GLP-1 Medications: A Lifeline or a Dangerous Shortcut?

GLP-1 receptor agonists, such as Ozempic, Wegovy, and Mounjaro, were originally developed to treat type 2 diabetes, but they have rapidly gained popularity as weight‐loss medications. When I was a dietetic student fifteen years ago, I remember our lecturer saying that one day they would be a “blockbuster drug for weight loss.” The future has come!

These medications work by mimicking the effects of a natural hormone that regulates appetite, blood sugar levels and digestion, often leading to significant reductions in body weight. But are they a genuine solution to weight‐related health concerns, or are they being misused in the pursuit of an unattainable body ideal? The answer is not straightforward, as it depends entirely on the context in which they are used. While they can offer transformative benefits to those struggling with obesity and related health conditions, they can also fuel disordered eating, body dysmorphia and dangerous health consequences when used inappropriately.

I get asked about GLP-1 medications in the clinic a lot – both by clients who are currently using them and by those who are intrigued by the idea. Some people want to understand how they work, while others are unsure if they should consider them. My answer is always nuanced because, like most things in health and nutrition, there is no one‐size‐fits‐all approach. In this piece, I will try to explain my perspective fully, in the hope that somebody may find it useful.

As a dietitian, I am happy to support people using GLP-1 medications in several ways:

1. Helping individuals build healthy dietary and lifestyle habits while they are on them, ensuring that the transition to stopping medication is smooth and that weight loss can be maintained through sustainable changes, rather than relying solely on medication.
2. Supporting those who are considering taking GLP-1s by improving their relationship with food beforehand, helping them develop balanced eating patterns that make it easier to sustain weight management with or without medication.
3. Guiding individuals who have stopped GLP-1s and are struggling to nourish themselves or maintain a positive relationship with food, ensuring they feel confident in their eating habits and do not fall into cycles of restriction or regain.

Scenario 1: A Tool for Health and Quality of Life

For individuals living in a larger body where excess weight is impacting their health – such as those with pre‐diabetes, type 2 diabetes, polycystic ovary syndrome (PCOS) or infertility – GLP-1 medications can be genuinely beneficial.

They help regulate appetite, so you feel full after a small amount of food. They also enhance insulin sensitivity, stabilising blood sugar levels and reducing energy crashes, which in turn lowers cravings for highly processed, carbohydrate‐heavy foods. This often makes it far easier to maintain a more balanced and nourishing diet without feeling constantly deprived.

Additionally, these medications can help break the cycle of weight‐related mobility issues. Carrying excess weight can make movement physically uncomfortable or painful, discouraging exercise and leading to further metabolic decline. As weight decreases, joint pain and fatigue often lessen, making physical activity more accessible. This creates a positive cycle where movement becomes easier, helping individuals sustain weight loss beyond the medication itself.

For many people in this scenario, GLP-1s can be a powerful tool for improving long‐term health outcomes but they should ideally be paired with nutrition and lifestyle changes to ensure success beyond the duration of the prescription.

Scenario 2: A Shortcut to Thinness at Any Cost?

However, for individuals who are already within a healthy weight range or only slightly above it, the widespread use of these medications raises serious concerns.

Weight loss, when not medically necessary, is often pursued with a ‘quick fix’ mentality that prioritises rapid results over long‐term health. The promise of effortless weight loss with GLP-1s can discourage the development of sustainable eating habits and a balanced relationship with food. If someone is already at a healthy weight but seeks to become significantly leaner using these medications, they may risk severe calorie restriction, which can lead to dangerous consequences, both physically and mentally.

One of the biggest risks is disordered eating. Many people who turn to weight‐loss medications without a medical need already experience body dissatisfaction. GLP-1s can reinforce extreme food restriction, creating a situation where weight loss becomes an obsession. This can easily spiral into eating disorders, such as anorexia or orthorexia, particularly for those with a predisposition to restrictive eating patterns.

From a physiological standpoint, excessive weight loss can disrupt key hormonal functions. For women, extreme calorie restriction and rapid fat loss can lead to hypothalamic amenorrhoea – the loss of menstrual cycles due to insufficient energy availability. This is a sign that the body is under extreme stress and is no longer prioritising reproductive function, essentially mimicking the hormonal effects of early menopause. The consequences include:

• Bone loss – Lower oestrogen levels weaken bones, increasing the risk of osteoporosis.
• Reduced fertility – Hormonal imbalances can make conception difficult or impossible.
• Cardiovascular risks – Oestrogen plays a protective role in heart health, so losing it prematurely can increase the risk of heart disease.

Additionally, when weight loss is achieved solely through medication rather than by addressing behaviour and lifestyle, weight regain is highly likely once the drug is stopped. Without a solid foundation of healthy habits, individuals who relied on GLP-1s to lose weight may struggle to maintain their results, leading to cycles of yo-yo dieting, muscle loss and metabolic slowdown.

What These Drugs Cannot Resolve for You

GLP-1 medications can be brilliant at helping individuals overcome weight loss resistance and improving health markers. However, once they are stopped, the following challenges are likely to return – this is why weight regain is so common once the medication is discontinued:

• Comfort eating – If food has been used for reasons other than physical hunger (e.g., emotional comfort, distraction, stress relief), those habits will likely resurface once appetite returns to normal.
• Emotional eating patterns – If there are no alternative coping mechanisms in place, it is easy to fall back into using food to regulate emotions.
• Gut health and digestion – These medications slow digestion, but gut health requires much more than that, including a fibre‐rich diet, phyto‐chemicals, prebiotics, hydration and a well‐balanced microbiome.
• Hormonal health – While weight loss may temporarily improve certain conditions, hormone balance requires more than just a number on the scales – it involves sleep, stress management and optimal nutrition.
• Metabolic health and muscle maintenance – Losing weight too quickly, particularly without adequate protein intake and movement, can lead to muscle loss, which negatively impacts metabolism and long‐term weight maintenance.
• Overall relationship with food – If weight is lost without learning how to eat in a way that supports long‐term health and satiety, individuals may struggle once off the medication, feeling lost about what, when and how much to eat.

Conclusion: Context is Everything

GLP-1 receptor agonists are neither inherently good nor bad – their value depends entirely on how and why they are used. For individuals with obesity‐related health conditions, they can be life-changing, improving metabolic health, making weight loss more sustainable and breaking the cycle of insulin resistance and food cravings. However, for those already at a healthy weight, using these medications purely for aesthetic reasons can lead to serious physical and psychological risks, including disordered eating, hormonal disruption and long‐term metabolic damage.

The key lies in responsible use. When prescribed appropriately and combined with education on nutrition, movement and overall well‐being, these medications can be powerful tools for those who truly need them. But their increasing use as a shortcut to thinness should be a cause for concern – especially in a culture that glorifies weight loss over true health.

Are GLP-1s a lifeline or a dangerous shortcut? The answer does not lie in the drug itself, but in who is using it – and why.