My Best Weight

My Best Weight A NEW approach to managing weight - Our clinic provides evidence based medical management for those

04/07/2026

“Understanding didn’t solve my obesity. But it helped me stop blaming myself.”

Those weren’t my words.

They came from a patient a few days after their consultation.

For decades, people have thought of obesity through the language of behaviour.

Eat less.

Move more.

Try harder.

But when people understand that obesity is a complex chronic disease involving genetics, life experiences, our environment and the biological regulation of appetite and body weight, something important can happen.

The biology doesn’t change.

But their experience of living with it often does.

Shame begins to give way to understanding.

Self-blame is replaced with self-compassion.

And people stop asking, “What’s wrong with me?” and start asking, “What support do I need?”

Education alone doesn’t treat obesity.

But understanding is often where good obesity care begins.

Because before we can treat a disease, we first need to understand it.

21/06/2026

People often ask me how they can tell whether a doctor, prescriber or clinic truly understands obesity.

Here’s one simple tool:

⁉️ Ask ⁉️

“What happens if my BMI falls below 25 while on treatment?”

The answer won’t tell you everything, but it may tell you whether they see obesity as:

❌ A short-term, quick-fix weight-loss problem

or

✅ A chronic disease that requires long-term care

A clinician doesn’t need to have all the answers. But they should be thinking beyond a number on a chart and focused on long-term health, function and sustainability.

I’ve met patients who have had an excellent response to treatment, only to find that the plan ended there. Medication was stopped, follow-up disappeared, and they were left to navigate the next phase alone.

The best obesity care isn’t about getting you to a target.

It’s about helping you optimise your health, physical function, quality of life and independence over the long term.

Obesity can be managed but it does not disappear, even when BMI is below 25.

Would we stop Blood Pressure medications when Hypertension is well controlled?!?

Ask about the long-term plan before starting treatment.

11/06/2026

💊 BIG NEWS FOR OBESITY MEDICINE 💊

Today, the UK Medicines and Healthcare products Regulatory Agency (MHRA) approved the first GLP-1 tablet specifically licensed for weight management: oral Wegovy (semaglutide).

The approval is based on the OASIS-4 trial, which evaluated oral semaglutide 25 mg in adults living with obesity.

Key findings:

• Average body weight reduction of 13.6% over 64 weeks
• Nearly 29% of participants were “early responders” (≥10% reduction by week 16)
• Early responders went on to achieve an average 21.6% reduction in body weight by week 64
• Significant improvements in physical function and quality of life
• Around 30% of participants achieved reductions in body weight of at least 20%

How does it compare with injectable Wegovy?

Injectable semaglutide 2.4 mg produced average body weight reductions of approximately 15% in STEP-1. While cross-trial comparisons should always be interpreted cautiously, oral semaglutide 25 mg appears to approach the efficacy of the injectable formulation.

The tablet is gradually escalated:

1.5 mg → 4 mg → 9 mg → 25 mg

with a minimum of one month at each dose level.

What about side effects?

As with other GLP-1 medications, gastrointestinal symptoms were the most common adverse effects.

• Gastrointestinal adverse events: 74.0% vs 42.2% with placebo
• Nausea: 46.6%
• Vomiting: 30.9%
• Constipation: 20.1%
• Diarrhoea: 17.6%
• Most events were mild-to-moderate and diminished over time
• Only 3.4% discontinued treatment because of gastrointestinal side effects

Potential advantages:

✅ No injections

✅ No refrigeration required

✅ Easier transport and travel

✅ May be preferred by people who dislike needles

Potential disadvantages:

⏰ Must be taken on an empty stomach

💧 With a small amount of water only

🚫 No food, drink or other medications for at least 30 minutes afterwards

The arrival of effective oral obesity medications may offer greater choice for patients. As always, the best treatment is the one that is safe, evidence-based and sustainable for the individual patient.

05/06/2026

Could GLP-1 medications influence cancer risk, recurrence, mortality or progression?

Several studies published and presented in 2026 have reported surprisingly consistent findings.

🔹 Lower progression to stage IV (metastatic) disease in several cancers including breast, lung, colorectal and liver cancer.

🔹 Lower mortality and recurrence rates among women with breast cancer who were prescribed GLP-1 medications.

🔹 Lower breast cancer incidence among women prescribed GLP-1 medications.

These findings are biologically plausible. Potential mechanisms - weight loss, improved metabolic health, reduced inflammation, immune pathways & direct effects on tumour biology.

However, there is an important caveat.

These studies were observational and cannot prove that GLP-1 medications directly caused the observed differences.

Some of the findings may reflect differences in healthcare engagement, underlying health, weight loss itself, metabolic improvements or other factors that cannot be fully accounted for in retrospective analyses.

Importantly, much of the available evidence comes from people with overweight, obesity and/or type 2 diabetes and may not be generalisable to all populations.

The consistency of the signals across incidence, recurrence, survival and metastatic progression studies is intriguing, but randomised clinical trials are needed before any conclusions can be drawn about causality.

For now, these findings should be viewed as promising and hypothesis-generating rather than practice-changing.

Tatum KL, Dahman B, Stevenson A, et al. Survival and recurrence with GLP-1 receptor agonists in breast cancer. JAMA Network Open. 2026;9(5):e2612133.

McDonald E S, et al. GLP-1 agonists are associated with a significant reduction in breast cancer incidence in women. JCO Oncol Pract 10.1200/OP-26-00485R1 Epub 2026 June 02.

Orland MD et al. Can GLP-1 receptor agonists mitigate cancer progression? A propensity-matched analysis across seven solid tumors.
Presented at ASCO Annual Meeting 2026

https://cdn.bfldr.com/KOIHB2Q3/as/w32hkswgp4jpg66kvw6f5rcs/AM26-Abstract_3143

03/06/2026

🧠 Could obesity medications influence addictive behaviours?

Many people taking GLP-1 medications have reported:

🍷 Drinking less alcohol
🚬 Smoking less
🤔 Experiencing fewer cravings

Now a major BMJ study involving more than 600,000 people with type 2 diabetes has found something intriguing.

Compared with another diabetes medication, GLP-1 medications were associated with:

⬇️ Lower risk of alcohol use disorder (HR 0.50)
⬇️ Lower risk of ni****ne use disorder (HR 0.72)
⬇️ Lower risk of opioid use disorder (HR 0.62)
⬇️ Lower risk of cannabis use disorder (HR 0.78)
⬇️ Lower risk of co***ne use disorder (HR 0.68)

And among people already living with a substance use disorder:

🏥 Fewer hospital visits
⚠️ Fewer overdoses
❤️ Lower substance-related mortality

But before anyone gets too excited…

⚠️ This was an observational study.

It cannot prove that GLP-1 medications prevent addiction and they should not be considered addiction treatments.

So why might these findings matter?

GLP-1 medications don’t just affect appetite. They also act on areas of the brain involved in reward, motivation and craving.

The most interesting message may be this:

🧠 Obesity is not about willpower.

And studies like this remind us that eating behaviours and addictive behaviours can both be influenced by complex brain pathways.

📚 Study: https://www.bmj.com/content/392/bmj-2025-086886

01/06/2026

“When I lose weight… I’ll be happier.”

It’s one of the most powerful promises society sells us.

And for many people, it feels intuitively true.

But the evidence suggests something more nuanced.

Obesity care can improve physical health, mobility, symptoms, metabolic health, confidence and quality of life. These benefits are real and they matter enormously.

But most obesity studies do not actually measure happiness itself.

They more commonly measure:
• Physical function
• Quality of life
• Symptoms
• Self-esteem
• Body image
• Depression and anxiety

These outcomes are important.

But they are not quite the same thing as lasting happiness.

Happiness is influenced by many other psychological, social and life factors and is not routinely measured in obesity trials.

For some people, a goal weight may represent more than a number on a scale.

It may represent a time in life that felt easier, happier, or when they felt more like themselves.

The challenge is that returning to a previous weight does not automatically return us to a previous life.

Life changes.

Relationships change.

Responsibilities change.

And humans adapt.

What once feels life-changing can, over time, become the new normal.

Psychologists sometimes refer to this as hedonic adaptation: our tendency to adjust to positive changes and gradually return to a familiar emotional baseline.

That doesn’t mean the benefits aren’t real.

It means that achieving a goal often brings a burst of satisfaction, while lasting wellbeing is shaped by many other factors, including relationships, purpose, autonomy and daily experiences.

Improved health can absolutely make these things easier to pursue.

Perhaps happiness comes less from weight loss itself…

And more from how improved health interacts with the broader realities of our lives.

Health matters.

Quality of life matters.

But happiness was never meant to be measured by a number on a scale.

What do you think?

23/05/2026

Maintaining weight loss & health is the real long-term challenge in obesity care - and SURMOUNT-MAINTAIN gives us important new evidence on how treatment dose matters.

Prof Carel le Roux, Co-founder of .ie , is a co-author on this major new study published in The Lancet.

At My Best Weight, our experts don’t just interpret the evidence — they help create it.

The study asked:

After 60 weeks of tirzepatide and substantial weight loss, what happens if treatment is continued, reduced, or stopped?

Participants were randomised to:

1️⃣ Continue maximum-dose tirzepatide
10mg or 15mg

2️⃣ Reduce to 5mg tirzepatide

3️⃣ Switch to placebo

📊 At 112 weeks, mean weight reduction was:

🔹 21.9%
with continued maximum-dose tirzepatide

🔹 16.6%
with 5mg tirzepatide

🔹 9.9%
after switching to placebo

But the key question was maintenance.

Participants maintained:

✅ 96.5% of prior weight loss
with maximum-dose tirzepatide

✅ 67.9%
with 5mg tirzepatide

⚠️ 42.8%
with placebo

Rescue therapy was offered if participants regained ≥50% of previous weight loss.

It was needed in:

⚠️ 67% of placebo participants

🔹 25% of the 5mg group

✅ 8% of those remaining on maximum-dose tirzepatide

Cardiometabolic improvements including blood pressure, lipids, HbA1c and waist circumference were also better maintained with ongoing treatment.

This matters because obesity is a chronic, relapsing disease.

The goal is not simply losing weight — it is maintaining long-term health improvement, safely and sustainably.

Follow the evidence, not Instagram.

21/05/2026

🚨 TRIUMPH-1: Retatrutide represents the next major leap in obesity medicine.

Eli Lilly has announced topline Phase 3 results from TRIUMPH-1 — a large global randomized trial of retatrutide, an investigational once-weekly “triple agonist” targeting GLP-1, GIP and glucagon receptors.

🧪 Trial design:
• 2,339 participants
• Adults with obesity or overweight + at least one weight-related complication
• Participants did NOT have diabetes
• Randomized to placebo or retatrutide 4 mg, 9 mg or 12 mg
• 80-week double-blind trial
• Pre-specified extension to 104 weeks in participants with BMI ≥35

📉 Weight loss results at 80 weeks:
🔹 4 mg: -19.0% (~47 lbs / 21.4 kg)
🔹 9 mg: -25.9% (~64 lbs / 29.2 kg)
🔹 12 mg: -28.3% (~70 lbs / 31.9 kg)

That degree of weight loss approaches levels traditionally associated with bariatric surgery.

Even more striking:
✅ 45.3% of participants on 12 mg lost ≥30% body weight
✅ 27.2% lost ≥35%
✅ 65.3% moved below the BMI threshold for obesity (BMI

17/05/2026

New evidence is changing how we think about long-term obesity care.

We are proud that Prof Carel le Roux, Co-founder of .ie , is an author on a new international study that may change how we think about long-term obesity treatment.

At My Best Weight, our clinical care is shaped by the latest science — and by experts who are not only interpreting the evidence, but helping to create it.

The ATTAIN-MAINTAIN study, just published in Nature Medicine, explored a clinically important question:

Can people who have already lost weight with injectable obesity medications maintain those benefits after switching to an oral GLP-1 treatment?

The study included people previously treated with tirzepatide or semaglutide, who were then randomised to once-daily oral orforglipron or placebo.

The results were striking:

In participants switching from tirzepatide to orforglipron, mean weight reduction was largely maintained — from 22.0% at the end of SURMOUNT-5 to 16.8% after 52 weeks of ATTAIN-MAINTAIN.

In participants switching from semaglutide to orforglipron, mean weight reduction was almost fully maintained — from 16.5% at the end of SURMOUNT-5 to 15.1% after 52 weeks of ATTAIN-MAINTAIN.

When analysed as maintenance of prior weight reduction, participants maintained an estimated 74.7% of previous weight reduction after tirzepatide and 79.3% after semaglutide with orforglipron — compared with 49.2% and 37.6% with placebo.

That contrast is important.

Stopping active treatment led to substantially more regain.

Switching to oral orforglipron helped preserve much more of the health gain already achieved.

Importantly, cardiometabolic improvements such as waist circumference, HbA1c, lipids and blood pressure were also broadly preserved, and the most common side effects were gastrointestinal, mostly mild to moderate.

This matters because obesity is a chronic, relapsing disease.

The goal is not just weight loss — it is long-term health improvement and maintenance.

World-leading obesity care means more than following trends.

Follow the evidence, not Facebook.

15/05/2026

Public conversation around obesity medications and “muscle loss” often lacks important nuance.

Across weight-loss interventions — including lifestyle change, bariatric surgery, and pharmacotherapy — some reduction in lean or ‘fat-free’ mass is expected as part of normal physiology.

In obesity medication trials, approximately 25–39% of total weight loss has been reported as “lean mass” on DEXA scans.

But this number is often misunderstood.

DEXA-derived “lean mass” does not equal skeletal muscle alone. It includes all non-fat, non-bone tissue — including total body water, glycogen-associated fluid, organ tissue, extracellular fluid, and changes in fat stored within tissues. This means DEXA may overestimate true functional muscle loss.

Emerging MRI data suggest skeletal muscle reductions may be more modest than headlines imply, while reductions in visceral fat, liver fat, and intramuscular fat may improve overall body composition and metabolic health.

Weight loss can also influence bone density through mechanical unloading and hormonal adaptation, but current evidence has not demonstrated a consistent increase in fracture risk directly attributable to these medications. Longer-term data remain important, particularly in higher-risk groups.

The real clinical question is not simply “Is some lean tissue lost?”

It’s:
How much of that reflects true skeletal muscle?
Is strength and physical function preserved?
And is treatment being paired with strategies that protect muscle and bone?

This is why evidence-based obesity care should include:
• Adequate protein intake
• Resistance training
• Physical activity
• Monitoring of functional health
• Personalised medical oversight

Obesity treatment should not be reduced to simplistic narratives.

The goal isn’t just weight reduction.

It’s improving metabolic health, reducing disease burden, preserving function, and helping people live healthier, stronger lives.

Follow the evidence… not Instagram.

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