The use of GLP-1 weight loss medications has increased remarkably fast in the last couple of years. Whilst awareness of their long-term impact and side effects is growing, I believe more needs to be said. I think GLP-1s have the ability to change lives and have a positive effect globally.
That said, there's no such thing as a free ride. As with all medications, we need to honour the body's intelligence, and it's important that GLP-1 users support their health with the necessary lifestyle changes.
The issue is that when things are working regardless and weight loss is happening, motivation and incentive may be lost. I have seen both outcomes. Sometimes the weight loss and reduction in inflammation provide an experience of health and better self-esteem that makes greater change possible.
The opposite can also be true, especially if struggles with food and alcohol are linked to emotions, mood imbalances, avoidance of difficult truths or unresolved past experiences. In these cases the GLP-1 simply becomes a new form of override, which may have consequences further down the line.
Current stats
A study published in BMC Medicine estimated that around 2.9% of adults in Great Britain (1.6 million people) used a GLP-1 to support weight loss between early 2024 and early 2025. The figure is likely higher today.
Women are more likely than men to be using them, at around 4% compared with 1.7%, and the typical age group is roughly 45 to 55, which overlaps closely with perimenopause and menopause.
Mounjaro (tirzepatide) is the most widely used, accounting for about four in five users, with Wegovy (semaglutide) making up most of the rest. NHS provision is much more limited. Wegovy is offered through specialist weight management services, and Mounjaro has been rolling out slowly through GP practices since 2025.
Safety and private providers
One of the concerns being discussed at the moment is how people access these medications.
Around 95% of users pay privately through online pharmacies and high street providers such as Boots, Superdrug, Asda, LloydsDirect, Juniper, Voy and Numan. This can mean they don't always get the right support and information about side effects.
In my practice, a couple of clients have mentioned not having their questions answered, especially as they come to the end of their treatment and decide not to continue with a GLP-1.
This matters for safety too. A large UK study published in the journal Anaesthesia in September 2026 followed more than 47,000 adults having anaesthetic care across 119 UK hospitals. Among those who had used a GLP-1 in the previous three months, around 1 in 71 had stomach contents come back up during their care (in a small number of cases reaching the lungs), compared with around 1 in 802 of those not taking one.
Because these medications slow down how quickly the stomach empties, food can still be sitting there even after the usual fast before surgery. More than 40% of the GLP-1 users in the study had obtained their medication outside GP or hospital prescribing, and the researchers stressed how important it is that anyone taking one tells their anaesthetist, wherever they got it from. The study can't prove the medication itself caused the difference, but the message is clear: if you are using a GLP-1, every medical professional involved in your care needs to know.
Important points about the effects of GLP-1s
1) Digestion and nutrient status
One of the best-known side effects relates to gastrointestinal function and gastric emptying. The delay in digestion can cause some degree of reflux, and this can be compounded by long periods without food, which can also slow down transit time through the gut. If the diet that accompanies GLP-1 use isn't nutrient dense, it can lead to nutrient insufficiencies such as low B12, folate and iron, which affect function throughout the body. The most common issues I have seen in clinic so far are anaemia, folate deficiency and dehydration.
2) Muscle and bone loss
It's well documented that fast weight loss increases the risk of both muscle loss and bone loss. At midlife this process is already speeding up naturally with age, which leaves you more vulnerable to injuries, joint problems and fractures, especially after a fall. It's vital that people understand sarcopenia (age-related muscle loss), osteopenia and osteoporosis, as all three need support through both nutrition and lifestyle.
3) Habits around food and alcohol go unaddressed
A GLP-1 doesn't address addictive patterns around eating and drinking. These habits can now continue with few visible consequences, because the weight gain that would often prompt someone to change is no longer there. In the background, further damage can still be done as people continue to eat highly processed, refined foods and overconsume alcohol, without the weight gain that would usually come with both.
4) A lack of education
Many people simply miss out on learning the lifestyle habits that become so vital as we age: looking after your circadian rhythm, eating a nutritious diet, moving regularly, holding on to muscle and bone, and practising self-care and self-compassion. Many of the lessons learned while losing weight become important foundations for a strong sense of self-esteem, self-worth and confidence going forward.
5) What happens when people stop
Perhaps the most interesting thing is what the research shows when people come off these medications. In the trials, around two thirds of the weight lost tends to come back within a year of stopping, and a 2026 review published in the BMJ found that weight is regained faster after stopping these medications than after stopping behavioural weight loss programmes.
My experience with clients
I work with clients using GLP-1s, and many of them are keen to use the medication as a supportive tool while they put a strong behavioural foundation in place. Many have been able to achieve results and sustain them.
It's the period after stopping the jab when they feel most vulnerable. They often need more support and accountability to begin trusting themselves and to stay consistent with their changes. Here are the foundations we work on together.
The foundations
1. Self-esteem, boundaries and self-care
One of the most helpful ways to use our coaching time is to build stronger self-esteem and self-trust, and to practise putting boundaries in place. These often sit upstream of the need for food, the lack of exercise or the alcohol excess. Together we work on breaking one of the hardest habits of all: putting your own health needs last.
Many of the people who need GLP-1s are hardworking, kind and have a lot of caring responsibilities. Many had adverse childhood experiences and didn't receive the best care themselves. They often find safety in sorting out everybody else, so self-compassion and self-care can feel immensely difficult. They rarely ask for help and can't allow time for exercise or healthy food prep if loved ones are struggling or deadlines haven't been met.
Anecdotally, I see that all this doing and worrying significantly increases appetite and cravings too. Part of my role is helping clients understand this, and then keeping them accountable to a routine that puts their own needs and nourishment back on the agenda.
2. Trusting your relationship with food and alcohol
A huge proportion of the population now struggles with food and alcohol, and I think this is very much a symptom of our fast-paced, stressful lifestyles.
It isn't as simple as finding a meditation practice, a breathwork routine or a journal. For me it's a combination of education, understanding how you may have developed coping mechanisms such as emotional eating or sad wine drinking, and understanding how anxiety shows up for you. From there, we find very personalised practices that support nervous system regulation and help you stay with difficult situations and emotions as they arise, so you don't need to reach for the thing that offers an escape.
3. A nutrient-dense, protein-rich diet
Appetite suppression with GLP-1s often leads to undereating and meal skipping, which puts people at risk of nutrient insufficiencies. Over time this can affect immune function, cognition and energy, and may raise the risk of disease further down the line. Slow healing, poor immunity, constipation, brittle nails, easy bruising and hair loss can all be signs of an under-resourced body.
The nutrients people are most likely to run low on are involved in basic cell function. If you become low in vitamin B12, folate, iron and numerous other minerals, the knock-on effects can be felt everywhere.
Protein matters too, of course. Aiming for at least 1.2g per kilo of body weight can help mitigate some of the muscle loss that occurs with GLP-1s, especially when paired with exercise. Not eating enough protein can negatively affect both muscle and bone density. Healthy bones also need a wide range of nutrients beyond calcium, including vitamin D, magnesium, boron, silica and manganese.
4. Strength training
It isn't just about eating the nutrients our musculoskeletal system needs. Muscle and bone have to be put under physical stress in order to regenerate, maintain themselves and grow.
This becomes even more important as we age, when we think about the risk of injury, loss of independence, sarcopenia, osteopenia and osteoporosis. A meaningful share of the weight lost on GLP-1s can be muscle, so a strength training plan and a protein-rich diet are essential.
Support on or off the jab
A GLP-1 can be a brilliant tool, but the foundations are what help you keep your results and feel well for the long term.
Whether you're currently using a GLP-1, thinking about starting one or coming to the end of your treatment, you don't have to work it out on your own. In a one-to-one consultation we'll look at your nutrition, energy and symptoms, and build a realistic plan around protein, strength, nervous system support and the habits that matter most to you.
Book a one-to-one consultation here
From there, you can continue with a 12-week package if you'd like ongoing support and accountability, or join our Mindful Body Method community.
