Kristina Chetcuti, a registered health coach (UKIHCA) specialising in behaviour change and lifestyle medicine (ELMO), answers your lifestyle dilemmas.
Q. I keep hearing about weight-loss jabs being a game changer, but as someone who genuinely loves food, I’m worried — would I lose my appetite overnight, and is it really that simple? I’m also a bit confused, as every week seems to bring new claims that these drugs help with everything from heart disease to even concussions. Are they really a cure-all?
A. If there is such a thing as a cross between a sigh and a sharp intake of breath, this might just be the short answer to your question. Instead, I’m going more wordy about it. As Julie Andrews once said, I’ll start at the very beginning. A good place to start is getting to know these medications on a first-name basis.
Back when Homo sapiens emerged on this planet some 300,000 years ago, they came with one thing already built into their biological package: a Glucagon-like Peptide-1 hormone. Admittedly, this is a bit of a mouthful, which is why everyone calls it GLP-1.
This hormone is made naturally in our gut straight after we eat, and sends signals to the brain and body to slow digestion, manage blood sugar and signal fullness so we stop eating. This effect lasts only a few minutes. It’s a sign that it’s time to pat your fed belly, (maybe burp), and sigh with contentment. Once that job is done, the GLP1 hormone doesn’t need to hang around.
For hunter-gatherer societies, it worked brilliantly. Hunter-gatherers weren’t likely to be tempted by Manneken Pis chocolates, waffle vans or friteries at every corner, at all times of day. Today, we still have the same biology, but our food landscapes have changed, and the way we live means that our natural GLP-1 signals have become a tiny mouse-squeak in our brains, compared to the roar of modern food noise.
It was not until the 2000s that scientists studying diabetes and obesity – which by then were rising at alarming rates - realised that GLP-1 plays a key role in the management of these chronic diseases. They eventually came up with man-made versions, in the form of injections, that mimic natural GLP-1. These synthetic GLP-1s are known as semaglutide. Sometimes, you might see them called GLP-1 receptor agonists, which is the umbrella term for the wider family of drugs. There are various brands, the most popular at the moment being Ozempic, Wegovy and Mounjaro.
How weight-loss drugs work
Weight-loss drugs essentially pretend to be our natural GLP-1, turning on the same body signals, but going one step further: instead of lasting for a few minutes, the drug stays active for days. So, instead of a short trigger after meals, the signal is present continuously, meaning the brain and stomach are being ‘reminded’ all day long that they do not need to eat as much.
Many users in fact describe it as the end of 'food noise'. "I used to think of food from the minute I wake up – I’d wake up in the middle of the night to eat," one user told me. With these medications, there was a change: “I now just think of food when I’m properly hungry," they said.
Prescribed and used properly, they can be genuinely life-changing for people living with diabetes and obesity. In fact, Belgium’s national health insurance, INAMI, has reportedly spent close to €76 million in 2024 reimbursing these drugs.
You ask if you lose your appetite overnight? Not precisely. You still want to eat, and delicious food will still taste delicious. What GLP-1 does is make you feel full more quickly, so it helps you eat smaller portions.
To infinity and beyond?
There appear to be other benefits, too. Scientists have found that the body’s GLP-1 system is linked not only to the gut and pancreas, but also to the brain, heart, kidneys and immune system, raising the possibility that these drugs may influence several parts of the body at once.
Recent studies suggest GLP-1 drugs may help reduce inflammation and lower the risk of conditions such as heart disease, kidney disease and sleep apnoea, sometimes beyond the effects of weight loss alone. Researchers are also exploring whether they could play a role in treating neurological conditions including Alzheimer’s, Parkinson’s and brain injuries. However, experts caution that much of this work is still in its early stages, and many of these wider benefits remain anecdotal, for now.
A word or two of caution
The problem with GLP-1s that over the past couple of years, their popularity has gone viral, and they are being touted as a quick fix for that dreaded term ‘beach body’. But the drugs are designed for people who are overweight or obese – they are not designed for cosmetic purposes or for people who want to shed off 5kg.
Which is why I start muttering at the screen when I see celebrities like Demi Moore and Nicole Kidman and Oprah Winfrey shuffling on red carpets with their new extremely thin frames held up as something to aspire to. Sadly, this obsession with the fragile look is making people buy these medications online and self-prescribe, without a doctor’s supervision.
In the UK, it’s estimated that around 95% of people taking GLP-1s have not been prescribed the drugs by a doctor. There are no official figures for Belgium, but there have been warnings about fraudulent adverts on social media. Please, I urge you, do not take risks, because although GLP-1s may sound like manna from heaven, they are, in fact, not a magic pill.
Side effects
For a start, there are side effects: nausea, digestive upsets, constipation, abdominal discomfort, and in rarer cases, gallbladder or pancreatic issues. Then there’s the less talked-about part: unless managed carefully, a significant proportion of the weight lost can be muscle and bone, leaving you very weak and with fragile bones. In fact, one client came to me because after a year of GLP-1 medication with no lifestyle changes, he was finding it painful to sit in a chair – his glute muscles has practically dissolved into nothing!
These medications do not automatically teach you how to eat well. If you’re eating less, but what you’re eating is essentially junk, your body will suffer drastically for it. It’s whole foods with enough protein and fibre, that you’d need to be looking at, otherwise there’s a risk of malnutrition.
If you’re not doing any strength training, then your muscles are doomed. In fact, the science is clear, if you do not improve your meals, your movement, and your sleep, while taking the GLP-1s, then you will go back to your previous weight (or more) once the medication is stopped.
The takeaway is simple: as things stand now, GLP-1 drugs, on prescription, can open a window for change, but lasting results only come from reshaping your lifestyle habits that will last long after the injections stop.
One to watch out for
So far, GLP-1s all come in the form of small jabs, injected usually weekly just under the skin (not into the veins), in the stomach, thigh or upper arm. However, things are about to change. A major new oral GLP-1 drug, called Orforglipron (really, who comes up with these names? Vikings?), has now been approved in the US and is beginning to reach the market. The cost of these pills is expected to be a fraction of injectable GLP-1s.
The real story on the impact of this drug is still to unfold, and as ever, the pleasures - or problems - are yet to come.
How you can boost your natural GLP-1
- Eat more protein and fibre. These are key triggers of the natural GLP-1 hormone.
- Choose foods that don’t spike blood sugar quickly. These include healthy fats like full-fat yoghurt, nuts and avocado, and whole foods.
- Move your body regularly. At the very least, go for a brisk walk after meals, as it improves how the gut releases GLP-1 and supports better blood sugar control.
- Prioritise sleep. Poor sleep can dampen GLP-1 and satiety signals, which may explain why, after a night of partying until 4am, you feel like a double Rambo smash burger.
- Avoid constant grazing. Forget what we were told in the 90s. Snacking all day can blunt normal hormone rhythms. Giving your body proper meal breaks helps your natural GLP-1 system function more effectively.
Got a lifestyle health question you’ve been turning over in your mind? Send your dilemmas to k.westwood@brusselstimes.com, and we'll tackle them confidentially right here.
