Obesity and semaglutide: everything you need to know

February 1, 2024
11 minute read

Did you know it’s harder for people classed as overweight or obese to lose weight?

Biological processes in the human body make traditional approaches of diet and exercise less effective, because the body defends itself against these actions. New weight loss drugs like semaglutide stimulate the body and are a successful addition to weight loss strategies.  

Take a deep dive through weight gain, obesity and how new treatments like semaglutide can help individuals to achieve their weight loss goals and enhance their overall health, wellbeing and longevity.

What is obesity and what causes it?

As defined by the World Health Organization (WHO), overweight and obesity are characterised by an abnormal or excessive fat accumulation that presents a significant risk to long-term health.

A useful tool for calculating obesity in adults is the Body Mass Index (BMI) scale:  

• 18.5 to 24.9 – healthy weight 

• 25 to 29.9 – overweight 

• 30 to 39.9 – obese

• 40 or above – severely obese 

Fundamentally, obesity emerges from an energy imbalance, when more calories are consumed than calories are expended. As obesity is such a complex disorder, multiple factors contribute to this energy imbalance, from genetics to psychological factors, socioeconomic conditions, medication, sleep deprivation and certain environmental factors.  

Over the past few decades, a marked increase in consumption of energy-dense foods that are high in fats and sugar, combined with a decrease in physical inactivity due to rapid urbanisation, changes in workplace behaviours and evolving modes of transportation have contributed to the rise of obesity worldwide. This is what’s often referred to as an “obesogenic environment”.  

What are the health consequences of obesity?

Being overweight or obese increases the risk of suffering from multiple diseases and conditions. Some of the main ones include:

  • Type 2 diabetes: obesity is a major risk factor for developing type 2 diabetes, a chronic condition characterised by elevated blood sugar levels.
  • Cardiovascular diseases: obesity increases the risk of developing heart disease, stroke, and high blood pressure.
  • Cancer: obesity is associated with an increased risk of certain types of cancer, including breast, endometrial and colon cancer.
  • Respiratory problems: obesity can worsen respiratory conditions like asthma and obstructive sleep apnoea.
  • Joint problems: excess weight puts strain on the joints, increasing the risk of osteoarthritis, especially in the knees and hips.

In general, individuals with a BMI between 25 to 30 are anticipated to live between 2-4 years less compared to those of a healthy weight. People with a BMI between 40 to 50 have a reduced lifespan of 8-10 years compared to their healthy weight counterparts. 

Besides having these profound negative implications on health and overall life expectancy, obesity puts considerable strain on health services, the broader economy and perpetuates social inequality.

Factors such as education and socioeconomic background affect the prevalence of obesity, while obesity in turn exacerbates existing social disparities. Obese individuals often face poorer job prospects, lower employment rates, greater challenges in rejoining the workforce, and earn approximately 10% less than their non-obese counterparts. Obese and overweight people can likewise be unfairly negatively judged as lacking willpower, motivation or the necessary work ethic to lose weight, when in reality, the picture is much more complex, as we’ll see below.

What are the health benefits of weight loss?

Achieving a significant amount of weight loss can substantially improve an individual’s overall health, wellbeing and longevity.

For a person that is obese, studies have shown that losing an average of 10kg can lead to a 20-25% reduction in overall mortality, roughly 30-40% reduction in death related to diabetes, and a 40-50% reduction in obesity-related cancer death.

Besides these broad benefits, losing weight also has a tremendous positive impact on cardiovascular health, and contributes to improved lung function, improved ovarian function, improved insulin sensitivity, reduced back pain, joint pain, breathlessness and sleep apnoea. Losing weight also contributes to an improved sense of wellbeing, such as feeling healthier, younger and more positive.

Why is it so challenging to lose weight successfully?

Weight loss is often a challenging endeavour, as it requires a long-term, sustained combination of lifestyle changes and commitment. More recently, however, it has become apparent that current approaches to weight loss are not nearly as effective as required, with studies showing that lifestyle interventions alone (diet and exercise) only contribute to a moderate decrease between 5-10% in body weight over the short term.  

More concerning are the long-term relapse rates (gaining back some or all the weight), which have been shown to often exceed 50% and even higher, depending on how participants were followed after a study.  

Such high levels of relapse rates are likewise difficult to explain, though general consensus suggests that a combination of the societal changes, coupled with physical, psychological, genetic and environmental factors are at play.  

We’ll attempt to briefly cover just a small part of these factors – physical barriers to losing weight.  Once a person is already significantly overweight or obese, the human body employs several multi-faceted mechanisms in an effort to prevent weight loss. These include but are not limited to:

  • Metabolic adaptation: the body responds to attempts at weight loss by slowing down metabolism. This means that you’re burning fewer calories throughout the day compared to a person of the same weight that is not actively losing weight, and over time, to continue losing weight you’ll need to reduce your caloric intake more and more, often to unsustainably low levels.  
  • Reduced appetite-supressing hormones: as you continue to lose weight, your body will decrease the production of appetite-lowering hormones, leading to an increase in hunger and cravings.
  • Increased appetite-stimulating hormones: likewise, the body counters weight loss attempts by also increasing hunger-stimulating hormones such as ghrelin.  
  • Increased insulin resistance: obese and overweight people often have insulin resistance, which can also lead to increased appetite and higher levels of fat storage.  

What is semaglutide and how does it work?

The good news is that the landscape of obesity treatment has recently seen its biggest breakthrough since its inception, in the form of GLP-1 agonists – medications such as liraglutide and semaglutide, the latter also known under the brand name Wegovy.  

As the name suggests, GLP-1 agonists work by mimicking the function of the natural hormone glucagon-like peptide-1 (GLP-1), which contributes to:

  • Increasing insulin production: GLP-1 stimulates the pancreas to produce more insulin, which helps lower blood sugar levels.
  • Slowing gastric emptying: GLP-1 slows down the rate at which food leaves the stomach, promoting satiety and reducing appetite.
  • Reducing hunger pangs: by mimicking GLP-1, semaglutide helps to suppress hunger cues and cravings, making it easier to control food intake.

Using semaglutide in combination with lifestyle changes has been shown to lead to rates of weight loss of up to 15% after a year’s use. The advantage of semaglutide is that it essentially makes weight loss a much, much easier endeavour, reducing some of the mechanisms and barriers that the human body employs to conserve energy.  

Those that have struggled repeatedly in the past, are now provided with an aid that helps to a considerable extent. Moreover, semaglutide can be easily combined with lifestyle changes, and can significantly boost the success of sticking to said lifestyle changes.  

Combining semaglutide with lifestyle changes

For optimal weight loss results and to maximise the benefits of semaglutide, it is essential to integrate it into a comprehensive weight management plan that includes lifestyle changes. These changes should focus on both diet and exercise.

Dietary changes

A healthy diet plays a crucial role in weight loss and overall health. It is recommended to adopt a balanced diet that is low in processed foods, sugary drinks and unhealthy fats, while incorporating plenty of fruits, vegetables, whole grains and lean proteins. Here are a few dietary tips:

  • Control portion sizes
  • Prioritise whole grains
  • Include plenty of fruits and vegetables
  • Choose lean proteins
  • Limit sugary drinks

Regular Exercise
  • Aim for at least 30 minutes of moderate-intensity exercise most days
  • Gradually increase intensity and duration

Additional Tips

Here are some additional tips for incorporating semaglutide and lifestyle changes into your weight loss journey:

  • Setting achievable goals can help you stay motivated and on track. Aim for gradual weight loss of 0.45-0.90 kg per week.
  • Surround yourself with supportive friends and family members who can encourage your weight loss efforts. Consider joining a weight loss group or finding an online community for additional support.
  • Weight loss takes time and effort. Don't get discouraged by setbacks. Celebrate your progress along the way and refocus on your goals.

By combining semaglutide with lifestyle changes, you can significantly enhance your chances of achieving sustainable weight loss and improving your overall health. Remember, consistency and dedication are key to success!

Learn more

To learn more about obesity and treatment options, explore the NHS Obesity Resource.

Do you have any additional questions? Get in touch with our friendly, professional pharmacy team who can offer you guidance and advice.

Content last reviewed on:
January 31, 2024
Next review date:
January 31, 2026
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