Weight Loss Jabs: Understanding the Facts and Finding Balance

 

Weight loss jabs are creating quite a stir right now. Originally developed for managing Type 2 Diabetes, these medications have surged in demand as weight loss aids for the wider public. This growing interest is fueled by celebrity endorsements as well as the fitness and weight loss industry.

As a nutritionist and coach, I want to provide a balanced perspective on this hotly debated topic, focusing on what these drugs do, their intended uses, and whether they should be considered as part of a broader weight management plan.

I’ll just point out before I begin: I’m no expert; however, my studies with Mac Nutrition Uni equipped me with a critical and researching mind. So, I’ll try and put that to good use here. 

What Are Weight Loss Drugs and How Do They Work?

Several medications are now being discussed as weight loss options, but they were primarily designed for managing Type 2 Diabetes. Here are the main ones to know:

• Ozempic (Semaglutide): Originally approved by the FDA for blood sugar control in Type 2 Diabetes, Ozempic has gained attention for its side effect of modest weight loss. It works as a GLP-1 receptor agonist, mimicking a natural hormone that influences blood sugar regulation, appetite, and digestion. It slows down how quickly the stomach empties, which can make you feel fuller longer and may help reduce calorie intake.

• Wegovy (Semaglutide at a Higher Dose): Wegovy is another medication that contains the same active ingredient as Ozempic (semaglutide), but at a higher dose. Unlike Ozempic, Wegovy is specifically FDA-approved for chronic weight management in adults with obesity or those with a weight-related condition, such as hypertension or high cholesterol. It helps with weight loss by reducing appetite and energy intake, similar to Ozempic.

• Mounjaro (Tirzepatide): Another newer medication that is gaining traction for both Type 2 Diabetes management and weight loss. It acts on two different hormone pathways (GLP-1 and GIP) to help improve blood sugar levels and reduce appetite.

Do These Drugs Really Help with Weight Loss?

Studies have shown that these medications can lead to weight loss, especially when used in conjunction with lifestyle changes like diet and exercise. For example:

• Research on Ozempic and Wegovy indicates that they can lead to significant weight loss in many patients. Some studies have shown an average of 10-15% body weight reduction in people taking Wegovy over a year, while Ozempic users may experience a more modest reduction.

• However, these effects can plateau over time, and weight regain is likely if the medication is stopped. This is a key consideration for anyone thinking of using these medications solely for weight loss.

Are There Long-Term Studies on These Medications?

The long-term safety of these medications for weight loss, especially in non-diabetic patients, is still under investigation. Here are a few points to keep in mind:

• Current Studies: Most of the studies conducted so far have focused on the use of these drugs for diabetes management, with weight loss as a secondary outcome. There is limited research on their long-term safety and effectiveness specifically for weight loss in people without diabetes.

• Potential Side Effects: Common side effects include nausea, vomiting, diarrhea, and in some cases, more severe gastrointestinal issues.

• Off-Label Use: Some doctors are prescribing these drugs for weight loss in people without diabetes. While this can be beneficial in certain situations, there is also a risk of drug shortages for patients who need these medications for diabetes management.

A Balanced Approach: My Take as a Nutritionist and Coach

While these medications can offer benefits, they are not a one-size-fits-all solution. Here’s how I approach this topic with my clients:

1. Open Dialogue: If you're considering weight loss drugs, I encourage a thorough discussion about their potential benefits and risks. Understanding the science behind how they work, their intended uses, and their limitations is crucial.
2. Holistic Weight Management: I firmly believe that effective weight loss and weight management involve more than just medication. They require a multi-faceted approach, including a balanced diet, regular exercise, stress management, and adequate sleep. Medications may play a role for some people, but they should be part of a broader lifestyle strategy.
3. Personalised Guidance: Each person's journey is unique, and provided you have clearance from your GP/Healthcare Provider, I then aim to provide personalised guidance that aligns with your health goals and medical history. If you are taking or considering these medications, I am here to support you with comprehensive coaching that addresses all aspects of your health and well-being.

Conclusion: The Right Choice for You

Weight loss drugs like Ozempic, Wegovy, and Mounjaro are promising tools, but they should be used responsibly and in the right context. If you're thinking about these options, I’m open to having a conversation to ensure you're well-informed and prepared to make the best choice for your body and your goals.

Remember: Sustainable weight loss comes from understanding and addressing the many factors that influence our health—not from relying on a single solution.

Important: Not surprisingly, there have been warnings issued about the availability of fake versions of weight loss drugs coming onto the market, especially as prescription versions are threatened to be in short supply (Pharmacists warn overfake weight loss jabs (bbc.com).  It should go without saying, therefore, that if you are considering this route for weight loss treatment, I strongly urge you to speak with your healthcare practitioner first. Don't be tempted to buy products online, especially if they are advertised at a low cost. This is a DEFINITE red flag and you should avoid parting with your money. You could be wasting that money, and jeopardising your health!

Beyond the Numbers: Understanding the Real Factors Behind Weight Fluctuations

I did a social media post on this topic recently for my followers (head over to my Insta profile beverleyforbesnutrition if you want the shorter version!  This blog, however, expands the topic a little bit and adds one or two more factors that I didn't include before.

Before diving in, I could shorten this blog to just this: The reason you're not losing weight is because YOU'RE.NOT.IN.A.CALORIE.DEFICIT!  While that may seem like stating the obvious, and, before I get thumped .... I know it's not particularly helpful and CERTAINLY not motivating, and it's my job to motivate my clients. So, while calories DO matter, here are some key factors that influence the scale and why you shouldn't stress over daily weight changes.

So, when it comes to tracking your health and fitness progress, many people focus on the number they see on the scale. But weight is a complex measurement, influenced by various factors that can fluctuate daily. While the scale provides some useful information, it's important to understand what it really tells you—and what it doesn't. 

Hydration

Water makes up about 60% of your body weight, so it's no surprise that hydration levels can cause weight fluctuations. When you're dehydrated, your body holds onto water to maintain balance, which can increase your weight temporarily. On the other hand, drinking a lot of water can also add weight, but this is also temporary and doesn't reflect fat gain or loss. 

Tip: Drink a decent-sized glass of water first thing in the morning and then sip throughout the day to stay hydrated, but avoid over consuming fluids right before weighing yourself. Aim for consistency in your hydration habits, as this can help reduce daily fluctuations caused by water retention.

Food Volume

The food you eat can temporarily increase your weight simply because of its volume. High-fibre foods, which are great for digestion, as well as acting as prebiotics for your bowl health, take longer to pass through your system and can add temporary weight. Remember, the number on the scale may go up after a meal, but this doesn’t mean you've gained fat.

A client once remarked how could it have been possible that their weight had increased by 2-pounds the morning after eating "only" a large salad for dinner. Understanding that this was just the weight of the food digesting helped them avoid unnecessary worry.

Muscle Mass

Building muscle through strength training is a positive change for your body, but it can affect the scale in unexpected ways. Muscle is denser than fat, meaning it takes up less space but weighs more per volume. As you build muscle, you might see the scale go up even as your body becomes leaner and stronger. This is why the scale alone isn't the best indicator of progress, especially for those (such as Yours Truly!) engaging in strength training.

Tip: Consider seeking professional body composition analysis rather than relying solely on weight. (I'll be adding this to my repertoire after February 2025),  

Exercise

Exercise, especially when it involves strength training, can cause temporary weight gain due to muscle repair and glycogen storage. When you exercise, your muscles store more glycogen for energy, which binds with water and can lead to an increase in weight. Additionally, exercise-induced inflammation can cause water retention as your muscles recover. This is a positive sign of progress and not something to stress about!

Tip: Focus on performance goals, like lifting heavier weights or running faster, rather than just the number on the scale.

Stress

Stress triggers the release of cortisol, a hormone that can cause your body to retain water. This can lead to temporary weight gain. But, before you head off screaming into the night: "IT'S BECAUSE OF MY CORTISOL!", hold it right there: Cortisol itself is not the demon here. Cortisol has many functions in the body but most think of it as the 'stress' hormone. Cortisol does not prevent fat loss, but chronic stress can lead to poor eating habits and lower physical activity, and it's these factors can lead to weight gain. There is much misleading information about the relationship between cortisol and weight management. The real importance is investigating underlying causes of elevated cortisol. Buying into some influencer's 'Eat-This-To-Lower-Your-Cortisol-Levels' programme, or purchasing some pedlar's supposed magic pill, is not the answer. 

Tip: Incorporate stress-relief practices into your daily routine, such as yoga or deep breathing exercises.

Sleep 

Poor sleep doesn’t just make you feel groggy—it can also impact your metabolism and lead to weight gain. When you’re sleep-deprived, your body produces more ghrelin (the hunger hormone) and less leptin (the hormone that signals fullness), leading to increased appetite and potential weight gain.

Tip: Maintain a consistent sleep schedule, even on weekends, to support your overall health and weight management.

Hormones 

Hormonal changes, particularly in women over 50 experiencing menopause, can lead to weight fluctuations. During menopause, decreased estrogen levels can cause the body to store more fat, particularly around the abdomen. In reality, this is more about fat redistribution, than fat gain however. Men also experience hormonal changes as they age, such as decreased testosterone, which can slow metabolism and increase fat storage.

Tip: Keep in mind that hormonal fluctuations are normal. Focus on a balanced diet, regular physical activity and stress management. Be patient with yourself and seek support if you’re finding these changes particularly difficult to manage.

Sodium Intake 

High sodium intake can cause your body to retain water, leading to a temporary increase in weight. Processed foods, restaurant meals, and even some seemingly healthy foods like canned soups can be high in sodium, which can skew your weight.

Tip: Opt for fresh, whole foods and use herbs and spices instead of salt to add flavour to your meals. Reducing your sodium intake is also beneficial for your heart health and stroke risk reduction.

Digestion 

Your digestive system plays a key role in daily weight fluctuations. Factors like bowel regularity, gut health, and even the time of day can affect what the scale shows. Regular bowel movements help keep your weight stable, while constipation can cause a temporary increase.

Tip: Incorporating fibre-rich foods, staying hydrated, and maintaining a balanced diet can promote regular digestion. If you're prone to digestive issues like bloating or constipation (IBS), consider tracking how certain foods affect you and making adjustments accordingly. 

Alcohol 

OK, don't shoot the Messenger!: Alcohol not only adds empty calories but also disrupts metabolism and can cause water retention. It also impacts the liver which prioritises processing alcohol over other metabolic functions, potentially leading to fat storage.

A night of drinking and a weight 'spike' the next morning wouldn't be due to fat gain, but rather alcohol-induced water retention and the high-calorie content of drinks.

Tip: Drink a glass of water between alcoholic drinks to stay hydrated and reduce overall consumption.

Carbs 

Don’t fear carbs—they’re essential for energy. Just remember that increased carb intake can lead to temporary water retention, so don’t panic if you see the scale go up slightly after a carb-heavy meal. So, before any Keto zealots try to convince you otherwise, your weight gain after eating carbs isn't fat, it's water weight. 

Tip: Pair carbs with protein and healthy fats to stabilize blood sugar levels and reduce water. Focus on quality carbs like whole grains, fruits, and vegetables, and remember that carbs are necessary for fueling your body, especially if you’re active.

So, there you have it: while the scale is just one of many tools you can use to track your progress, understanding the various factors that influence your weight can help you interpret the numbers more accurately and avoid unnecessary stress. 

Note on Weighing Yourself:

• Timing: The best time to weigh yourself is first thing in the morning, after you’ve used the bathroom and before eating or drinking anything.
• Consistency: If you must weight yourself, try to do this once a week rather than daily to avoid getting caught up in the normal day-to-day fluctuations.
• Focus on Trends: Look for long-term trends in your weight rather than focusing on the daily numbers. This gives you a more accurate picture of your progress.

My favourite piece of advice that I give to my clients is this: Instead of focusing solely on the scale, pay attention to how your clothes fit, how strong you feel, and other non-scale victories.