People used to sometimes think,
"Will there ever be a pill or a drug
"that can just make you lose weight?", and it's here.
There's the new Hollywood face that is very chiselled, kind of gaunt.
They've appeared quite a lot on my social media feed.
I think the obvious one is probably Ozempic.
They're the drugs that so many of us
seem to be taking. A lot of people
say they've been life-changing, for the better.
I now have a body that I've always dreamed of.
But they can come with
a hefty price tag.
I've had patients that have sold kitchen items
and furniture in their house, in order to keep up payments.
I spent about £2,000 on the injections in total,
but I've no idea how much
that would have ran to since the prices have gone up.
And a hidden psychological cost
can be attached, too.
There's an addiction to keep it going,
because it makes me feel in control.
So how do people safely come off these drugs
that are hailed by so many as a miracle?
For me, it's more threatening to go back to what I used to feel like
than to say, "What happens if you're on this drug forever?"
Great. I'd love that!
We've been obsessed with diets for decades...
Over the years, the styles
and shapes of the girls have changed quite a bit.
And it is, it's the keep-fit craze
hitting Kensington.
The rack used to be an instrument of torture.
It stretches the vertebrae,
tones up the muscles and makes a girl feel marvellous,
if they remember to switch off in time.
..but recently, a new tool has completely changed the landscape.
Weight-loss injections,
otherwise known as GLP-1s.
They became THE new way for Hollywood to shift weight quickly,
with a long list of those willing to try it.
Can we just talk about Saxenda weight-loss injections?
And I just thought I would let you all know
that I've lost 6kg... The popularity of the drug
has soared, and searches for them
have grown and grown and grown.
As of 2025, an estimated
1.5 million people are on
weight-loss injections in the UK.
That's roughly one in 46,
more than 2% of the population.
1.5 million people is a huge number,
and I suspect over time, that's only going to increase.
Now, I guess one of the key reasons that we see it being
so popular is that as a nation, unfortunately,
we are suffering with increased weight.
In England, 28% of people are classed
as obese and another 36% are overweight.
So that's nearly two thirds of us
falling into one of those categories.
And it's a similar picture
across the rest of the UK.
Living with obesity has a number of health impacts,
whether it be some of the conditions like Type 2 diabetes,
high blood pressure, increased risk of cancer.
It's the second-biggest risk factor for that.
And I think that combination of health concern,
as well as people's body image and confidence
and the related mental health impacts there,
it drives a lot of people to want to spend their own money
to access care. I think body weight still has
an impact on our social currency.
Previously, the obsession with body weight
was largely aimed at women,
but I definitely feel now that more men are under scrutiny.
And I think part of that has to do with social media,
part of it has to do with the increasing
amount of reality TV shows that celebrate a certain kind of body...
..and that's now held up as
the way to become famous
and to become rich and successful.
And when you see that,
particularly at a younger age, it makes you think that that is
the route to getting all of those things in life.
There are three drugs on the market.
Semaglutide, which is marketed as Wegovy.
Tirzepatide, sold as Mounjaro.
And Liraglutide, branded as Saxenda.
All GLP-1s have to be prescribed by a health care professional.
Some get it on the NHS, others pay for it
through private clinics and pharmacies.
Emma is a GP and she runs a private clinic which provides
weight management advice, along with support and coaching
for patients, using GLP-1 medications that she prescribes.
She's also using weight-loss jabs herself.
I've always struggled with my weight since before I was a teenager,
and I've literally done every diet out there.
And every diet I do lose weight with,
I just can't keep the weight off.
At the start of last year, I felt panic, If I'm honest.
I was the biggest I've ever been,
I was bordering morbidly obese, and all I was doing was dieting
all the time, and I had no clue how to stop it.
I previously got up to 23.5 stone.
I lost all that weight
and then I put it all back on again.
I got to about 22st, and I was gradually losing weight,
but it's frustrating and it's slow.
And I saw it as a way that I could just
speed that up, a bit of a cheat.
I've always been on a diet and never found anything that worked.
I work in the fitness industry
and I felt, personally, that
I was a bit of an impostor.
Like, I wasn't valued for my opinion, based on my size.
So initially, I went on the medicine
just to almost prove a point, to say,
"Hey, if I lost weight, does my career progress?
"Do people take me any more seriously?"
I ended up having to have a hysterectomy
surgery in 2023. And prior to that,
I'd had various different treatments for cancer.
I was on various different drugs,
which then made me balloon in weight.
It was a key turning point for me, having to sign a waiver
to say that I may not actually make it through that surgery
because I was so overweight.
GLP-1 medicines work by copying
a natural hormone your body releases
after eating. This hormone helps
regulate blood sugar and appetite.
When you take a GLP-1,
it tells your pancreas to release
insulin when needed,
stops another hormone
from raising your blood sugar,
and slows down digestion,
so you feel fuller for longer.
What these medications are trying to utilise is that pathway
to help reduce the cravings and the food noise,
in order to support a lower calorie intake.
And that regular energy deficit
will, over time, lead to weight loss.
I didn't know anybody else that was on it
and I was kind of convinced that it wasn't going to work for me.
I didn't even tell my husband at the time either.
As the drug peaked in popularity,
it was touted as a miracle cure.
But that miracle can come at
a hefty cost for private buyers.
I spent about £2,000 on the injections in total,
but I've no idea how much
that would have ran to since the prices have gone up.
In September 2025,
buyers of Mounjaro faced a steep
price hike, which the makers,
Eli Lilly, said was to bring it in line with other countries.
I've had patients that have sold kitchen items
and furniture in their house, in order to keep up payments.
So as more face the reality
of tighter purses due to price surging,
it begs the question, what happens when you decide to,
or have to, come off those weight-loss jabs?
So I was on it for 22 weeks in total,
and that included coming off it over a period of six weeks as well.
Then I think I'd lost then,
it was 3st and 8lb I'd lost altogether.
So I started taking them in February 2024,
and I was taking them for somewhere between
six and eight months in total.
Over that period of time, I lost about 4st.
I started taking Mounjaro on the 12th of October, 2024,
and by the end of January 2025,
I'd lost nearly 60lb.
A few reasons compounded to make me stop taking them.
So there was the cost, because the most expensive dose,
it's quite expensive, and it just seemed to be counterintuitive
to be taking something that had stopped working.
Deciding when, or if, to come off the jab is entirely personal,
but it's not just as simple as stopping.
I often see that some patients will come off it
when they're on its highest dose, because they've reached
their target, and then they stop off. And really,
the advice is that you would need to work down on those doses,
so therefore, it isn't a big shift in your experience
of appetite from one day to the next. The guidance is that you need
to have a review, to ensure that the health outcomes have been met.
What were the targets, at the first place?
Have we reached those? And really,
that needs to happen long before you decide to come off it.
So that's a discussion that you need
to think about, really, from the outset.
What is the exit strategy, as you want to call it?
What is the plans that you're going to put in place to ensure that
it's not going to be sort of jumping off a cliff kind of feeling?
I remember actually shifting my goal, because I had an original goal
in sight of wanting to get to a certain weight,
and I got to that very quickly.
Checking it against the BMI scale,
I wasn't in the green section.
And I know it's very outdated, but then I just became
obsessed with trying to get in that green section.
One of the main reasons people come off
the injections is reaching their target BMI,
otherwise known as your body mass index,
the standard way of categorising people's weight.
But BMI does have limitations,
because it measures weight, not fat.
For example, someone who's very muscular
can also have a high BMI.
I moved my goal even further
and was kind of astonished when I even got to that.
So at that point then, I knew it was time to come off,
because you can get very obsessed over these things.
Another reason people stop taking
the medication - the side effects.
It can lead to stomach pain,
headaches and sometimes hair loss.
And in rare cases, it can be more serious.
Between one in 100
and one in 1,000 people
may develop pancreatitis,
which can be life-threatening.
And there's also the risk
of poor nutrition.
And some jabs may even
reduce how well contraceptives work.
But because these drugs are still so new,
it's hard to know just how common
these more serious issues really are.
So initially, I thought, I'll do it for a four-month period.
And in the first few months, I did feel awful.
I was struggling with nausea. I had headaches every day.
I hadn't slept in four months.
My hair was falling out in clumps.
But I'd lost about three-and-a-half stone.
It was amazing to see the reaction of people that came up to me after.
They were like, "Well done, that's so much weight."
And I was like, "What do you mean, well done,
"that's so much weight?"
The purpose of that conversation was, I have really suffered.
A spokesperson for Wegovy's manufacturer,
Novo Nordisk, said...
I definitely think there's a culture where we praise weight loss,
even if we don't know why somebody has lost weight.
And it might be that they're taking medication to lose weight,
but it also might be that they are going through some sort of illness.
And I definitely know that during periods in my life
where I've lost weight from burn-out or stress,
people have praised me. And that becomes very addictive,
but it's also odd.
At that point, I thought, "I'm going to come off it."
And then my brain said,
"But you go on holiday in a couple of months.
"You've never been this slim. Why don't you keep going
"and you can come off it after you've been on holiday?"
So that's what I did. And then when I came back from holiday,
I thought, "Nah, it's nearly Christmas.
"Just keep it going now until the end of the year.
"And we'll get through this year and THEN we'll come off it."
And now it's 19 months and we're still on it.
I had some health issues that meant that I had to stop the medication.
And at the time, I didn't really care too much.
I lost about 4lb in the five weeks that I was off it.
In the final week that I was off it,
I remember going and having a meal and not feeling full.
And I ate another meal and I still didn't feel full.
And I was back with the pressure on my ribcage,
how I used to feel, not able to take a deep breath,
and I thought, "Oh, it's back."
On a couple occasions, I've made the decision to come off of
the medication and just to stop. And I got, on both occasions,
three days in. And after day three,
I had eaten so much food and was so horrified with myself
because I didn't even realise I was eating food.
It was literally like something opened up in my mind that said,
"Eat everything. Go on. You deserve it
"because you haven't ate anything for 19 months."
When you come off these injections,
of course you're going to see your appetite drive go up.
The dosage that we see in these injections are far higher than
what you naturally produce in your body.
For some, and a number of the patients that I've spoken to
describe it as feeling like an avalanche,
a bit of a tsunami, and how the sensation and the noise
quickly comes back - sometimes, the next day.
The idea of food noise isn't new, but the phrase itself
only started gaining traction when the medication became popular.
Thinking about food is very normal,
but food noise refers to persistent
or repetitive thoughts about food.
It's like just genuinely being hungry.
And even though you know you've had enough to eat,
your brain's not telling you that. It's like, it's a mind trick.
That's exactly what it is.
So I don't mind openly admitting now that I was an emotional binge-eater.
If I was happy, I would binge. If I was sad, I was bingeing.
Doesn't really matter. I had no filter whatsoever. And for me,
the medication just switched all of that off.
And nobody understands what that means, really,
unless you've actually been on this medication.
It can be quite traumatic, those weeks and months afterwards,
when you've gone through that period of time where you've managed
to suppress the food noise through the medication.
There's a fear and an anxiety around those days,
those first few days when you come off it.
And it kind of takes over a little
bit in your mind because you go from never thinking about eating,
and the second that that's no longer in your system, it's like a switch
just goes straight back on and you're instantly starving.
One of the things that comes up a lot
when people talk about food noise, people say,
"Eat food that satiates you and keeps you full for longer."
That doesn't work with food noise, just doesn't seem to happen.
But what I've noticed, over the last three months,
is I'm eating things that keep me full up.
I'm finding that through doing the work that I am,
that the food noise is still there sometimes,
but overall, it's largely gone.
So I still crave sweet and savoury things, but I'll have alternatives.
And I know now that I would rather fuel my body with something
that is more nutritional than a quick sugary fix, for example.
So it's massively helped just reassess my lifestyle
and help implement those changes.
For a lot of people who are thinking about coming off the jab,
the main question is whether the weight will sneak back on.
Your weight does spike when you come off
because you've no longer got the medication
that's helping you suppress your appetite, and a lot of people
then don't continue eating a calorie deficit.
We know that weight regain is common
when you come off GLP-1 medications,
and that, probably in the next one to three years,
you're likely going to see
a significant proportion of that weight go back on.
Somewhere in the region of 60% to 80%
of the weight that you lost will return.
In the first part of your journey on these injections,
you will see significant weight reduction,
without having to do any meaningful lifestyle changes.
And if we do not ensure that significant changes
have been done in the whole lifestyle,
then unfortunately, people are going to start regaining weight.
I put about a stone on in...probably around a month,
so pretty rapid. When I stopped taking them,
I expected to put some weight back on, because I thought,
there's going to be an adjustment. Expecting some to go on
was in my mind. How quick it went on wasn't.
If you think about it from a psychological perspective,
the significant drop in weight - let's say 21% of your body weight -
that is really going to transform the way you look, the way you feel,
and to lose that, that's really quite upsetting.
It messed with my head a little bit, I'm not going to lie.
When you've gone from being somebody that is obese
and having issues with binge-eating
and I guess your self-image as a whole,
seeing those numbers start to creep up a little bit freaked me out.
So why does the weight rebound for some?
Experts say there are a few reasons.
Your own GLP-1 production may dip.
Your pancreas may struggle
to regulate your appetite properly.
Or your body can kick into survival mode,
trying to regain the lost weight.
The body likes putting on weight.
It's great for survival. Fat is a fantastic energy store.
So if it's lost a lot of weight,
it will want to actively put that back on.
It's called set point theory,
where if you've been a weight for a long period of time,
it then will make changes
in your physiology and your behaviour
to encourage you to put that weight back on.
I think there's a lot of people that are so scared,
and I was one of them, of just piling the weight
back on again once the medication stops. But if you are
implementing those lifestyle changes while you're on the medication,
all you have to do is continue with that afterwards.
To help motivate me, like I say,
I used a PT to give me something to aim for. And I've entered,
or I'm trying to enter the Great North Run,
so I've got something to train towards.
However, some people who pay privately don't feel like
they're supported to overhaul their lifestyle
when, and if, they come off the jabs.
It's mad, because you've got the guidance and what they say to do,
and then you've got the reality of being on the medication.
So I come back to strength training being super important.
But I also know that nine times out of ten, we can wake up feeling achy,
tired, nauseous, with headaches. We haven't slept all night.
The last thing we want to do, sometimes, is go to a gym.
So you have to accept that there is guidance
and what we should be doing is one thing,
and then the way that the medication makes you feel is another.
What do you eat after? So I'm fortunate to have done things
like Weight Watchers before, which gave me a bit of an idea.
But if you've never done anything like that and you're taking
these injections and you just stop taking them,
you're going to get back all the food noise and the hunger,
but then what's going to happen? Are people going to go back to
just their old ways, eating? And then... I put on a stone,
but people are going to put on even more?
Every Sunday, for 19 months,
I've said to myself, "Stop. Don't take it now. You don't need it."
And then I wake up Monday,
feel a bit hungry and think, "No, we're going to take it.
"We'll do one more week." What I ultimately always come back to is
for the first 38 years of my life, I was overweight.
I'm 6st lighter
and, therefore, there's part of me that feels like
there's an addiction to keep it going, because it makes me feel
the way that I feel. It makes me feel in control.
I think that feeling of being in a socially acceptable
thin body is really addictive, especially if you've never had that.
If you're someone who has always been in a larger body,
it can feel very novel.
Because of the evidence of the weight coming back on,
for me, I think I'll always find a way to stay on it.
And that both petrifies me and also excites me
that potentially, I could be slim forever, which is mad, right?
Coming off the jab long-term isn't part of everyone's plans
because for some, it's become a key part of how they manage
their health day-to-day.
I went back on the medication in March,
and I had exactly the same response
as when I started it in October.
I instantly felt better in myself.
I just can't regulate my hunger and how I eat without a medication.
Now I can. In the long-term,
people ask me if I'm worried about staying on it.
But for me, it's more threatening to go back to
what I used to feel like on a day-to-day basis than to say,
"What happens if you're on this drug forever?" Great. I'd love that!
So what I do find quite interesting
is even though I'm still taking the medication,
I haven't actually lost any weight for around four months.
Haven't gained either, but haven't lost.
And I think there's an understanding that once you get
as far in with the medication, it will stop working.
There is currently no definitive timeline
for how long you can be on a GLP-1 for weight loss.
But given the novelty of the medication,
a lot remains unknown about long-term use.
The question is, is what are these people's experiences
once they come off the injection, over THAT period of time?
And I think we're not yet at that phase where there are many people
talking about that yet. And so we're getting to this point now
where people have been on it for a year or two,
and more and more are starting to come off it - because they've
achieved, maybe, the target that they were aiming for - and they're
starting to realise that, actually, this isn't a miracle cure.
Looking back, I think they're a good thing
because they helped me on the way. They didn't get me to my end point,
but that was my choice. Since I've stopped taking them,
I'm going to the gym four or five times a week,
I've been eating really, really sensibly, but I've not lost
any weight. It's really frustrating. But weight loss isn't always
like that. I can see there's a change in my face,
but the weight hasn't changed. And my obsession is with my weight,
not with the way that I look. So I would go back to them,
yeah, I'd be lying if I said that I wouldn't.
I feel like I'm done with the chapter.
I've lost nearly 8st now,
and I guess the fact that
I'm now keeping it off as well
is good for others to see, in that,
you know, I'm not on the medication any more.
They can see that, actually, life after Mounjaro,
it can be sustainable as well.
We've got a pretty good idea of
what these jabs can do in the short-term,
but when it comes to lifelong impact,
scientists are continuing their research,
and there's still a lot we don't fully understand yet.
I think the future holds a potential opportunity
to engage with a group that,
I'll be honest, health care has neglected for a period of time.
I don't think we've supported people living with obesity properly.
The thing is, we don't know the causes of obesity.
But shaming people, we know shaming people for their weight
and pointing it out actually results in them gaining more weight.
So the current approach we've got is actively harmful.
People taking the jab will need to balance
the benefits with a few of the long-term unknowns,
like possible issues with the pancreas,
kidneys or gall bladder.
My worry is that if we overly rely on injections
to try and solve this problem,
we're not going to work on both the harder things that we need to do
as an individual, but also, the challenging things that government
needs to do. Because obesity isn't a GLP-1 deficiency.
These injections will merely help
as a tool to achieve that long-term outcome.
And it's not just a medical shift. The popularity of the jabs
is forcing us to think about how obesity is perceived
and treated in everyday life.
I definitely think there's been a shift
in how society views thinness,
because now, potentially, more people can become thin
who might have struggled to diet or restrict themselves previously.
If we are seeing less and less people in larger bodies,
on the streets, on social media, in campaigns, etc,
then that does automatically show everyone
that a larger body is to be hidden and it's not aspirational.
So that automatically will really affect people.
At the moment, GLP-1 medicines
for weight loss are only available as injections,
but there are weight-loss pills
in development which have the potential to work the same way.
There is a lot coming down the track. In fact, the amount
being invested in obesity medicine is quite eye-watering.
But I am worried that there will be an overfocus on the pharmaceutical
elements, without appreciating and understanding
that there's a lot of benefit that can be gained
from the key lifestyle elements that support that process,
that you will never really be able
to get from an injection or a tablet.
A spokesperson from Eli Lilly,
the manufacturer of Mounjaro, said...