WEIGHT LOSS GUIDE

The GLP-1 receptor agonists like Semaglutide have taken the weight loss world by storm, offering a revolutionary approach to shedding pounds and improving overall health.

In this guide, we dive deep into GLP-1 receptor agonists, exploring their mechanism of action and how they can help you reach your weight loss goals. We'll also break down the differences between popular brands like Wegovy and Mounjaro,  And of course, we'll cover essential lifestyle considerations for optimizing your results, ensuring that you get the most out of your investment if you decide to move forward with using a GLP-1 for your health journey. 

 

If you're ready to take control of your health and see real results, GLP-1 receptor agonists may be just what you need. We will guide you through everything you need to know about these groundbreaking medications and how they can transform your life.

 

UNDERSTANDING GLP-1 MEDICATIONS

 

WHAT ARE THEY?

GLP-1 stands for Glucagon-Like Peptide. Glucagon is a naturally occurring hormone in the body. GLP-1 is a peptide that looks and acts very similar to glucagon, and that's why it's called "glucagon-like". 

 

These medications have been around for 20-plus years as a medication for type II diabetes. It's only recently have they become known for their ability to help with weight loss, regardless of a diabetes diagnosis.

 GLP-1 acts on the brain, particularly the hypothalamus, to reduce appetite and promote a feeling of satiety, which leads to decreased food intake.

GLP-1 receptor agonists help to regulate blood sugar levels and improve insulin sensitivity. At the same time, they slow gastric emptying, which can help prevent spikes in blood sugar after meals.

Additionally, these medications have been shown to reduce appetite and food intake, making it easier for individuals to make healthy eating choices and maintain a lower body weight.

HOW DO THEY WORK?

Semaglutide and other GLP-1 receptor agonists work by binding to the GLP-1 receptors in the pancreas, which stimulates the release of insulin while lowering glucagon secretion. This process helps lower blood glucose levels. Additionally, by slowing gastric emptying, they increase satiety, leading to reduced calorie intake.

Additional research has also revealed they reduce inflammation, which may improve chronic illnesses such as osteoarthritis, Parkinson's, and heart disease. 

LEPTIN RESISTANCE

Leptin is a hormone involved in regulating hunger signals. When leptin is released, it signals the brain that you're full. Leptin resistance is a condition where the body does not respond effectively to leptin signals, leading to increased food intake and weight gain. GLP-1 receptor agonists can indirectly improve leptin sensitivity by promoting weight loss and improving metabolic health.  

Metabolic Benefits:

• Improved Insulin Sensitivity: Weight loss induced by GLP-1 receptor agonists is often accompanied by improvements in insulin sensitivity and other markers of metabolic health.
• Reduction in Fat Mass: These medications particularly help reduce visceral fat, which is associated with a higher risk of metabolic diseases.
• Craving Reduction: GLP-1 receptor agonists may reduce cravings for high-fat and high-sugar foods, further aiding in weight management.
• Food Preferences: Patients on GLP-1 therapies often report changes in food preferences, favoring healthier options.

UTILIZING A GLP-1 FOR WEIGHT LOSS

When using a GLP-1 for weight loss, patients can expect gradual weight reduction, primarily due to decreased appetite and caloric intake. Initial results are typically seen within the first few weeks, with more significant weight loss occurring over months.

 

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What is Wegovy? (Available)

Wegovy is a weight loss medication that has been proven to work in clinical trials. It is made by Novo Nordisk and comes as a pre-filled pen that you can give yourself injections with, once a week.

It works by making you not want to eat as much. When used with a healthy diet and exercise, it can help you lose weight.

It’s available on prescription for people with a body mass index (BMI) of 30 and above, or 27 and above with weight-related conditions.

• Wegovy is injected under the skin once a week with or without food. You should try to take it at the same time each week. Each Wegovy pen has 4 doses and lasts for 4 weeks of treatment, then you'll need to start a new pen.

  Always double check you have the correct dose prescribed and that you have the right medication before injecting. This may seem obvious, but it’s always best to make sure.

  When choosing where to inject Wegovy, try to inject it in a different place each week. The best places to inject Wegovy are the stomach, upper legs, or upper arms.

  Taking your Wegovy injection

  Ensure you have read the Wegovy patient information leaflet for full instructions, diagrams and follow our additional doctor advice. The steps below are a general guide and do not replace this information.

  Check the name and dose of your Wegovy pen to ensure it matches your prescription request. Remove the pen cap and check the liquid is clear and colourless. Use a new needle for each weekly dose. Attach and secure the needle. Remove the outer and inner needle cap and perform a flow check of the pen as per the leaflet instructions (this only needs to be done when using the pen for the first time). Set the dose on your pen by turning the dose selector until the correct dose is showing. Select your skin injection site (e.g. thighs, abdomen). Insert the needle into the skin at a straight angle, as shown in the diagram in the patient information leaflet. You should be able to see the dose counter. Remove the needle and carefully replace the outer needle cap. Unscrew the needle and dispose of the two together in a sharps bin. If there are still doses left in your pen, place the pen cap back on, and safely store it for future use.

  Wegovy is best taken at the same time each week, so it’s important to set yourself a reminder, so you don’t forget.

  How much Wegovy do I take?

  The usual dose is 2.4mg, but your treatment will start at a lower dose and gradually increase.

  Wegovy dosage plan:

  weeks 1-4: 0.25mg once a week weeks 5-8: 0.5mg once a week

   

  You should never increase your dose after you reach the maximum dose of 2.4mg a week.

  • weeks 9-12: 1mg once a week
  • weeks 13-16: 1.7mg once a week
  • week 17 and onwards: 2.4mg once a week
  •  

  Who can take Wegovy?

  Wegovy can be taken for losing and maintaining a healthy weight in adults. To start Wegovy treatment your BMI must be 30 or over. Alternatively, you must have a BMI of 27 or over and a weight-related health problem such as diabetes.

  You should speak to your doctor before using Wegovy pens if you have:

  • kidney problems
  • diabetes
  • inflammation of your pancreas
  • low blood sugar levels (hypoglycaemia)
  • diabetic eye disease (retinopathy)

  You should not take Wegovy if you are allergic to any of the ingredients in the medication. Wegovy is not suitable for women who are pregnant or breastfeeding.

  What if I miss a dose of Wegovy?

  If you forget to take Wegovy and it has been 5 days or less since it was due, you can take Wegovy as soon as you remember. Take your next dose on your usual injection day, even if this means you are taking your next dose within 2 or 3 days.

  If you have missed a dose of Wegovy and it has been longer than 5 days since your dose was due, skip your missed dose. You can then continue your treatment when your next dose is due. Never take a double dose, as this can increase your risk of side effects.

  Very common side effects of Wegovy include:

  • headache
  • diarrhoea
  • constipation
  • nausea or vomiting (feeling or being sick)
  • feeling weak or tired
  • stomach pain

  These side effects go away over time and once your body gets used to the medication. You are given Wegovy gradually to reduce the risk and severity of these side effects.

  Common side effects of Wegovy include:

  • upset stomach or indigestion
  • dizziness
  • burping or gas (flatulence)
  • bloating
  • reflux or heartburn
  • hair loss
  • reactions at the injection site, such as redness, swelling, or soreness
  • gallstones
  • inflamed stomach (gastritis), which can cause nausea, vomiting, and stomach ache
  • hypoglycemia

  Uncommon side effects of Wegovy include:

  • fast heartbeat
  • an increase in pancreatic enzymes, which will show up in blood tests
  • delayed gastric emptying (gastroparesis)

  Wegovy also has some serious side effects, which should be treated straight away:

  • In diabetic patients, a common serious side effect is complications of diabetic eye disease (diabetic retinopathy). If you have diabetes you should inform your doctor if you experience eye problems, such as changes in vision, during treatment with this medicine.
  • An uncommon serious side effect is an inflamed pancreas (acute pancreatitis). If you have long lasting and severe pains in your stomach or back, speak to your doctor straight away or call 999.
  • A rare serious side effect of Wegovy is a severe allergic reaction. You must call 999 or get to A&E straight away if you have breathing problems, wheezing, difficulty swallowing, swelling in your face and throat, dizziness, or weakness.

  You can find out more about the side effects of Wegovy in your patient information leaflet.

  Interactions

  Wegovy can interact with other medications, so it’s important to tell your doctor what you’re currently taking before starting treatment. Your doctor may change the dose of your other medications whilst taking Wegovy to make sure it’s safe for you to take.

  Wegovy interacts with insulin and sulfonylureas, which are both treatments for type 2 diabetes. Taking Wegovy with one of these medications can increase the risk of low blood sugar levels.

  You should never use Wegovy with another medication that contains a GLP-1 receptor agonist, such as Saxenda.

  How long does nausea last with Wegovy?

  This is different for everyone. You may feel sick for a few days to a few weeks after starting Wegovy, and this side effect might come back when you increase your dose. Speak to your doctor if your nausea isn’t going away or is getting worse and interfering with your daily activities.

• Any Wegovy® pens that haven’t been opened should be kept in the fridge.
• During use you can keep the pens for 6 weeks in the fridge or room temperature (below 30°C).
• Pens need to be disposed of in the sharps bin you’re given when you start your treatment.
• When you're prescribed Wegovy® you’ll need to check your local council’s website to find out how to get rid of the sharps bin and its contents. 

 

Mounjaro( Tirzepatide) - Available

Mounjaro is a weekly self–injectable pen used for weight loss. It contains tirzepatide which works by regulating blood sugar and energy balance levels, helping to reduce appetite and prevent cravings.

Tirzepatide works on two different hormonal receptors: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). You may have heard of GLP-1 from other weight loss injections.

GLP-1 helps to regulate blood sugar levels, which in turn talks to the brain to make you feel less hungry and prevent cravings. It also slows down the emptying of the stomach to keep you feeling fuller for longer.

GIP regulates energy balance in brain and fat cells, enhancing the GLP-1 effect of suppressing your appetite and improving sugar control.

By mimicking the effects of both these naturally occurring hormones, Mounjaro has been shown to have greater weight loss potential than medicines that work on GLP-1 alone.

You inject Mounjaro under the skin (subcutaneously) in your stomach area, thigh or upper arm once a week using an injection pen. Don’t worry, it’s actually much easier than it sounds and if we prescribe Mounjaro for you, we’ll provide you with full instructions on how to use it.

Usually, you’ll start with a dose of 2.5 mg of Mounjaro, which will increase every four weeks (or as advised and if suitable for you) until you reach your maximum maintenance dose of 5mg, 10mg or 15mg.

If you’re wondering how much weight you can lose on Mounjaro, clinical trials have shown that patients could achieve at least 20% weight loss after using tirzepatide for 72 weeks (18 months) when combined with healthy lifestyle changes.

Mounjaro can cause some side effects to occur. Very common ones are gastrointestinal in nature: nausea, vomiting, diarrhoea and constipation. These are mainly seen with dose increases, and tend to settle with time.

Other common side effects could include: fatigue, feeling lightheaded, excess wind (flatulence), gallstones, gastroesophageal reflux, injection site reactions, hair loss and hypoglycemia in patients with type 2 diabetes.

In rare cases, there can be serious side effects, such as:

Pancreatitis – if you develop severe abdominal pain, with or without persistent vomiting, this may be a sign of pancreatitis and you need to get medical help immediately.

Anaphylaxis – if you experience difficulty breathing, swelling of the face, lips or tongue and difficulty swallowing, you may be having a severe allergic reaction (anaphylaxis) and you must seek immediate medical help.

Please read the Patient Information Leaflet that comes with your medicine for full details of side effects and how to use Mounjaro.

Mounjaro is approved for people with a BMI over 30 (obesity), as well as those with a BMI over 27 (overweight) who also have weight-related health problems such as prediabetes, high blood pressure, high cholesterol, or heart problems.

You shouldn’t use tirzepatide if you’re pregnant, and you should stop taking Mounjaro at least one month before trying to get pregnant.

Mounjaro is not suitable in some medical circumstances, for example if you use some other diabetes medicines, have severe problems with digesting food, or have a history of pancreatitis or thyroid cancer. If you’re allergic to tirzepatide or any of the other ingredients in this weight loss injection treatment, you must not use Mounjaro.

It’s essential that you give us a full medical history and details of any conditions or other medicines you’re taking when you fill out our online questionnaire. This ensures we’re able to prescribe weight loss treatment that’s suitable and safe for you.

If you’re using Saxenda or Wegovy, you’ll need to wait 1 month before switching to Mounjaro. This is called the 'washout' period, and gives the body time for the first drug to leave the system. All patients using Mounjaro for the first time will start with 2.5mg. Keep in mind, Mounjaro may not be suitable for you (even if you're using another weight loss medicine). We’ll assess if it’s right for you during your consultation.

What happens if you miss a dose of Mounjaro®?

If you’ve missed a dose of Mounjaro® you should take the missed dose within 4 days after the missed dose. Try to take it as soon as possible after you’ve realised you’ve missed it.

If more than 4 days have passed since the missed dose, then skip it and take your next dose on your scheduled day. Make sure not to take 2 doses within 3 days of each other.

What is the best time to inject Mounjaro®?

You should inject Mounjaro® on the same day every week. You can take it at any time of day. You might want to set a reminder on your phone, so you don’t forget what day you normally take it.  

Wegovy and Mounjaro are both weekly injection pens and work in similar ways to aid weight loss. Mounjaro has proven more effective in clinical trials, as it works on GLP-1 and GIP hormones, whereas Wegovy only works on GLP-1.  Deciding if or which medicine is right for you will depend on different factors, which we’ll assess during your consultation. If you’re already on Wegovy  and losing weight, we recommend you keep using it. Keep in mind, weight plateaus are normal on your weight loss journey.
Prices :

MOUNJARO 2.5MG& 5MG - £199 , 7.5MG& 10MG -£219,12.5MG& 15MG- £239

WEGOVY 0.25MG,0.5MG & 1.0MG-£189 ,1.7MG-£239 , 2.4MG-£295

 

 

 

 

 

 Extra Guidelines

  To maximize the benefits of GLP-1 therapy and ensure a balanced, healthy lifestyle, patients should follow the following guidelines for nutrition, exercise, supplements, and overall well-being.

1. Nutrition 

GLP-1 medications affect appetite and digestion, which makes nutrition choices even more important.

a. Prioritize Protein Intake

• Why: GLP-1 medications slow down digestion, reducing appetite. This can lead to reduced protein consumption, which is critical for muscle maintenance, especially during weight loss.

• How Much: Aim for 1.2 to 1.6 grams of protein per kilogram of body weight. For a person weighing 70 kg (154 lbs), this equates to 84-112 grams per day.

• Sources: Include lean meats (chicken, turkey), fish, eggs, dairy products, tofu, beans, and legumes. Plant-based proteins like lentils and quinoa are great options too.

b. Balanced, Whole-Food Diet

• Focus on Fiber: To improve digestion and prevent constipation (a common side effect), aim for 25-35 grams of fiber daily. Fiber-rich foods like vegetables, fruits, whole grains, and legumes are excellent choices.

• Healthy Fats: Include sources of healthy fats like avocados, olive oil, nuts, seeds, and fatty fish (salmon, sardines) for heart health.

• Complex Carbohydrates: Choose whole grains, sweet potatoes, and legumes over simple sugars to help stabilize blood sugar levels.

2. Exercise Recommendations

Regular exercise is essential to enhance the effectiveness of GLP-1 therapy and to preserve muscle mass during weight loss.

a. Strength or Weight-Bearing Exercises

• Why: Weight loss, especially if rapid, can lead to muscle loss. Incorporating strength training helps maintain lean body mass, which is essential for metabolic health.

• Types: Weight lifting, resistance bands, bodyweight exercises (squats, lunges, push-ups), and Pilates.

• Frequency: Aim for 2-3 strength training sessions per week, targeting all major muscle groups.

b. Cardiovascular Exercise

• Why: Cardiovascular activities support overall heart health and help in weight management.

• Types: Walking, jogging, swimming, cycling, or low-impact activities like elliptical machines. Start with 20-30 minutes of moderate exercise 3-5 times a week and gradually increase.

c. Flexibility and Balance Training

• Why: Flexibility and balance exercises reduce the risk of injury and improve posture.

• Types: Yoga, Pilates, and simple stretching routines. These exercises can also alleviate joint discomfort and improve mobility during weight loss.

3. Supplements

Patients using GLP-1 medications may benefit from certain supplements to support overall health and prevent nutrient deficiencies

a. Magnesium supplements

Magnesium supplementation can help patients on weight loss injections by supporting muscle function, improving energy and sleep, regulating blood sugar, alleviating constipation, reducing inflammation, and enhancing mood. It’s important to ensure that magnesium levels are adequate through diet or supplements, as it can enhance the benefits of GLP-1 medications while mitigating some potential side effects.

 

b. Protein Supplements

• For individuals struggling to meet protein goals through food, a whey, casein, or plant-based protein supplement can be added to smoothies or snacks.

c. Omega-3 Fatty Acids

Omega-3 supplements can greatly enhance the overall health benefits of GLP-1 weight loss injections by supporting cardiovascular health, reducing inflammation, improving mood, promoting fat metabolism, and preserving muscle. They also help regulate blood sugar and reduce joint pain, supporting an active and healthy lifestyle. These benefits make omega-3s a valuable addition to the routine of patients undergoing weight loss with GLP-1 medications.

e. Vitamin D

For patients on GLP-1 weight loss injections, vitamin D supplementation offers several benefits: it helps maintain bone density, supports muscle strength, boosts immune function, improves mood, and enhances insulin sensitivity. It may also aid in weight loss by reducing inflammation and improving metabolic function.

Since vitamin D deficiency is common, especially in individuals with higher body weight, it's important to monitor levels and supplement .

e. Creatine Powder

Creatine powder can be a valuable addition to the routine of patients using weight loss injections like GLP-1 receptor agonists. It helps preserve muscle mass, improve exercise performance, boost metabolism, enhance recovery, and even support cognitive function and mood. These benefits complement the weight loss process, helping patients achieve better body composition and overall health outcomes.

4. Lifestyle Modifications

In addition to diet and exercise, the following lifestyle changes can support your overall well-being and enhance the benefits of GLP-1 medications:

a. Sleep

• Why: Poor sleep can impair weight loss, appetite regulation, and insulin sensitivity.

• Goal: Aim for 7-9 hours of quality sleep per night. Establish a consistent sleep schedule and create a relaxing bedtime routine.

b. Hydration

• Why: GLP-1 medications can slow digestion, leading to potential bloating or constipation. Proper hydration can help counteract these side effects.

• Goal: Drink at least 8-10 cups of water per day. Increase your intake if you're exercising .

c. Mindful Eating

• Why: Eating slowly and being mindful of portion sizes can help you better control hunger and satiety.

• Tips: Focus on the taste and texture of your food, chew thoroughly, and avoid distractions (like phones or TV) during meals.

d. Stress Management

• Why: Chronic stress can interfere with weight loss and blood sugar management, increase CORTISOL

• Techniques: Incorporate relaxation techniques such as meditation, deep breathing exercises, or engaging in hobbies you enjoy.

e. Avoid Alcohol and Sugary Beverages

• These can hinder weight loss progress and affect blood glucose levels, especially in patients with diabetes. Limit alcohol , juices and soft drinks and opt for healthier beverage options like herbal teas or flavored water.