Touted as one of the greatest medical breakthroughs of the decade, GLP-1 weight-loss drugs (such as Ozempic, Wegovy, Mounjaro and Zepbound) have not only revolutionised the way we tackle type 2 diabetes, they've also moved into the mainstream.
As WeightWatchers files for bankruptcy, the semaglutides market is expected to be worth £82.3bn by 2035, with the jabs becoming the most coveted status symbol peddled by the rapidly shrinking bodies we see on red carpets and in our social feeds.
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But in the midst of what has become a tension-filled landscape, beset by growing ethical concerns and regulation issues, Dr. Jack Mosley, GP registrar and expert in GLP-1 drugs, has stepped in as a beacon of common sense with his new book Food Noise: How Weight-Loss Medications and Smart Nutrition Can Silence Your Cravings.
Having dedicated the book to his late father Dr. Michael Mosley, a much-loved fixture on our screens and airwaves whose work has had a lasting impact on the nation's health (Michael pioneered the popular 5:2 diet), Jack is keen to continue in his own way, the Mosley mission to help us lead healthier lives.
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"My father taught me that health isn't just about numbers on a scale. My book is dedicated to him, and to everyone looking for a better, quieter relationship with food," he says.
Dr. Jack Mosley on Ozempic
"[Weight loss] drugs can be effective for those who have tried dieting and struggled – and many have," says Jack.
He notes that "food noise" is contributing to our eating habits, explaining: "In our modern Western food environment, we are exposed to more food noise – the inner voice that urges us to eat – than at any time in our history as a species.
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"These foods, which we would not find in nature, are designed to overwhelm our primitive Stone Age brains, which have not changed significantly over the past few thousand years, while our food environment has.
"We're surrounded at every turn by addictive foods that are low in nutrients but high in calories, and these foods make us want more, and more, and more.
"They're a sensory overload: the sight, the sound and the smell of processed junk foods keep us craving, and an unhealthy diet is now the number-one modifiable risk factor for an early death."
"GLP-1 drugs are a spectacular breakthrough in weight-loss treatments, but with regard to the way they're currently being used, it's the Wild West of online pharmacies out there.
"These drugs can be very effective for some people, but to get the most out of them, you need the right nutritional strategies and changes to your lifestyle, which may even include resistance [strength] training to protect your muscles, too."
Muscle loss on weight loss drugs
Many people taking weight loss drugs experience muscle loss, too, with Jack explaining the cause: "Whenever you're in a calorie deficit, your body is trying to scavenge energy from somewhere. If you haven't eaten enough protein or stressed your muscles by exercising, you’re likely to find the amino acids [building blocks for protein] in your muscles and break them down.
"As far as we know, this isn't a special effect of the drugs; the ranges of muscle loss are within the range of many diets. However, it's important that you double down on protein and strength training if you want to retain as much muscle mass as possible."
Who should take weight loss drugs?
"Like my dad, I've always suggested a 'diet and lifestyle first' approach. However, these drugs can be effective for those who have tried different dietary approaches and struggled, and many have, or for people living with obesity or an obesity-related disease.
"They reduce your appetite and also food noise, leading you to lose weight, which improves your metabolic health and overall wellbeing.
"In the book, I suggest dietary approaches such as intermittent fasting and a Mediterranean-style diet that can work for you whether you’re taking these medications or not."
Weight loss drug dangers
"When people on the jabs don't change their eating habits, they may not lose as much weight as we've seen in studies where participants are supported by nutritionists.
"Malnutrition is another big concern. When using GLP-1s, if we waste our tiny appetites on processed junk food, we may exacerbate malnutrition, which Robbie Williams demonstrated recently when he contracted scurvy [after using an appetite-suppressant drug].
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"Muscle loss, as we mentioned before, is also a problem. Muscle is important not for looking ripped, but because it has a host of health benefits, is vital for metabolism and is one of the best predictors of longevity, as well as quality of life in later years."
Regaining weight
"Then there's the issue of regaining weight. People are understandably anxious about putting weight back on once they come off the drugs.
"Two-thirds of any weight lost is regained in the first year, once the food noise comes rushing back, so it's important to ensure that you have the right nutritional strategy to quieten it naturally – for example, eating filling foods such as protein, fibre and healthy fats.
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"Although exercise is not, in fact, the best weight-loss tool, some studies suggest that it's a good way to keep weight off once you've lost it.
"One issue with the way weight-loss drugs are currently prescribed is that online pharmacies have a financial incentive to keep you on the highest dose you can tolerate.
"If you do want to come off these drugs, it may be more sensible to reduce your dose slowly, over a period."
Jack’s new book is out now (published by Octopus, priced £16.99)
