Weight loss drugs – a good option for you?

By: Dr Neil Forrest

Star Vista clinic
Posted on: 21 Mar 2024

There has been increasing excitement over the past couple of years about weight loss medications. This is because a family of drugs called GLP-1 mimetics have been licensed for weight loss in many countries, including Singapore.

This class of medication has been used for almost 20 years to treat diabetes, but as more potent versions have been developed, they have been found to cause significant weight loss. The arrival of versions that only need to be taken once per week has further fueled their popularity. Here, I’ll try to give you some of the basic facts, as well as dispelling some of the myths around these medicines.

Do they work?

They certainly do. They mimic a hormone that is found naturally in the body (GLP-1), causing reduced appetite, increased fullness and lowering blood sugar. They are available as pills or as injections which you can do yourself at home, and you can expect to lose around 15% of your body weight with the versions currently available in Singapore. Newer versions already licensed in the UK and USA can result in even higher levels of weight loss.

How long will they take?

In my experience, weight loss continues for 10-12 months, but is most rapid in the first 3-6 months, where we see people losing around 0.5-1kg per week. The dose is gradually increased in the first couple of months to minimize side effects.

Sounds too good to be true? What’s the catch?

The first consideration is cost, these medications do not come for free. The oral version can be slightly cheaper than the injections. Secondly, side effects. Most of these are gut related – nausea, reflux and sometimes vomiting. More serious but very rare side effects included gallstones and pancreatitis. Lastly, unwanted effects. Muscle loss can happen, but this can be minimized by maintaining adequate protein intake and doing resistance training. There have been cases in the media where celebrities complained of facial muscle wasting, but these people almost certainly didn’t need to be on weight loss medication in the first place!

A common complaint is that the weight loss is not sustained after the medication is stopped and this is true if there is no other change in lifestyle or behaviour. I help my patients to develop their own personalized tactics for maintaining weight loss long-term.

Considerations before starting

When someone comes to discuss weight loss medication, I’ll discuss the things they’ve already tried and why these have not been successful. I then look at ways to optimise lifestyle (sleep, stress, diet and exercise), correct hormone imbalance, and treat any deficiencies. This will give you the best chance of losing weight in a sustainable, healthy way and keeping it off for good!

 

Dr Neil Forrest is Medical Director of Osler Health Star Vista, Men’s Health Co-Lead & Lifestyle Medicine Co-Lead. He is a British GP/Family Physician based at our Star Vista clinic (near Holland Village). For a discussion with Dr Neil or any of our doctors, please visit our appointments page.

 

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