Healthy Weight, Healthy You

Semaglutide (Wegovy &
Ozempic); Tirzepatide (Mounjaro); Liraglutide (Saxenda) are all being used to help treat obesity. Semaglutide and Tirzepatide are once weekly injections, whereas liraglutide is an everyday injection. There is an oral Semaglutide daily tablet available in the UK, but it has not reached the Irish market yet – we believe it is coming to the market very soon, but we have no confirmation of a date yet.

They belong to a class of drugs called GLP-1 analogues (Glucagon-like peptide-1 receptor agonists) – What does this mean? These drugs mimic GLP-1, which is a hormone naturally produced in the gut, which regulates appetite and blood sugar. By mimicking GLP-1, it sends signals to the brain to tell it that you’re full, reducing hunger and cravings.

NOTE: This is why it is so important for people to eat distraction-free, otherwise, these signals can be missed.

Tirzepatide (Brand name Mounjaro) is not only a GLP-1 analogue, but it also affects another hormone, GIP (glucose-dependent insulinotropic polypeptide), which is thought to affect lipid metabolism and insulin release.

So, in short, they help to make you feel fuller faster by slowing gastric emptying. They are not appetite suppressants, more appetite regulators.

Obesity is a chronic, relapsing disease, which needs long-term treatment. One of the treatment options is for medication (like GLP-1’s), which help to regulate appetite among other things. It is absolutely not a fad. In order to successfully treat Obesity, we need to move away from a cultural desire for everyone to be thin! Instead, we need to
think of it as living in a healthy body. Make it about health, not “skinny”. Is your weight/the size of your body impacting your ability to lead a healthy life? Obesity is a complex disease that is a result of our genetics, our biology and the world we live in. There are many factors at play which are out of our control – so we need to try and stop blaming and shaming people living with obesity. This medication is most successful when used in conjunction with lifestyle changes – Education around healthy eating, increased physical activity and psychological support. The sub conscious brain plays a huge role
in obesity and appetite regulation – we need to try and reduce the stigma and shame for people carrying excess weight, and make sure they have access to strategies and treatment to manage this chronic disease of obesity.

Common side effects: Constipation, diarrhoea, bloating/uncomfortable fulness, fatigue and thirst.

Loss of lean muscle mass is also a huge factor to consider and can be managed by consuming sufficient protein, as well as incorporating at least 2 x resistance exercise workouts per week (bodyweight exercises count for this). Many of these side effects can have a major impact on the person’s quality of life, affecting
their ability to socialise too.

Ways to minimise constipation – Fibre
is crucial for a healthy gut, but if you eat too much bulky fibre, particularly when starting GLP-1’s, you can end up feeling uncomfortably full, bloated and “blocked up”. Soluble fibre is much more digestible and better tolerated. Eg’s: oats, beans,
lentils, berries, apples, flaxseeds, chia seeds.  NB when we eat fibre we MUST drink water with it – otherwise it can cause constipation and food won’t pass through the gut comfortably.

With proper support alongside healthy eating, physical activity and psychological support, these medications can be hugely successful for people. But they are not a quick fix.

Many people do regain weight after stopping GLP-1 medication. As obesity is a chronic disease, it requires long-term treatment. Lifestyle changes with regard to healthy eating and increased physical activity, as well as psychological support is crucial to help maintain a healthy weight after stopping treatment.

The danger is, often, when weight is lost
rapidly, both fat and muscle mass is lost. When weight is regained quickly, this is usually gained as fat (not muscle). So unless people are careful about protein intake and undertake adequate resistance training regularly, they can be at risk of losing muscle mass, resulting in loss of strength, and increased frailty (which is what we are seeing happen). Most people on GLP-1 treatment will find their weight will plateau after about 6-9 months of treatment – this is due to their genetics & life experiences and is not always within the person’s control. It is important for users to understand the science behind this to try avoid feelings of failure, guilt and shame.

Implementing sustainable lifestyle changes with regard to healthy eating, increased physical activity, including resistance training / weight bearing exercises, plus getting psychological support to help cultivate new behaviours. E.g. CBT

Again, it’s about health, not about weight/being skinny.

Somebody living in a bigger body, carrying excess weight, is going to be
statistically at a higher risk for certain medical conditions and chronic diseases. So regardless of size, we should be trying to focus on healthy eating and physical activity. Remember being skinny doesn’t equate to happiness. We need to shift the focus to valuing health and nurturing a good relationship with our bodies, and with food.

WHO Estimate (2023): Up to 80% of
heart disease, stroke, and type 2 diabetes and 40% of cancers could be prevented with better dietary patterns. Shift the focus away from weight-loss and towards living in a healthy body, or at a healthy weight. The goal needs to be on overall health, not just being “skinny”.

Interesting fact: Healthy Ireland Survey from 2024 – almost 60% of our population are overweight or living with
obesity, including 1 in 5 primary school children.

Worldwide adult obesity has more than doubled since 1990, and adolescent obesity has quadrupled!!