of weight-loss medication

• Stimulates both GLP-1 and GIP for a double effect

• Up to 26% weight loss

The market for weight-loss medication is developing rapidly. Work is under way on oral medicines and other alternatives, for example.

Medicines such as retatrutide and bimagrumab are showing promising results in studies: they help burn fat and preserve muscle mass [10,11].

In the future, even more effective and more personalised weight-loss medication may be developed.

No, and that is a good thing.GLP-1 injectionsare only available on prescription, from a registered pharmacy. Only a doctor can assess whether you are eligible and which dose is safe and effective.

These medicines are intended for people with obesity or serious overweight-related health problems, not for cosmetic weight loss. Use without supervision can lead to serious health risks, such as dehydration, gallstones or heart rhythm disorders.

Please note:the black market for weight-loss medication is growing. Never buy through unreliable websites or social media. Without medical supervision, you risk fake medicines, incorrect doses and serious side effects.

Yes. Weight-loss medication can be a powerful tool, especially if you are not getting enough results with diet and exercise alone. But: it is not a quick fix. The best chance of lasting success lies in combining medication with a healthy lifestyle.

Want to know whether weight-loss medication is right for you? At Wellis we look at the whole picture: your body, your goals, your health.Fill in our short questionnaireand discover what is possible for you.

What exactly are weight-loss medicines?

These are prescription medicines that help with weight loss. They are intended for people with obesity or overweight combined with health problems, such as high blood pressure or diabetes.

How does weight-loss medication work?

Most medicines work by mimicking the hormone GLP-1. This hormone affects your appetite and satiety.

What you may notice as a result:

• Less appetite

• Feeling full sooner

• Fewer snack cravings

What does “off-label” use mean?

Sometimes a doctor prescribes a medicine differently from what it has officially been approved for. For example:

• Using a diabetes medicine to lose weight

• Combining two medicines

• Using a medicine for longer than the leaflet says

That is allowed, provided it is medically justified and well substantiated. Only a doctor can assess that.

How effective are weight-loss medicines?

They can be extremely effective, but only in combination with a healthy lifestyle. Think of healthy eating, enough exercise and little stress.

Can weight-loss medicines really help?

Yes, definitely. For people with overweight or obesity who have already tried everything, medication can make the difference. Not as a replacement for lifestyle change, but as a tool to support it.

What is the most effective weight-loss medicine?

At the moment, GLP-1 agonists appear to be the most powerful. Mounjaro stands out because of its dual action (GLP-1 and GIP), but comparative research is still ongoing.

More important than which medicine you use is how you use it and combine it with a healthy lifestyle.

How can you stop taking weight-loss medication?

Stopping is possible, but it should be gradual and only when your lifestyle is on track. Stopping cold turkey? Not a good idea, as the kilos often come back.

Consider tapering off under the guidance of a doctor. Sometimes you continue to use a maintenance dose.

Are there safe weight-loss products without a prescription?

Most weight-loss products without a prescription do not work or are downright dangerous. Even when influencers promote them. They can cause palpitations, diarrhoea or liver problems, for example.

Only consider a supplement in consultation with your doctor.

What is the role of exercise?

That role is big. Medication can help you lose weight, and exercise helps keep it off. It also does much more, for example it provides:

• A better mood

• More energy

• Better sleep

• Stronger muscles

Tips to get started:

• Start small (a 10-minute walk is already a win)

• Set a goal (a step counter helps)

• Exercise on at least 5 days a week

• Stay realistic and celebrate your progress

Keep it up! Exercise naturally becomes a habit, and then you no longer have to think about it.