WEIGHT LOSS: DRUGS OR NATURAL?
If you are one of the 1.6 million adults in the UK using weight-loss drugs, you need to read this blog. Especially if you are in the majority of users who pay for your own prescription of drugs like Wegovy, Ozempic or Mounjaro. Why have they become so popular on social media and in celebrity circles? They work - fast. But at what cost to health? Can there be serious side effects? Yes, there can! Are users informed about potential side effects beforehand? Not always, or certainly, not adequately. That is why you should inform yourself if you are taking them or considering taking them. Are such drugs a miracle or yet another pharmaceutical disaster waiting in the wings? Please read on …
Weight loss drugs are not new
Pharmaceutical companies were developing weight- loss drugs back in the 1930s. These were stimulants like amphetamines but which were found to have high addiction potential with side effects of strain on the heart, increased anxiety and psychosis. In the 1990s, the drug Fen-Phen was initially hugely popular but later withdrawn in 1997 when it became linked to heart valve damage and pulmonary hypertension. This was a landmark moment in obesity-drug caution. The next kid on the block was fat absorption blockers like Orlistat, which unfortunately created gastro-intestinal distress and were not so popular. Next came CNS (Central Nervous System) and combination drugs like Lorcaserin (withdrawn because of cancer risk). Others in this category had psychiatric and cardiovascular side effects. In short, most previous weight-loss drugs failed because they overstimulated the brain, disrupted heart function, and produced unacceptable long-term harm.
Enter GLP-1 drugs - why they seemed safer
The modern class of popular weight-loss drugs like Ozempic, Wegovy and Mounjaro are called GLP-1 receptor agonists. This stands for Glucagon-like peptide-1 which is a hormone released by the body after eating. The word “agonist” means it acts like a key to turn on reactions.
Modern weight-loss GLP-1 drugs were originally developed for type 2 diabetes, not weight-loss.
Normal amounts of GLP hormone in the body stimulate insulin release, suppresses glucagon (a hormone that raises blood glucose), slow gastric emptying (food passing through the gut) and signal to the brain that you have eaten enough (satiety). GLP-1 drugs just amplify this signal. They reduce appetite, delay stomach emptying, reduce reward signalling round food, and lower blood glucose.
Diabetes trials with these drugs demonstrated weight- loss independent of the diabetes. This was the first time for many that weight-loss seemed effortless. The obesity epidemic fuelled the financial incentive of drug companies to re-market GPL-1 drugs as weight-loss drugs. These are now used off-label in non-diabetic populations.
The repeating historical pattern
Every wave of weight-loss drugs has followed this arc:
1.Drug works well
2.Cultural excitement (people want to look slimmer)
3.Expanded use beyond original population
4.Risks minimised
5.Long-term consequences emerge
We are currently between steps 2 and 3 with GLP-1 drugs.
Black Box Warning
Weight-loss drugs like Ozempic, Mounjaro and Wegovy all carry an FDA Black Box Warning. This is the strongest safety warning the US FDA (Food and Drug Administration) can require on a prescription drug. It appears prominently on the drug label to alert prescribers and patients about serious or potentially life-threatening risks that must be clearly communicated.
The black box warning on weight-loss drugs means:
*Prescribers must screen patients carefully
*Patients should be informed of:
- Possible symptoms of thyroid tumours (neck mass, hoarseness, trouble swallowing)
*These drugs should only be used only when benefits clearly outweigh risks.
Documented risks with GLP-1 drugs
These are the known documented potential risks and side effects of GLP-1 weight-loss drugs:
Common/Expected risks
*Digestive symptoms: Nausea, vomiting, diarrhoea, constipation - often early on or after dose increases. This can be severe for some.
*Gastroparesis/Slow stomach emptying: GLP-1 drugs slow gastric emptying, which can cause persistent fullness and bloating. In rare cases, clinically significant gastroparesis (food not moving through the gut) can occur. This can be life-threatening.
*Dysbiosis (disrupted gut bacterial balance): Due to slowed passage of food through the gut. This can trigger a wide range of health problems because gut health plays significant roles in whole body health. One major consequence of slowed food moving through the gut can be SIBO (Small Intestinal Bacterial Overgrowth) which means gut bacteria in the wrong place on the body. In this case, bugs in the upper gut ferment your food, causing increased toxicity and brain fog and nutritional deficiencies.
*Depression: GLP-1 receptors on cells are present in areas of the brain involving mood. These drugs can alter neurotransmitter balance, potentially triggering low mood and reducing pleasure from eating. This can mimic depression in vulnerable patients.
*Gallbladder issues: Increased risk of gallstones and gallbladder inflammation, especially with rapid weight loss. Some people require surgery (gallbladder removal).
*Pancreatitis: Acute pancreatitis has been reported in a small proportion of users; this is serious and requires urgent care.
*Kidney effects: Indirect risk: dehydration from GI side effects can stress the kidneys, and, in rare cases, contribute to acute kidney injury.
*Thyroid effects: Rapid calorie restriction can increase the stress hormone cortisol and reduce the conversion of inactive thyroid hormone T4 into active T3. The result is fatigue and low mood.
Less common reported concerns
*Thyroid cancer/tumours: Black Box Warning for medullary thyroid carcinoma (MTC) risk seen in animal studies; human risk is unclear but significant enough for caution. GLP-1 drugs are typically contraindicated in people with history of MTC or MEN2 (a genetic condition that predisposes people to develop tumours in multiple endocrine glands).
*Sarcopenia (Muscle Loss): Rapid weight loss can lead to loss of lean mass if protein intake and resistance exercise are inadequate. Some data suggest a significant proportion of weight loss can be lean tissue, which is undesirable if you want to live a long and healthy life.
*Hair Loss and Skin Changes: Reported anecdotally and in some post-marketing data; this may relate to rapid weight loss or nutrient changes.
*Dental decay and Nutrient Concerns: Reduced appetite and altered eating patterns may contribute to dental decay or nutrient deficiencies if food intake is very low.
*Vision loss - the eye has one of the highest concentrations of the body’s master antioxidant glutathione. Weight loss drugs indirectly lower glutathione (antioxidant) levels in certain individuals.
Other possible risks
*Hypoglycaemia or low blood sugar (especially with other diabetes medications)
*Gallstones impacting liver function or leading to bile duct complications.
*Rare allergic reactions in injection site issues.
Drug discontinuation effects
Side effects of GLP-1 drugs can persist for a long time after discontinuation. Symptoms related to digestion and appetite may take days to weeks to fade away. In some cases, gastroparesis-like symptoms can persist for weeks to months. Hair loss may continue for months after stopping. Kidney effects resolve if the problem is dehydration, but acute kidney injury may have lingering effects. Serious side effects like pancreatitis or gallstones don’t just go away after stopping - they need medical treatment.
Rebound weight gain after drug discontinuation
Weigh regain is common after stopping GLP-1 drugs, especially if lifestyle or underlying metabolic factors haven’t been addressed. In one analysis after discontinuing Wegovy, people regained two-thirds of lost weight within a year. This isn’t a “drug flaw” per se - it reflects how appetite regulation and energy balance adapt once the pharmacologic effect wears off.
The popularity and visibility of these drugs in the media and social circles has significantly increased interest. GLP-1 drugs are seen by some as transformative for weight loss. However,
there is currently no clear guidance as to the safety profile of these drugs if taken indefinitely. The media popularity for these drugs is good for Big Pharma but not necessarily good for the patient who may have to pay several thousand pounds a year for a private prescription.
Buying weight loss drugs without a proper prescription - from social media sellers, salons or unregulated online sources - is illegal and potential dangerous. Authorities have warned of serious side effects from fake medicines.
Informed consent
Informed consent is essential when considering prescription weight-loss drugs. These medications can offer meaningful benefits for the clinically obese but they also carry real risks, uncertainties about long-term use, financial costs, and the likelihood of weight regain after stopping.
True informed consent means taking responsibility to understand both the pros and cons - including side effects, dependency potential, lifestyle requirements. and what is still unknown - rather than viewing the drug as a simple quick fix or risk-free solution.
Responsible prescribers should act as medical gatekeepers - not retailers. Informed consent requires honesty: many people say they have “tried everything” to lose weight when, in reality, they may not have explored nutritional support or had any metabolical tests or assessment to discover the actual underlying causes of why they are overweight.
The Functional Medicine approach to weight loss
The Functional Medicine approach to weight loss is very different to the conventional calorie-based or exercise-centric or pharmaceutical models. In Functional Medicine, weight gain is regarded as a protective, biologically intelligent response to underlying issues like inflammation, immune stress, low grade chronic infections, hormonal imbalance and toxic load.
Until these underlying drivers of weight gain are addressed, slimming efforts can either fail or drive more symptoms as mobilised toxins are forced into circulation. The result is increased inflammation and rebound weight gain. When the reasons for being overweight are gone, the weight goes away by itself. It’s not just about looking better, it’s also about feeling better!
Drivers/root causes of weight gain
When doing a metabolic assessment of why a person is overweight, I take a full case history. These are some of the underlying factors I look for that trigger weight gain:
*Food allergy/food addiction
*Unresolved emotional stress
*Inflammatory foods (gluten, cows’ milk, refined sugars, trans fats, processed foods) known to increase weight gain
*Low fat/high carb diet of the kind promoted by the government’s “Food Plate”
*Lack of food education
*Insulin resistance/ precursor to diabetes type 2
*Hypothyroidism (if the thyroid is underactive, it can be hard to slim down naturally without correcting this first - you need to do a full thyroid panel, not just TSH or T4)
*Ongoing stress with high cortisol - promotes weight gain round the waist.
*Chronic low grade infections (local and systemic) and inflammation
*Sex hormone imbalances
*Dysbiosis/gut bacterial imbalance/toxic gut
*Sleep problems
*Endocrine disruptors (environmental chemicals that mimic oestrogen)
*Certain medications (steroids, antipsychotics, antidepressants)
*Wifi addiction (can raise blood sugar levels all on its own!)
The right lab tests can pinpoint the underlying causes for a person’s weight gain. This takes the guesswork out of formulating a plan. One person’s obesity triggers may be very different from another person’s triggers, hence the problems created by ‘one-size-fits-all’ social media approach.
The goal for addressing obesity should be weight-loss and appetite control without the risks. It is possible to create a similar GPL-1 effect using plant-based phytonutrients without the side effects of pharmaceutical drugs. There is a sustainable approach for life, rather than yoyo dieting, followed by weight regain, which is hard on the body and demoralising on the soul.
If you would like to slim down in a healthy and sustainable way, please get in touch with the Good Health Clinic on goodhealthclinic@outlook.com to request a free 30 minute Enquiry Call or book an appointment. Please note that an Enquiry call is not a consultation but an exploratory call to see if this is a clinical approach you wish to pursue.To your very good health,
Suzanne Jeffery (Nutritional Medicine Consultant)
M.A.(Oxon), BSc.(NMed), PGCE, GNC, BSEM, MNNA, CNHC
The Good Health Clinic at The Business Centre, 2, Cattedown Road, Plymouth PL4 0EG
Tel no: 07836 552936/ Answer phone: 01752 774755
Disclaimer:
All advice given out by Suzanne Jeffery and the Good Health Clinic is for general guidance and informational purposes only. All advice relating to other health professionals’ advice is for general guidance and information purposes only. Readers are encouraged to confirm the information provided with other sources. Patients and consumers should review the information carefully with their professional health care provider. The information is not intended to replace medical advice offered by other practitioners and physicians. Suzanne Jeffery and the Good Health Clinic will not be liable for any direct, indirect, consequential, special, exemplary or other damages arising therefrom.