The Fat Jab – Is it worth it?
Fat-loss injections are becoming increasingly common in the UK. The two main fat-loss injections are Mounjaro (tirzepatide) and Wegovy (semaglutide), available on NHS prescription from specialist weight-loss clinics. But many people are asking – is it worth it? There are increasing concerns with side effects and long-term impact which is not fully understood. In this blog I look at some of the pros and cons and offer an alternative perspective.
How do the weight-loss injections work?
The mechanism of action by which they help people lose weight is by mimicking a hormone called GLP-1 (glucagon-like peptide-1) which is released after eating.[1] The aim is to mimic GLP-1 to slow down your digestion, decrease your appetite and make you feel fuller after eating. The intended result is to make people eat less food and thereby lose weight.
Mounjaro contains the active ingredient tirzepatide which mimics another hormone in the body called GIP (glucose-dependent insulinotropic polypeptide), which can also reduce your appetite. Wegovy contains the active ingredient semaglutide. Semaglutide is also prescribed as a treatment for type 2 diabetes under the brand name Ozempic.
What are the Pros?
The best thing about the weight-loss injections are that they are focussing attention on achieving and maintaining a healthy weight.
Healthy weight is important for overall health and we are all aware of the dangers of obesity in increasing risk of cardiovascular diseases, strokes and heart disease. The immune response is also compromised in people with obesity, since obesity is characterised by a state of chronic inflammation and systemic metabolic dysfunction.
Excess body weight places increased mechanical load on joints, particularly the knees, hips and ankles. Each additional kilogram significantly increases the force transmitted through these joints during everyday activities such as walking and climbing stairs. Over time, this accelerates cartilage degeneration and contributes to the development and progression of osteoarthritis. In addition to mechanical strain, obesity is associated with chronic systemic inflammation, which can worsen joint pain and stiffness.
What are the Cons?
Weight-loss injections are not the ‘quick fix’ they seem to be.
First of all, they come with side effects that range from inconvenient to serious complications. Digestive problems are common, including nausea, diarrhea, constipation and abdominal pain. Many people report fatigue, low blood sugar, dizziness, breathlessness and even hair loss.
Secondly, many people are uncomfortable with using syringes on themselves and do not like the idea of self-administration.
Thirdly, there are many concerning reports that flag problems such as inflamed gallbladder and pancreas, cases of acute pancreatitis (affecting up to 1 in 100 people), optic nerve damage to delicate blood vessels in the retina and over 40,000 adverse reactions to tirzepatide in 2025. The MHRA has also warned that Mounjaro may even reduce the effectiveness of the contraceptive pill.
A complex case…
I would argue that the issue of weight loss and healthy weight is a much more complex topic.
Many people think that to lose weight, they need to eliminate all fat from their diet. But our bodies actually need healthy fats for optimal health. Healthy fats can actually help stabilise weight, promote overall health and reduce the risk of developing chronic disease. You can read more about healthy fats and weight loss in my blogs titled ‘Fighting Obesity’ and ‘Weight Management’.
People using GLP-1 drugs face a higher risk of losing muscle mass as they lose weight. This is alarming because a skinny frame is not the ultimate health goal. Weight loss that causes loss of muscle weight is not good for long term health. A healthy body needs muscle and fat for strength, mobility and balance. One study from 2016 showed that unfit skinny people were twice as likely to get diabetes as people who were much heavier but much fitter.[2]
An interesting meta-analysis published this year in the British Medical Journal reviewed 37 studies to find out the long term weight loss of people who used weight-loss medications such as Wegovy and Mounjaro and what happened to them when they stopped using the medications. The reports covered 9,341 people and the meta-analysis found that when people stopped taking the drugs they regained the weight they had lost. Interestingly, people using medications returned to their original weight faster than people who used other methods of weight loss such as dietary, lifestyle and exercise changes.
How can nutritional therapy help?
Nutritional therapy is much more than a one-off solution. As a nutritional therapists I take a long-term approach to a range of personalised approaches that take into account the complexities detailed above. From initial assessments of diet, symptoms, lifestyle and health history, I devise personalised nutrition plans and supplement protocols. I use a number of different laboratory tests for hormonal, gut and nutrient analysis. As a trained lifestyle coach, I also employ lifestyle coaching for advice on implementing long-term changes on sleep, stress, exercise and habits that contribute to positive outcomes.
Here are the first things I would suggest trying before starting the weight-loss injections:
- Reduce food portions. Aim to eat smaller, more nutriti
ous portions of food. One easy way to do this is to swap your normal plate for a smaller plate! Instead of eating a big bowl of pasta, you might like to follow BANT’s Wellness Plate. It is a good guide to getting the right foods in the right amount on your plate! - Shorten the time-frame in which you eat. So instead of eating whenever you want to, try to eat within an 8 hour window or reduce your main meals to two meals instead of three meals. Drink healthy liquids and eliminate snacking in between. If you find meal spacing difficult, it may be because your blood glucose is dysregulated so this may be something you would like to talk to me about in your consultations.
- Fast more. Learn the best way to fast that works well for you. Many people find that drinking lots of water when they wake up and delaying your breakfast means they can easily fast for up to 18 hours before eating again! You can find out more about healthy fasting in my previous blog here. If you find fasting difficult, it may be because your adrenal glands are compromised so please do let me know about this.
- Increase your exercise. Choose a form of exercise that works well for you and work hard at increasing the time and intensity of each session. Resistance exercise is a great way to increase muscle mass.
- Be careful to increase your intake of protein and to eat nutrient-dense food. If you are eating smaller portions, you need to have nightly dense nutrients in that food. My latest favourite recipe might become your new favourite recipe too!
- Instead of reaching for fat-free processed food and drink, opt for the healthiest fats in the most nutrient dense whole foods.
If you are concerned about the side effects of the new fat jabs but you want to have a healthier weight, a consultation is a great first step on a rewarding journey. If you have already tried all of them and want a nutritional and lifestyle plan alongside judicious use of fat-loss injections, nutritional therapy can also provide help. I look forward to hearing from you and working with you on this important journey to finding a healthy, sustainable weight that is best for you!
With every blessing,
Emma
Emma Maitland-Carew – Registered Nutritional Therapist
Dip.ION, mBANT, CHNC Registered Practitioner, ILM Accredited Wellbeing Coach
Certified Live and Dried Blood Analysis, Metabolic Balance® Coach, HeartMath Coach, Accredited Wellbeing Coach
[1] Injections that mimic this hormone are known as GLP-1 agonists and were originally designed to treat type 2 diabetes
[2] Guo F, Garvey WT. ‘Cardiometabolic disease risk in metabolically healthy and unhealthy obesity: Stability of metabolic health status in adults.’ Obesity (Silver Spring). 2016;24(2):516-525. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4731253/
