Mounjaro and Wegovy are Glucagon like peptide 1 receptor agonists

Abbreviated to GLP-1RAs or ‘GLPs’

Patients have been told for decades to eat less and made to feel like a failure for not being successful. OBESITY is a CHRONIC DISEASE and being a healthy weight has not been achievable for them despite best efforts leading to low self esteem, poor healh, It is fact that obese patients are often shamed by society and many adults have never been a healthy weight.

We need to treat obesity as we treat other chronic diseases!

Why do I need to see a medically trained clinician? Can’t I just buy it over the internet?

Internet providers will prey on patients to sell this medication to but it is crucial to see a medically trained doctor / nurse who has knowledge of how this medication works and how to support healthy weight loss. We must ensure responsible use of these drugs.

If patients lose muscle mass and not fat, it is more dangerous for health than having a high body fat.

Body Composition measurement is essential to support patients using weight loss injections

How do weight loss injections work?

Wegovy and Mounjaro are hormones developed to treat diabetes that stimulate the pancreas to make more insulin when your glucose goes up. Effects are glucose dependent and there has to be glucose around for it to work. If you don’t have diabetes your blood sugar won’t drop, causing hypoglycaemia.

For weight loss patients, the target is hunger and anticipation of reward from food and drinks. Hunger hormones are altered and you feel fuller quicker and the reward response from food or drink is reduced.

There are different versions of these drugs and the most effective one at the moment is Mounjaro (Tirzepatide). New versions are being launched in 2026 including a triple acting injection and a monthly injection. Oral medication will also find its place for certain patients.

Are GLPs OK to use for just a few months?

NOT USUALLY. GLPs are not usually just a temporary prescription.

Mostly – we are treating OBESITY. When the weight is optimised, the condition often CONTINUES to need to be treated- just like blood pressure or diabetes. Obesity is often a condition that has been a struggle for years- and so the treatment is likely to be ongoing.

Maybe during the peri / menopause or after a life event like having a baby- there may be a more temporary need for the medication.

Is there enough safety data for GLPs to reassure us that they are safe to use?

YES. GLPs were discovered in the 1980s and they have been used for Type 2 Diabetes since 2005- so 20 years of safety data.

Could the GLP sent to me be fake?

YES – You must ensure that your prescriber is using a regulated pharmacy to supply your GLP medication.

How fast or slow should I increase the dose?

Wegovy has a starting dose of 0.25mg – this is designed to be taken for one month only so that patients can get used to the treatment. Not much weight loss is likely to be noted and as long as feeling OK then the dose can be increased, slowly. It is designed to help patients to TOLERATE the medication.

It is crucial not to increase until any side effects like nausea have settled on the dose being taken.

Mounjaro- the first dose, 2.5mg is a therapeutic dose and so weight loss can be seen on this starting dose.

The speed of dose increase is individual to every patient.

DO NOT MOVE TO THE NEXT DOSE UNTIL YOU ARE SYMPTOM FREE AS SIDE EFFECTS ARE MORE LIKELY

Avoiding high fat food and ignoring your ‘I feel full’ messages will lead to side effects.

Is Microdosing a good idea?

NOT REALLY! This means using a lower dose than the starting doses. BUT if the doses above are the lowest effective doses then ‘microdosing’ is not likely to do anything.

If you don’t then want the weight loss effect, we need a body composition test to see if weight loss is needed. If not then there is NO ADDED BENEFIT to using these medications.

How important is it to eat healthily when using a GLP?

CRUCIAL – GLPS won’t work and you will feel unwell if you eat fatty food.

What is visceral fat and why is it important?

Visceral fat is when fat collects in our organs like the liver. This causes chronic inflammation and leaves our immune system distracted and vulnerable. GLPs can reduce chronic inflammation in part because we eat less processed food, salt, fat and sugar. Loss of visceral fat reduces chronic inflammation leading to better overall health and patients feel noticeably better.

Who are GLPs not safe for?

Patients who have a history of Medullary Thyroid Carcinoma, Multiple Endocrine Neoplasia, Anorexia

If I am on HRT will GLPs affect by hormone treatment?

No

Will my IBS be worse?

No. With medical guidance, usually IBS improves.

Can I make my GLP work better?

YES, through what you eat and how you exercise. You must maintain your muscle by eating more protein and ideally building muscle to maximise the effect. Aim to minimise muscle loss.

Can a GLP improve PCOS?

YES. PCOS is a problem of insulin resistant hyperinsulinaemia and hyperandrogenism. GLPs help to improve insulin sensitivity and decrease hyperinsulinemia, reducing visceral fat and symptoms.

Could a GLP be part of menopause management?

YES. If your body composition scan shows that it would also be beneficial to lose weight.

Is bone loss a concern when using GLPs?

Bone and muscle are connected- building one builds the other. This is why body composition testing is important.

What is Ozempic face?

The loss of firmness / elasticity in the skin.

ANY weight loss / diet can cause this.

LOSE WEIGHT SLOWLY- DON’T LOSE TOO MUCH WEIGHT TOO FAST!

Skin and Hair are made of collagen and elastin. Too much weight loss and you will lose skin collagen, elastin and hair!

What do we need to eat when taking GLPs?

PROTEIN- for maximal fat loss and protection of bone and muscle

FIBRE

WATER- side effects are often related to dehydration

HOW MUCH WEIGHT LOSS SHOULD I BE SEEING ON GLPS?

Optimum weight loss per month is 2kg- NO MORE

It may be more at the beginning.