A Nutritionist’s Take: Do Weight Loss Drugs Actually Improve Quality Of Life?

In the last couple of years the conversation around weight loss has been dominated by medications. New drugs promising greater weight loss are being made increasingly accessible – but while the pound-shedding effects are undeniable their impacts on quality of life and improvements in health may not be so clear cut, according to a new study. Nutritionist Kim Pearson gives her take.

Weight Loss Drugs Don’t Improve Quality Of Life, Major Study Finds

A major review of studies published in the BMJ analysed data from 262 randomised controlled trials involving 99,791 participants, comparing the benefits and harms of 19 weight loss medications. As expected, newer GLP-1 based medications, particularly tirzepatide and semaglutide, produced the greatest weight loss.

But one of the study’s most interesting findings was not about the amount of weight lost, it was about quality of life. Authors noted that: ‘Despite substantial weight reduction, no drug produced clinically important improvements in quality of life at one year’.

Evidence for reduced disease risk was also limited. Despite assessing 19 medications, subcutaneous (injection) semaglutide (Wegovy and Ozempic) was the only agent found to have ‘moderate to high certainty evidence of reduced death and major cardiovascular events.’

Another analysis of studies published in the BMJ earlier this year highlighted how weight rebound occurs rapidly after people stop using weight loss medication, and that improvements in health markers quickly reverse too.

Beyond The Number On The Scale

Quality of life and health outcomes are every bit as important as the number on the scale. The people who come to see me don’t just want to see their weight come down, they want to feel better in themselves. They want improved energy, more confidence, to feel lighter and fitter, and they want to see improvements in wider indicators of health. Seeing the improvements my clients make, and the positive impact this has on their lives, is one of the most rewarding parts of my work.

While important, weight loss should never be viewed as the only measure of success. If a treatment leaves someone feeling unwell, unable to enjoy food, social occasions, or even everyday life, we have to ask whether it really is the best approach. 

I know that it is possible to achieve effective and sustainable fat loss naturally, in a way that doesn’t require suffering with hunger, cravings or a diet that leaves you feeling miserable and deprived.  

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GLP-1 Roulette

The study also highlighted that ‘greater weight loss was consistently accompanied by higher rates of adverse events and treatment discontinuation, indicating a clear benefit-harm trade-off’. Simply put, the more weight people lost, the higher the risk of negative effects. The reality is that starting a weight loss drug can be a roulette: before treatment begins, nobody can say with certainty which experience an individual will have. 

Some people experience life-changing improvements. They lose weight, their mobility improves, joint pain reduces, and for the first time in years the constant food noise ceases.

For others, the experience is very different. Persistent nausea, vomiting, constipation, diarrhoea, fatigue or other side effects can significantly affect daily life. In some cases, serious adverse effects occur. A friend of mine is currently on a waiting list to have her gallbladder removed after several bouts of excruciating pain, resulting in multiple trips to A&E. Her doctors believe this is likely related to taking Mounjaro, a decision she now deeply regrets.

While we are aware of many of the risks associated with these medications, we cannot accurately predict who will tolerate these medications well and who won’t. Will you be the person who has a positive experience? Or will you end up on an operating table?

Informed Consent Is Often Lacking

Authors of the new study also concluded that treatment decisions should consider the potential benefits against the harms through shared decision making, an important informed consent process that is often lost when people access weight loss medication via online pharmacies. 

In my opinion, it is vital that anyone considering taking these medications is fully aware of the risks. 

A Natural Approach

I will admit, I am biased. As a nutritionist, my training and my core focus over the last two decades working with clients has been to take a natural approach to weight loss. To work with the body, rather than suppress its natural signals.

I know that, when the right nutrition and lifestyle strategies are implemented, food noise, cravings and excessive hunger can vanish, without the need for medication. Mental health, physical health, energy levels and quality of life can improve dramatically. I know it can be every bit as effective as weight loss medications, while being a lot less risky, and more likely to result in long term weight loss. 

This is one of the reasons I wrote The Nozempic Diet. I wanted to offer people another evidence based option. Not because I believe weight loss drugs have no place at all, but because many people feel that the benefits of them do not outweigh the risks, they are not suitable candidates for medical reasons, or they are looking to transition off medication and are seeking a sustainable way to maintain their weight loss long term without relying on medication. The Nozempic Diet is an eight pillar plan, designed to fit easily into everyday life. Based on my two decades experience working with many hundreds of clients, I know it works.

Ultimately, while weight loss is important, the goal is not simply to lose weight: it’s to improve long term health and quality of life. Whether medications can deliver on this remains in question.

Kim Pearson is Country & Town House’s contributing health editor. A qualified nutritionist with almost two decades of clinical experience, Kim specialises in weight loss, metabolic health and healthy ageing. Her new book, The Nozempic Diet, is a practical guide to natural, effective and sustainable weight loss. To find out more about Kim’s work, visit her website kim-pearson.com or follow her on Instagram.