21/05/2026
GLP-1 MEDICATIONS: NAVIGATING THE PROMISE AND REALITIES OF MODERN WEIGHTLOSS
WHAT ON EARTH IS GLP1 MEDICATION AND WHY SHOULD YOU CARE?
GLP-1 is a bit like your built-in security guard for sugar. When you eat, it steps in to tell your pancreas to release just the right amount of insulin to handle the meal you've eaten, helping to keep your blood sugar from spiking and crashing like a roller coaster. This not only steadies your energy, but it signals your brain that you're full. Which helps to curb those sneaky cravings and mid-afternoon snack attacks. As we age or face busy lives, our natural GLP-1 production can slow down, leading to tiredness, cravings and weight worries.
GLP-1 MEDICATION
Originally designed as a diabetic medication, in 2021, GLP-1 medications were approved for weight loss, and they have fast taken the world by storm, with 20% of adults now estimated to be using them.
SO LET'S START WITH THE BENEFITS
If you are morbidly obese, and the medical definition of that is a BMI over 30, AND you have significant metabolic challenges, then the reduced risk of Cardiovascular Disease, Diabetes and Alzheimer's makes them an attractive treatment option.
They may also be beneficial when used appropriately in helping people to make long-term positive habit changes by beating cravings and reducing addictive behaviour. In some cases, they may reduce the anxiety and depression associated with being clinically obese.
HOW DO THEY WORK?
GLP1 is a naturally occurring hormone (chemical messenger) with a short duration of action. When we eat carbohydrates and fat, our blood sugar rises, and these messengers are released to signal to us that it's time to stop eating, by influencing our appetite, blood sugar regulation and movement of food through the gut. They also influence our cardiovascular systems by increasing heart rate and lowering blood pressure.
There are several GLP1 receptors around our bodies that are influenced by these hormones, and these occur in the gut, brain, nervous system, pancreas, heart and kidneys. The medications are synthetic versions of these hormone messengers, but unlike the naturally occurring hormones, which are short-acting, these medications have a half-life of a week. This means side effects will continue for at least a week after using them.
ALL THIS SOUNDS GOOD, SO WHAT IS THE PROBLEM?
SUPPLY ISSUES AND MEDICAL CONCERNS
The NHS has very limited funding for GLP-1 medications, which poses a great problem in a society where 1:3 adults are known to be obese. The current NHS criteria for Tier 3 weight management states that you must have a BMI of over 40 AND a comorbidity of Hypertension, Type 2 Diabetes, Cardiovascular disease, raised lipids on blood test, or a Sleep Apnoea diagnosis.
This means the majority of people (an estimated 95% of users) are obtaining their supplies privately through search engines, social media, online pharmacies & beauticians. What could possibly go wrong?
A sizeable number of sources clearly have no more ethics than your neighbourhood drug dealer. There are significant safety issues. With 18% of users ending up in A&E, these concerns need to be taken seriously.
In some cases, people have unwittingly been sold pure insulin or products containing antifreeze and bacterially contaminated sources of the medication. This has led to significant injuries. Injecting yourself with Insulin could prove fatal.
Don't assume an online pharmacy is reputable either. There have even been cases of pharmacies being found selling substandard sources of the medication.
DOSING CONCERNS
Dosing is often exploited by private suppliers - at a cost of between an average of£200-£400 per month per prescription, greed may influence prescribing.
The medication should always be started at the lowest dose and titrated up slowly. The dose should only be increased when no further weight loss is achieved at the lowest dose. Low doses = low incidence of side effects!
If your prescriber is recommending high doses without justification, or recommending you start at a high dose, then see this as a red flag and find a more reputable source.
A future worrying trend is the increased use by those with underlying eating disorders. It is very easy to lie online about your BMI in an online calculator to ensure you get the medication to meet the criteria for recommended use.
SO WHAT ARE THE POSSIBLE SIDE EFFECTS?
50-60% of people suffer from nausea and vomiting.
Bowel issues are common, with either diarrhoea or constipation
60% of users suffer from abdominal pain
16% suffer from gastrointestinal bleeding
7% suffer from gastroparesis, meaning the stomach just isn't emptying anymore. (Symptoms associated with gastroparesis are severe vomiting. If vomiting is severe or doesn’t go away, it’s important to have it checked by a GP.
4% suffering from pancreatitis, with rare reports of pancreatic tumours
Gallbladder issues are common
Thyroid issues
Increased incidence of SIBO
A significant increase in nutritional deficiencies, which will contribute in the long-term to a slowing down and impairment of metabolism.
20-40% loss in lean mass. This isn't just muscle, it's organ tissue, enzymes and connective tissue
Significant Eye Disorders
WHAT ABOUT LONG-TERM ISSUES?
There are no long-term studies, but what we do know is that muscle loss in the long term is going to slow your metabolism down and contribute to weight gain post medication
We also have to think about food addiction. Weight gain often covers deeper issues. What happens when you take away the food addiction? There can be increased feelings of depression and shame to deal with, and there have been some users reporting feeling empty and lacking in motivation, and experiencing increased suicidal ideation.
All these side effects mean that compliance is very poor. It's unusual for anyone to stay on the medications for over a year. Another issue is coming off the medication too quickly. Ideally, the medication would be tapered down slowly to reduce any rebound effect. If you stop the medication suddenly, the food noise is described as deafening - likened to that of a newly made vampire with an insatiable desire to eat.
The bottom line is you can't interfere with a crucial enzyme process in your body on a long-term basis and expect good results.
SO HOW CAN NUTRITIONAL THERAPY HELP?
SUPPORT WHILST USING GLP1 MEDICATION
Nutritional therapists can support you whilst on medication to help develop better food habits: Improved food choices help to reduce the development of any nutritional deficiencies, which will reduce the risk of problems further down the line.
Nutritional therapists specialise in keeping the digestive system healthy, helping improve gut motility, easing nausea, and encouraging regular bowel habits. The gallbladder often benefits from good nutritional care and targeted supplements. Functional testing can spot nutrient deficiencies and guide smart supplement choices. Partnering with a supportive nutritional therapist who can help with habit changes and address mood-related concerns can also increase your chances of success in your weight loss journey.
SUPPORT IN LIFE POST GLP1 MEDICATION
Having a nutrition and lifestyle coach by your side as you deal with returning appetite issues, fight off cravings, and rebalance your metabolism can make life much easier. A nutritional therapist can help you build healthy routines, watch out for deficiencies, and guide you toward a healthier life, one step at a time..
There's a lot to reflect. Society has been wrongly educated for decades about what constitutes a healthy diet - the food pyramid directed us to high carbs, low fat, with fat being painted as the devil when in fact the opposite is true, high fat and low carbs are evidenced to produce reductions in HbA1c, Triglycerides, Cholesterol, blood pressure, and weight gain.
Put this together with life in a society where we want everything we want RIGHT NOW. The quick fix. This impulse-driven behaviour is part of what drives appetite disorders and weight gain in the first place, just one more biscuit.....
