It is well known that overweight and obesity can by harmful to your health. Excess weight raises blood pressure, cholesterol, and blood sugar, increasing the risk of heart disease and certain cancers. Losing weight helps — but for many people, it is not easy. For some, eating healthy and exercising regularly is enough. For others, it ‘s not. This is where weight loss medication may help.
Some health conditions make weight loss difficult. These include PMOS (Polyendocrine Metabolic Ovarian Syndrome, previously known as PCOS) — which affects nearly 1 in 5 Caribbean women — Hypothyroidism (an underactive thyroid gland), and Type 2 Diabetes or Pre-Diabetes.
Am I Overweight? Understanding BMI
Doctors use a tool called Body Mass Index (BMI) to check if someone is carrying too much body fat. BMI is based on your weight and height. You can work it out yourself using a free online calculator.
- BMI 25–29 = Overweight
- BMI 30 or more = Obese
BMI is helpful, but it does not tell the whole story. Your doctor will use it along with your full health history to make the best plan for you. Everyone is different.
The New Generation of Weight-Loss Medications
Right now, the most effective weight-loss drugs are called GLP-1 Receptor Agonists. You may have heard names like Ozempic, Wegovy, or Mounjaro — they all belong to this group.
GLP-1 is a hormone made in the gut that helps control our appetite and blood sugar. These medications give the body an even higher dose of this hormone. The result: you feel full sooner, crave less food, and your blood sugar stays steadier.
How much weight can you lose — and how?
The three main tools doctors use for weight loss:
- Diet and exercise: which can lead to about 5–8% total body weight loss for most people. This is still meaningful and improves health, but it has its limits.
- GLP-1 medications can lead to 15–20% total body weight loss within one year — a big step beyond what diet and exercise can do on their own.
- Bariatric surgery — to reduce the size of the stomach and change how food is absorbed — can lead to the greatest weight loss, often 25–35% or more total body weight loss. This option is considered for people with severe obesity when other options have not worked.
There are so many new names. Which medication is for what?
For Weight Loss (Obesity):
- Tirzepatide (Zepbound) — weekly injection
- Semaglutide (Wegovy) — weekly injection
Both have been shown to lead to 15–20% total body weight loss within one year.
For Type 2 Diabetes:
- Tirzepatide (Mounjaro) — weekly injection
- Semaglutide (Ozempic) — weekly injection and Semaglutide (Rybelsus) — a tablet (the only one that is not an injection)
A common question: “Where is Ozempic on the weight-loss list?” Ozempic is FDA-approved for Type 2 Diabetes — not weight loss. But because weight loss is a known side effect, some doctors prescribe it for weight loss too. It also lowers cholesterol and reduces the risk of heart attack, stroke, kidney disease, and fatty liver disease. This is why a personalized plan is so important.
Side Effects and Setbacks
As with all medications, there are side effects. The most common ones are loss of appetite, nausea and vomiting, diarrhea and/or constipation and headaches and dizziness.
This is especially the case when you first start the medications Avoiding fatty foods and eating slowly can help reduce these effects.
More serious, but rare, side effects include pancreatitis, medullary thyroid cancer, kidney injury, and severe allergic reactions. This is why medical supervision is so important.
Setbacks
The Weight Comes Back — Fast.
Here is a hard truth: most people who stop taking these medications regain most of the weight. Studies show that within one year of stopping, people regain about two-thirds (just over 60%) of the weight they lost. For some people, this takes just a few months. This is not a sign of failure. It reflects the fact that obesity is a chronic condition — like high blood pressure or diabetes — that often needs long-term management.
It’s Not Cheap — And That’s a Problem
These medications generally cost over $1,000 per month without insurance and private insurance plans rarely cover them fully.
This creates a serious fairness problem. The people who are most likely to struggle with obesity — those with lower incomes, fewer resources, and less access to healthy food — are often the same people who cannot afford these medications.
Weight is not just a matter of willpower. It is shaped by income, food access, stress, environment, and biology.
Healthy Eating and Exercise Are Still Essential
These drugs are powerful tools, but they are not a replacement for healthy habits. Eating well and staying active remain important when you are on these medications.
When you eat less, what you eat matters more. Not getting enough nutrients and water can cause bone loss, hair loss, and kidney damage. Building good eating habits takes time and a clear plan.
Exercise matters too — because as you lose weight on these drugs, you can lose both fat and muscle. Muscle is important for your metabolism and blood sugar control. Weight training at least three days a week is ideal — especially for women in peri-menopause or menopause.
Key Takeaways
- GLP-1 medications help with weight loss when diet and exercise alone have not worked.
- Your plan must be built around you — your age, health history, and any other conditions you have.
- Healthy eating and exercise are still important, even when on medication.
- Many people need to stay on these medications long-term — talk to your doctor about this before you start – are you prepared for long-term use? And can you afford it?
For the future of weight loss treatment for all who need it:
When the most effective treatments are only available to those who can afford them, we are not solving the problem — we are deepening the gap.
Until these medications become affordable and accessible to all who need them, we must continue to push for policies that make equitable healthcare a reality — not a privilege.
Wherever you are on your health and/or weight loss journey, I wish you all the very best. The behavior change needed for consistent diet and exercise, and in some cases sticking to medications, is not easy. But you can do it if you have a plan and if you have some help. Talk to your doctor about options that are best suited for YOU.
Wishing you a safe and healthy week!
Dr Rachel Thwaites-Williams,
Family Physician and Public Health Specialist
