An advert caught my attention recently. Its message was simple: obesity is a disease.
My immediate reaction was scepticism. I knew a pharmaceutical company was behind it, and my thoughts went straight to weight-loss injections.
I’ll be honest: I’m not naturally enthusiastic about them. But I also recognise that my opinion is strongly influenced by my own experience.
I never thought I had the discipline
Before July 2023, my relationship with food was very different.
I ate far too much of the things I enjoyed, with very little consideration for what I was doing to my health. If you had asked me whether I could consistently change those habits, I would probably have doubted it.
Then I did.
Almost overnight, I changed how I ate. I surprised myself during those first few days. Each day I stuck with it gave me more confidence that I could keep going.
As the results followed, that confidence grew. What had initially seemed unlikely became something I was actually doing.
Training later became another important part of my life. Over time, I built routines, learned more about nutrition and discovered ambitions that went well beyond losing weight.
That experience inevitably shapes how I look at weight-loss medication. My first instinct is to think: could someone else discover that same ability to change?
The principle is straightforward. Living it can be harder.
At its most basic, losing weight requires a sustained calorie deficit: taking in less energy than the body uses. Weight-loss injections do not bypass that principle; medicines such as semaglutide and tirzepatide can reduce appetite and help people eat less. NHS information on weight management.
For me, understanding my food intake and changing my habits made an enormous difference.
But understanding a principle and consistently putting it into practice are different things.
Food can be tied to comfort, stress, routine, depression and difficult circumstances. Appetite and biology also influence how manageable a change feels.
I have experienced how life can disrupt a routine. During the spring of this year, while my mum was ill, I went off track a little. I hadn’t forgotten what I knew about nutrition. I was dealing with something difficult.
That matters when I think about other people’s struggles.
What concerns me about the injections
My biggest concern is the possibility of medication being provided without enough help to build sustainable habits.
I would want someone to receive support with nutrition, appropriate portions, physical activity and the circumstances that make eating difficult for them. Simply eating less does not automatically teach someone how to put together a balanced diet.
That support should be part of treatment. NICE recommends dietary, physical activity and behavioural support alongside weight-management medicines, as well as support for people who stop taking them. NICE recommendations.
I also have questions about side effects and longer-term use. These are medicines with benefits and risks, and I want those risks discussed honestly. There are recognised side effects, including gastrointestinal problems and an infrequent risk of pancreatitis. Evidence is still developing as treatment continues over longer periods. MHRA information.
Those concerns make me cautious about advertising that might make a complicated decision feel simple.
Where my own experience has limits
My instinct has been to see these medicines as a possible starting point: help someone lose weight, build healthier habits and eventually manage without them.
But that will not necessarily be the right course for everyone.
Research has found substantial weight regain after stopping tirzepatide, even when dietary and activity counselling continued. That does not tell us exactly why each person regained weight, but it does mean I should be careful about assuming that everyone can replace medication’s effects with the habits they have learned. SURMOUNT-4 trial.
My own success cannot tell me what another person’s hunger feels like, what they have already tried or what treatment is appropriate for their health.
I can favour the approach that worked for me while recognising those limits.
Don’t write yourself off
I have sometimes wanted to say: “If I can do it, anyone can.”
The intention is encouragement. I know how unlikely my own transformation once seemed.
But I think there is a better way to express it.
If you believe you are the last person who could change their habits, I understand. That is how I saw myself.
I cannot promise your journey will look like mine. You may need different support, and decisions about medication belong in a conversation with a qualified healthcare professional who understands your circumstances.
But don’t write yourself off before you have given yourself a chance.
I had no idea what I was capable of either.