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The Complexities of Weight Loss Drugs

Writer: Jasmine Cortazzi
Jasmine Cortazzi
Jan 22
4 min read

Updated: Sep 23

Understanding Obesity


Does taking a weight loss drug address the root cause of obesity or overeating?

Obesity is a chronic condition caused by multiple factors, such as:


  • Genetics

  • Environmental factors, including poverty and deprivation

  • Psychological issues, like trauma or stress, and using comfort eating as a coping strategy

  • Poor sleep

  • Dietary issues, such as consuming processed foods

  • Side effects of medications, including anti-depressants or anti-psychotics

  • Lack of exercise[1]


A person measures their waist with a yellow tape in oversized jeans, wearing a white top. The background is blurred, conveying a sense of achievement.

Given the complex root causes of obesity, medication might help people in the short term. But will drugs address issues like changing our habits around food, our lifestyle choices, and our trauma—especially generational trauma? In such cases, therapy, along with nutrition, lifestyle choices, and exercise, would be needed to address both the root causes and the symptoms.


Safety of Weight Loss Drugs


Are weight loss drugs safe long term?

Approximately 15.5 million adult Americans have taken weight loss drugs[2]. On average, a patient can lose 15% of their body weight within a year of taking these drugs[3]. Interestingly, at least 50% of users, if not more, will stop taking these drugs after a year[4]. The reasons for stopping may include financial constraints (costs can vary but typically range from £50 to £100 per month) or adverse side effects.


The most common health risks associated with these drugs are digestive issues[5] and decreased bone density and muscle loss[6]. Believe it or not, 1 in 6 hospital admissions are due to a side effect of weight loss drugs[7].


Health Risks of Weight Loss Drugs


Why do weight loss drugs cause digestive issues? Rapid weight loss and slower gall bladder emptying occur because these drugs suppress a key hormone that aids digestion in the gut. Consequently, the composition of bile is altered, which can lead to cholesterol crystallising and forming gallstones[8]. Gallstones can be painful, resulting in sharp abdominal pain, nausea, or fever. Furthermore, gallstones can cause pancreatitis, which is inflammation of the pancreas. The pancreas plays a crucial role in regulating blood sugar and facilitating digestion[9].


Rapid weight loss can also lead to muscle and bone density loss. Some individuals have lost up to 20% of their body weight due to these drugs[10]. While this may sound positive, a third of that weight loss can consist of muscle and bone loss[11]. Muscles help regulate blood sugar. Less muscle mass means a higher susceptibility to blood sugar issues, which is linked to Type 2 diabetes. This condition can lead to blindness, poor circulation, nerve damage, heart attacks, and strokes[12]. Compromised bone density increases the risk of fractures and broken bones[13]. Therefore, when taking weight loss drugs, doctors advise regular weight-bearing exercise and ensuring a diet rich in quality protein[14].


Research shows that people who stop taking weight loss drugs are likely to regain the weight within 1.4 years after ceasing treatment, compared to those who follow diet, exercise, and behaviour change programmes[15]. Strikingly, patients who stop taking weight loss drugs are four times more likely to regain the weight and do so more rapidly than those who simply diet[16]. Thus, those who take these weight loss drugs are advised to have regular check-ups with a doctor, eat nutritious food, and incorporate weight training into their exercise routine. Lifestyle choices and habit changes are essential for sustained weight loss[17].


Moreover, there are concerns about patients purchasing these drugs online instead of from reliable sources that ensure quality control. Drugs bought from unreliable sources could be contaminated, the doses could be incorrect, and they could be mixed with other substances that may cause harm[18].


Worryingly, some consumers of weight loss drugs may have eating disorders, such as bulimia, anorexia, or body dysmorphia[19]. Taking these drugs could increase vulnerability, leading to heightened anxiety, depression, and potential long-term health conditions. Some individuals with eating disorders may enjoy receiving compliments about their weight loss and could become addicted to seeing weight reduction, losing sight of their overall health and well-being.


Scale with yellow tape measure, green bell pepper, apples, citrus, water bottles, and dumbbells on a light surface. Fitness concept.

Even without disordered eating, these drugs suppress appetite, making it easy to forget to eat or to snack on unhealthy food. Supermarkets are recognising this market, creating ‘nutrient-dense’ special food packages for those on weight loss medication. Shoppers receive less food in smaller packages but pay more for it[20].


Given all these risks, ensuring that patients are carefully monitored by a doctor is vital.


Eligibility for Weight Loss Drugs


Criteria

To be eligible for weight loss drugs on the NHS, a patient must have a BMI (Body Mass Index—using height and weight to estimate body fat) of 40 and at least four health conditions related to obesity, such as:


  • High blood pressure

  • Sleep apnoea

  • Cardiovascular disease

  • Type 2 diabetes

  • Abnormal fat levels in the blood[21]


Some NHS schemes offer weight loss drugs alongside lifestyle support programmes, focusing on enhancing patients’ sleep, exercise levels, and overall well-being, while providing regular check-ups and monitoring[22].


The Benefits of Weight Loss Drugs


Weight loss drugs help people lose weight and suppress cravings for food. For many, losing weight can reduce heart and cardiovascular risks and lower blood sugar levels. This can lead to increased self-confidence and reduced anxiety or depression. Interestingly, weight loss drugs could also be effective in treating addictions to alcohol, opioids, and nicotine[23].


Final Thoughts


Taking weight loss medication is a personal decision. However, it is wise to consult a doctor for safe prescriptions, regular check-ups, and to use the medication alongside healthy nutrition, exercise, and therapy. Therapy can help clients understand the complex and multi-faceted reasons behind obesity and food addiction.


Bibliography


[3] Ibid.

[11] Ibid.

[14] Ibid.

[15] Ibid.

[16] Ibid.

[17] Ibid.

[18] Ibid.

[21] Ibid.


 
 
 

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