The weight loss jab phenomenon is endemic but are they really the answer?

Traditional “eat less, move more” advice often fails people long-term, so it’s no wonder so many people are turning to medications to achieve weight-loss goals.  

However, the rate in which their use has been popularised over the last year has sent alarm bells ringing throughout the medical community, in this article Heart Research UK’s registered Nutritional Therapist, Amie Leckie explores the other alternatives that a person could explore before embarking on the jab, while Chief Medical Cardiologist of Heart Research UK, Dr Roy Jogiya also weighs in with some expert advice on those who have already decided to take these weight loss medications. 

Weight loss is complex and involves many biological considerations – it isn’t just about willpower. This article isn’t a means to demonise a weight loss solution that has improved the lives of many but delves into how weight-loss medications work and what other ways individuals can achieve weight loss. From improving gut health to prioritising sleep, we will cover a whole-body approach to weight loss to increase the chances that the results will stick. 

Dr Roy comments: “Obesity is not simply about appearance; it is one of the strongest drivers of cardiovascular disease we see in clinic. It increases the risk of heart attack, stroke, atrial fibrillation and heart failure.” 

Weight-loss injections explained 

Weight-loss injections are prescription medications known as GLP-1 receptor agonists, including brands such as Wegovy, Mounjaro, and Ozempic. They were originally developed to treat Type 2 Diabetes due to their effects on blood sugar regulation, but doctors soon observed that many patients also experienced significant weight loss. This led to their use in weight management. 

GLP-1 medications are effective because they act on biological systems that regulate body weight, which are often dysregulated in individuals with obesity. They enhance appetite regulation by influencing hormones such as GLP-1, leptin, and ghrelin, which control hunger and fullness. When these signals are impaired, hunger can feel stronger and satisfaction after eating harder to achieve. By boosting GLP-1 signalling, these medications make it easier to feel full sooner and to stop eating. 

They also support weight loss by improving insulin sensitivity and blood sugar control. Chronically high insulin levels can promote fat storage and increase hunger, while large blood sugar fluctuations can cause cravings. By stabilising these responses, GLP-1 medications reduce the drive to eat. 

Like all medications, these treatments can have side effects and are designed to be used alongside healthy eating and regular physical activity. Without meaningful changes to nutrition and exercise habits, weight regain after stopping the medication is common. 

This is particularly concerning because research suggests that up to 40% of the weight lost on these medications may come from lean mass, including muscle. However, when weight is regained, it tends to return primarily as fat mass. This shift in body composition can leave someone in a poorer metabolic state than when they started. Muscle plays a critical role in long-term health. It supports metabolic function, blood sugar regulation, physical strength, and healthy ageing. Losing muscle without actively working to preserve it can reduce metabolic rate and increase the risk of future weight regain. 

Loss of muscle during weight reduction can lower resting metabolic rate and impair long-term cardiometabolic health. Preserving muscle through resistance training and adequate protein intake should be considered essential and not optional – whether weight loss is achieved via medication or lifestyle 

For these reasons, weight-loss medications are most effective and sustainable when paired with balanced nutrition (especially adequate protein intake) and regular exercise, particularly strength training. This combination helps protect muscle mass, improve metabolic health, and support long-term results. 

For those who prefer not to use medication, approaches such as supporting gut health, stabilising blood sugar, managing stress, prioritising sleep and daily movement can influence many of the same systems – often more gradually, but still effectively, especially when combined. 

The gut-weight connection 

The ‘gut’ refers to the whole of the gastrointestinal tract, including the stomach, intestines and colon. It contains trillions of microbes, which is often referred to as the ‘gut microbiome’ and is responsible for digesting food, absorbing nutrients and eliminating waste. Gut microbes can influence appetite signalling, cravings, blood sugar response and fat storage, meaning they can play a key role in weight management. Furthermore, research has found differences between the gut bacteria of people struggling with obesity vs. those who are metabolically healthy. 

Many things can negatively impact our gut microbiome, such as eating diets high in ultra-processed foods and low in fibre, chronic stress, poor sleep and even some medications. The good news is you can take practical steps today to improve the health of your gut and support your weight-loss journey. 

Eat for your microbes: our healthy gut bacteria thrive on fibre-rich diets with lots of diversity, so don’t just stick to the same five veggies on repeat. Expand your intake and try to incorporate an abundance of different plants into your diet such as beans, lentils, oats, root vegetables, leafy green vegetables, nuts, seeds and fruits. Aim to pack in about 30g of fibre per day – you can try our High Fibre Meal Plan to get you started. 

Avoid ultra-processed food: ingredients commonly found in highly processed foods can negatively affect our gut microbes and therefore impact hunger signals. Cook from scratch as much as possible and start swapping out any processed foods you regularly reach for, for homemade versions where possible. 

Prioritise hydration: drinking enough water is essential for fibre to support a healthy gut microbiome. Fibre needs fluid to ferment properly in the gut, helping beneficial bacteria thrive, soften stools, and promote regular bowel movements. 

Balancing blood sugar 

When it comes to weight management, blood sugar stability is often overlooked, yet it is a key part of the puzzle to achieving successful weight loss. The term blood sugar stability means minimising the large rise and fall in our blood sugar levels. It’s biologically normal for it to fluctuate, but big swings can trigger a cascade of hormonal responses that make weight loss more difficult – such as cravings, energy crashes and a strong desire to eat.  

Blood sugar stability is closely linked to gut health. A diverse, fibre-rich diet slows digestion and feeds beneficial gut microbes, which helps moderate how quickly glucose enters the bloodstream. Supporting stable blood sugar doesn’t require extreme restriction. Simple strategies can make a meaningful difference. 

• Prioritise protein with meals: protein slows down digestion and therefore the release of glucose into the bloodstream – supporting balanced blood sugar. Make sure to include a healthy source with every meal AND snack if weight loss is your primary goal. Examples include chicken, turkey, fish, eggs, cottage cheese, quark, beans, lentils, nuts and seeds. 

Amie says: 

For an adult with a healthy weight, the recommended daily amount of protein is 0.75g per kg of body weight per day. Which is 45g of protein for someone weighing 60kg. However, eating more near 1.5g per kg of body weight per day can be much more supportive of weight loss as protein keeps us feeling fuller for longer, helping reduce overall calorie consumption. 

• Frequent fibre intake: as well as protein, eating fibre with meals supports blood sugar balance, so include fibre with every meal, working towards consuming 30g a day. Research shows eating the fibre before your main meal can magnify this effect, so why not try introduce a veggie starter to your evening meal? We’ve got some recipes for you to try here. 

• Movement after meals: research also shows that movement after eating, can reduce the large fluctuations we see in blood sugar. Taking a gentle 20-minute walk after your meals can therefore support blood sugar and therefore weight-loss. 

Stress, sleep and the gut-brain axis 

Chronic stress can disrupt gut bacteria and alter signalling between the gut and brain, influencing hunger, cravings, and metabolism. Elevated cortisol levels (our primary stress hormone) are associated with increased abdominal fat storage, particularly when stress is ongoing. At the same time, poor sleep disrupts appetite hormones like ghrelin and leptin, increasing hunger and reducing fullness cues. When the nervous system remains in a state of dysregulation, the body is more likely to prioritise energy storage over fat loss. Supporting stress management, nervous system regulation, and consistent, quality sleep is therefore just as important as nutrition and exercise in achieving sustainable weight loss. Take steps today to work on stress and sleep. 

• Get 7-9 hours sleep every night: if you’re someone who struggles sleeping this is difficult. We have a whole Healthy Tip on this subject, including a downloadable Sleep Improvement Action Plan. 

• Try breath work: our breath is powerful, and it’s the only bodily function we can control both consciously and unconsciously. A simple breathing exercise like box breathing can shift the body from a state of stress into a state of rest and relaxation. 

• Slow down: easier said than done when life is busy, but slowing down is one of the best ways to signal to our bodies that everything is ok. Rather than rushing to get everything ticked off your list, ask yourself if you can take it easier a few days a week. 

Calories, BMR and exercise 

Calories still matter when it comes to weight loss, even when other factors like hormones and stress are addressed. Understanding your basal metabolic rate (BMR) and overall daily calorie needs can help create an appropriate, sustainable calorie deficit without undereating. There are lots of apps available to help you work out your BMR and therefore your daily calorie needs to achieve weight loss, it can be really helpful to use an app like this to help you on your journey. Alternatively, find a BMR calculator online and manually track your calorie intake. 

Rather than drastically cutting intake, pairing a balanced calorie approach with consistent daily movement is far more effective. Regular activity supports energy balance, and strength training in particular is key for preserving muscle mass, maintaining metabolic rate, and improving body composition during weight loss. 

Bringing it all together 

Weight loss medications can be transformative for some, but they are never the only path,  they should be considered as part of a broader, personalised approach to managing obesity. Real, lasting change comes from building healthy habits that support your body and lifestyle. By following the principles outlined above, you can achieve sustainable weight loss that lasts. Remember, it takes about 90 days to solidify new habits – so start tracking your progress today.

Download our 90-Day Meals & Movement Journal to log your food, hydration, exercise, and even your mood, and take the first step toward a healthier, more empowered you. 

Doctor Roy concludes: 

“These drugs are medical treatments for a chronic condition – not cosmetic solutions. They are most effective when combined with structured lifestyle change, particularly resistance training and adequate protein intake to preserve muscle mass. 

From a cardiometabolic perspective, preserving muscle is critical. Muscle tissue plays a central role in glucose regulation, metabolic rate and long-term cardiovascular health. Losing weight without protecting muscle can undermine those benefits. 

For individuals without diabetes or established heart disease, optimising sleep, nutrition, strength training and metabolic health should be the foundation. In many cases, this alone can meaningfully reduce cardiovascular risk, with or without medication. 

The aim should always be long-term heart health, not just short-term weight loss. 

At Heart Research UK, we always encourage people to think beyond the scales. Sustainable weight management should improve blood pressure, cholesterol, blood sugar and overall cardiovascular risk, not just body weight.”