Medical Weightloss
GLP-1–Based Weight-Loss Treatments
Medical Weight Management and Its Role Alongside Surgery
GLP-1–based medications are prescription treatments used to support weight loss and improve metabolic health in selected patients. They work by acting on gut hormones that regulate appetite, fullness, and blood sugar control.
These treatments can be effective for some patients on their own and may also be used alongside bariatric surgery as part of a long-term obesity management strategy.
How GLP-1–Based Medications Work
GLP-1 (glucagon-like peptide-1) is a hormone released naturally after eating. It:
Reduces appetite
Increases feelings of fullness
Slows stomach emptying
Improves blood sugar regulation
Some newer medications also act on GIP (glucose-dependent insulinotropic polypeptide), another gut hormone involved in metabolic regulation.
These effects support reduced calorie intake and gradual weight loss when combined with lifestyle measures.
Who May Be Considered for Treatment
GLP-1–based weight-loss medications may be considered for adults who:
Have obesity or excess weight affecting health, and
Have not achieved adequate or sustained benefit from lifestyle measures alone
Suitability depends on:
Body weight and BMI
Presence of weight-related conditions (such as type 2 diabetes, hypertension, sleep apnoea)
Previous treatments
Overall medical history
Prescription requires individual clinical assessment and ongoing monitoring.
Wegovy® (Semaglutide)
What is Wegovy®?
Wegovy® contains semaglutide, a GLP-1 receptor agonist. It is licensed for weight management in adults who meet clinical criteria.
How it is taken
Once-weekly injection
Injected under the skin
Dose is increased gradually to reduce side effects
What the evidence shows
Clinical trials have shown that semaglutide is associated with clinically significant weight loss when used alongside lifestyle measures. The degree of weight loss varies between individuals.
Common side effects
Nausea
Vomiting
Diarrhea or constipation
Reduced appetite
Side effects are most common during dose escalation and often improve with time.
Mounjaro® (Tirzepatide)
What is Mounjaro®?
Mounjaro® contains tirzepatide, which acts on two hormone pathways (GLP-1 and GIP). It is licensed for type 2 diabetes and has also been approved for weight management in adults who meet criteria.
How it is taken
Once-weekly injection
Injected under the skin
Dose is increased gradually
What the evidence shows
Large clinical trials have shown that tirzepatide is associated with substantial weight loss over time, with variation between individuals and doses.
Common side effects
Nausea
Vomiting
Diarrhea or constipation
Reduced appetite
As with other GLP-1–based treatments, side effects are usually gastrointestinal and often improve.
Important Safety Considerations (All GLP-1 Treatments)
GLP-1–based medications are not suitable for everyone.
Medical assessment before starting
Gradual dose escalation
Ongoing monitoring
They are not cosmetic treatments and should only be prescribed as part of a structured, medically supervised programme.
How Medications and Surgery Fit Together
Obesity is a chronic, relapsing condition. Long-term outcomes are influenced by biology, hormones, environment, and behaviour.
Medication and surgery are not competing treatments
Instead, they may be used:
Before surgery – to reduce surgical risk or support weight loss
After surgery – to support weight maintenance or treat weight regain
Instead of surgery – where surgery is not appropriate or not desired
What the evidence shows
Large clinical trials have shown that tirzepatide is associated with substantial weight loss over time, with variation between individuals and doses.
What surgery adds
Bariatric (metabolic) surgery:
Produces larger and more durable weight loss on average
Leads to profound and sustained hormonal changes
Is associated with long-term improvement in obesity related disease
Reduced appetite
However, surgery is not appropriate or necessary for every patient.
A personalised, long-term approach
For some patients:
Medication alone is sufficient
Surgery offers the greatest long-term benefit
A combination approach provides the most durable outcome
Treatment decisions are based on:
Health impact
Response to previous treatments
Patient preference
Long-term sustainability
There is no one-size-fits-all pathway.
Follow-Up and Long-Term Care
Whether medication, surgery, or both are used, long-term follow-up is essential to:
Support weight maintenance
Monitor metabolic health
Adjust treatment as needed
GLP-1 Weight-Loss Treatments – FAQs
Common queries related to the Weight Loss Treatment.
Are these injections a replacement for surgery?
Do I need diabetes to use these medications?
Will I regain weight if I stop injections?
Are these treatments lifelong?
Can I have injections after bariatric surgery?
Are these medications safe?
Key Message for Patients
GLP-1–based medications and bariatric surgery are complementary tools in the management of obesity. The aim is to select the right treatment, at the right time, for the right patient, based on evidence and individual health needs.
How Do Injections and Surgery Fit Together?
Weight-loss injections and bariatric surgery are complementary treatments, not competing ones.
Injections may be used:
Before surgery, to reduce surgical risk
After surgery, to support weight maintenance or manage weight regain
Instead of surgery, where surgery is not appropriate or not preferred
What surgery adds
Bariatric (metabolic) surgery:
Produces greater and more durable weight loss on average
Leads to sustained hormonal changes
Is associated with long-term improvement in obesity related disease
However:
Surgery is not suitable for everyone
Surgery does not remove the need for long-term follow-up
Some patients still benefit from medication after surgery
There is no single correct pathway.
Key Principles of Care
Obesity is a chronic disease
Treatment should be long-term and structured
Medication alone may not be sufficient for everyone
Surgery is one tool within a wider pathway
Decisions are individualised and evidence-based
Weight-Loss Treatments: Medication and Surgery
Aspect
GLP-1–Based Medication
Bariatric Surgery
What it involves
Weekly injection prescribed and monitored medically
Keyhole surgery on the stomach ± intestine
How it works
Reduces appetite, increases fullness, improves metabolic regulation
Restricts intake and alters gut hormones
Reversibility
Medication can be stopped
Surgery is intended to be permanent
Weight loss
Clinically significant in many patients
Greater and more durable on average
Speed of effect
Gradual over months
Gradual over 12–18 months
Long-term commitment
Ongoing treatment often required
Lifelong follow-up required
Impact on diabetes
Improves blood sugar control
Can induce remission in some patients
Nutritional supplements
usually required during treatment
Required long-term
Hospital stay
None
Usually 1 night
Role in care pathway
Standalone treatment or adjunct
Definitive metabolic intervention
Who it may suit
Patients preferring non-surgical treatment
Patients needing durable metabolic change
Evidence-Based Sources (Primary, Traceable)
Semaglutide (Wegovy®)
Wilding JPH et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity.
New England Journal of Medicine,2021
Once-Weekly Semaglutide in Adults with Overweight or Obesity | New England Journal of Medicine
Tirzepatide (Mounjaro®)
Jastreboff AM et al. Tirzepatide Once Weekly for the Treatment of Obesity.
New England Journal of Medicine, 2022
Tirzepatide Once Weekly for the Treatment of Obesity | New England Journal of Medicine
Weight Regain After Stopping GLP-1 Therapy
Rubino D et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance.
JAMA, 2021
Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial
Weight regain after cessation of medication for weight management: systematic review and meta-analysis
Surgery vs Medical Therapy – Long Term Outcomes
Schauer PR et al. Bariatric Surgery versus Intensive Medical Therapy for Diabetes.
New England Journal of Medicine, 2017
Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes | New England Journal of Medicine
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