GLP-1s: Not a Magic Fix — A Powerful Tool When Used with Care?

The Hype Is Real — But So Is the Nuance

If you’ve been online lately, you’ve probably seen the buzz around GLP-1 medications — Ozempic, Wegovy, and Saxenda — hailed by some as miracle weight-loss injections. But in clinic, the conversation sounds a little different.

We don’t talk about magic fixes.We talk about context.We talk about you — your body, your history, your goals.

Because these medications can be transformative for some, but they’re not a quick fix. And they’re not without risk.

What Are GLP-1s, and Why Are We Talking About Them So Much?

GLP-1 stands for glucagon-like peptide-1, a hormone that helps regulate blood sugar, appetite, insulin levels, and that feeling of fullness after eating. GLP-1 receptor agonists — like Ozempic, Saxenda, and Wegovy — mimic this hormone to support better metabolic balance.

Originally developed for type 2 diabetes, these medications are now being used more widely to support weight loss, particularly in people with PCOS, insulin resistance, or metabolic challenges. They can reduce cravings, improve blood sugar, and in many cases, help people feel more in control of their eating — sometimes described as a reduction in food noise.

But just because something is popular doesn’t mean it’s right for everyone. In clinic, we take time to explore the bigger picture and ask: is this truly supportive for you — your body, your lifestyle, and your long-term health?

Side Effects, Dosing, and the Importance of Individualisation

Let’s be honest — the side effect profile of GLP-1s isn’t light.

Nausea, reflux or heartburn, bloating, and even vomiting are not uncommon. These medications slow down gastric emptying — which is part of how they work — but it also means digestion can feel quite disrupted for some.

More seriously, there are risks of cholecystitis (gallbladder inflammation) and pancreatitis, particularly when weight is lost too rapidly. While large clinical trials didn’t find a statistically significant increase, real-world reports — such as nearly 400–560 UK cases of pancreatitis and several deaths — have prompted further investigation.

For those with a personal or family history of thyroid cancer, we also need to tread carefully. Concerns have been raised based on rodent studies showing increased rates of medullary thyroid carcinoma, leading to warnings and contraindications in some cases.

Another key area we focus on in clinic is dosing. Many people assume more is better — but with GLP-1s, that’s often not the case. While the idea of microdosing is still emerging and not yet robustly supported by large studies, there’s growing clinical experience that starting slow, increasing gradually, and staying on the lowest effective or tolerated dose helps ensure consistency and reduces the likelihood of stopping due to side effects.

There’s also growing concern about muscle loss and bone density. Declines in muscle and bone mass are more often due to rapid weight loss itself, not GLP-1s per se, but this has been one of the criticisms of the medication. Some studies suggest GLP-1 use along with exercise helps preserve bone health.

That’s why I always emphasise:

• Prioritising protein intake

• Supporting bone health with vitamin D, K2, and magnesium glycinate

• Incorporating some form of movement — ideally resistance-based — to preserve muscle

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And yes — in case you’ve heard the buzz — Wegovy is expected to be available in New Zealand soon. It's created a lot of interest, particularly because it’s a weekly injection, while Saxenda is a daily injection. I’ll be writing a separate blog soon comparing both options in more detail — but for now, the key difference lies in dosing frequency, not the core mechanism.

These Medications Are a Tool — Not the Whole Plan

GLP-1s can help, but they don’t do the work for you.

They don’t replace:

• A balanced, whole-food approach

• Emotional healing or therapy for trauma and disordered eating

• The importance of supporting your body with consistent nourishment

  
  

For many people, weight gain isn’t just about food or exercise — it’s tied to years of survival mode, hormonal shifts, burnout, and unresolved stress. There’s powerful research linking childhood trauma and adversity to obesity, insulin resistance, and chronic health conditions later in life.

Recognising this helps us shift the focus from shame to support. From willpower to what’s actually going on beneath the surface.

“GLP-1s aren’t about shortcuts. They’re a valid form of treatment for managing obesity — and when used with care, they can give your body the space it needs to reset and heal.”

GLP-1s might help create space — but it’s what you do in that space that truly makes the difference.

What to Know Before You Start

GLP-1s are not a one-size-fits-all solution. Like any treatment, they need to be part of a personalised, well-supported plan.

They may be worth considering if:

• You have insulin resistance or PCOS

• You’re struggling with weight regain post-bariatric surgery

• You experience food noise, cravings, or emotional eating

• You’ve trialled lifestyle changes and still feel stuck

  
  

They may not be suitable if:

• You have a history of thyroid cancer or MEN2

• You’ve experienced gut issues such as gastroparesis

• You have a history of eating disorders or untreated trauma

• You don’t have access to follow-up support or regular monitoring

  
  

Informed consent matters — and so does being genuinely heard when making decisions about your health.

Your Health Journey Is Your Own

For some, there can be stigma around using medication — a sense that it’s taking the easy way out. But GLP-1s aren’t about shortcuts. They are a valid form of treatment for managing obesity and metabolic health. When used safely and with the right support, they can help quiet the noise — allowing a window of opportunity to lay the foundations for healing, nourishment, and sustainable change as part of a holistic plan.

You are not behind. You are not broken. And your health journey is valid.

GLP-1s aren’t the answer for everyone, but when used wisely — with the right guidance, mindset, and support — they can be one potential tool , for some, within a personalised approach to metabolic health.

And remember: whether you choose medication or not, you still deserve care that looks at the full picture — body, mind, and everything in between.