Weight Loss Injections

Whilst writing the title of this, it made me think: would the generations before ours have believed the requirement for this subject was possible? One thing’s for certain: we humans are as complex as we are diverse, and we’re as progressive as we are regressive.

Maybe, at this point in time, the world is experiencing the greatest margin in human evolution that it’s ever had. Logically, this would make complete sense, as once, a very long time ago, we were as simple and as vulnerable as the creatures and animals that we watch on one of David Attenborough’s many wildlife programmes.

I sometimes look at the lives of these majestic beings in envy, thinking, “It would be so much easier to just be a puma in the Amazon.” No bills, no inflation, and no stress other than finding food and being ‘present’ on this beautiful planet that we call home. Life in its most natural form.

Maybe our greatest achievements will be balanced by our greatest flaws. Fast forward 100 years from now, and you could say with absolute confidence that no one could begin to fathom what the topic of any blog or highly Googled subject could be. One thing’s for sure: the human imprint on the planet and the way we interact, both with it and with ourselves, will be incomprehensible compared to today’s life.

Anyway, more to the topic in question. There are many ways to cover this subject: why the need for it? How have we got to this? Who stands to profit? Does the pharmaceutical world actually want healthy humans? Or who am I, and what the hell do I know?

Personally, I think at a time when opinions and information are fed to us on a ‘high-octane IV drip,’ let’s just park all that for the time being and stick to the facts. Let’s strip it right down to a biological, nutritional, and metabolic standpoint to see what the hell is happening.

This new one, the headline maker, and the one that you’ve probably heard people talking about is called Wegovy, by Danish pharmaceutical company Novo Nordisk. The active ingredient, Semaglutide, works by mimicking a hormone called GLP-1. This hormone regulates appetite by signaling fullness to the brain. Thus, when injected (weekly), your appetite is suppressed, and ‘compounded over time,’ your calorie intake significantly drops.

Well, not exactly. Carl Jung (Swiss psychoanalyst, 1875–1961) once said, “Beware of unearned wisdom”, and in some sense, this rings true with what’s happening here.

Now, the trouble is, when you suppress your appetite and your calorie intake drops, you are, quite obviously, going to consume less food. Although this sounds absolutely fine, “the devil,” like always, “is in the detail.”

At this point, we need to just look at metabolism and the role your basal metabolic rate (BMR) plays. In short, this is the rate at which your body burns calories to produce energy. It is this energy (calorie figure) that your body needs at rest to maintain basic function. The higher this figure, the more calories you burn at rest and the easier weight loss is. Simply put, this is your:

“Engine,” your fire. The bigger the fire, the more “wood” (i.e., food) it will burn through during the day. It’s almost like passive income for your physique.

Your metabolism is dictated by various things: age, genetics, muscle mass, hormones, and nutrition (frequency of eating relative to protein intake) are the key fundamentals. Genetics play the biggest role.

The issue here is that when you suppress your appetite, you, in turn, suppress your metabolism, and messing around with your metabolism is not something to be taken lightly. If you lower your BMR, then you’ll burn fewer calories at rest and effectively reduce your body’s ‘functioning’ efficiency.

It’s relative. Just looking at it from a basic biological and nutritional standpoint, the human body needs nutrition to function. From protein, carbohydrates, and fats, the most important macronutrient is protein. Every cell in your body is made of protein, and without an adequate amount, cell repair, regeneration, and growth cannot occur. This results in a plethora of issues, from autoimmune conditions to the early onset of osteoporosis. Muscle tissue is made up almost entirely (water aside) of proteins. This is why the multi-billion-pound supplement industry targets its protein powders at ‘gym goers’ and almost anyone on the ‘fitness train.’

To generalise, we need 1g of protein per kg of body weight to facilitate this repair/regeneration. Now, if you exercise or do strength training of any sort, then it’s well-researched and highly advised to up this figure to between 1.5–2.0g of protein per kg. Logically, if you strain your body through exercise, then additional protein is required for such growth and repair.

• It’s very difficult to get your daily requirement of protein with a suppressed appetite.
• If you DO NOT get an adequate amount of protein based on your body’s requirement due to body weight, then you will lose muscle tissue.
• If you lose muscle tissue by reducing appetite, then your metabolic rate will drop.
• If your metabolic rate drops, then you will burn fewer calories at rest.
• If you burn fewer calories at rest, then your total daily intake of calories will, at some point, level out with your new ‘synthetically lowered’ metabolic rate (measured in calories).
• At this point, weight loss will no longer occur, and you will have experienced severe muscle atrophy (loss) and quite possibly other aforementioned issues.

No, not really. These weight loss injections perhaps encapsulate the term “short-term pleasure for long-term pain” almost better than anything else, as the ultimate toll is taken not on material matters but on ourselves.

It’s important to note that if we go more than 4–4.5 hours without eating, our bodies will always go to muscle tissue for fuel over fat stores. Rather annoyingly, our bodies are not overly keen on using body fat for energy. This is why preserving, maintaining, and developing our BMR is so important.

Standard ‘textbook’ weight loss usually equates to being around 75% fat loss and 25% lean tissue (muscle) loss. You can negate the reduction in lean tissue by prioritising protein to around 60% of the day’s intake breakdown (relatively speaking). Furthermore, if this is combined with resistance/strength training, then it’s possible to actually lose body fat and gain muscle at the same time.

Though, you’ll need to know what you’re doing in order to achieve this, and again, genetics will play a key role.

Ultimately, it’s early days. Wegovy injections have been out for almost two years now, and the stats just reaffirm what many, myself included, thought would be the case. The main findings are as follows:

• 60–75% muscle tissue loss, 25–40% fat loss
• Potentially irreversible metabolic health damage
• Multiple gastrointestinal issues
• Gallbladder problems
• Pancreatitis
• Thyroid tumours (risk greatly increases with GLP-1 agonists like semaglutide)
• Bone density reduction (osteoporosis, as previously mentioned)
• Rapid weight regain

Ok, give the devil his due: when would this be a sensible and worthwhile alternative to conventional means?

Now, you could say this almost has to be answered from a subjective standpoint, as everything you’ve read so far is more fact-led than opinion-derived.

As someone that’s spent 20 years in fitness, sports nutrition, and aesthetics, my own opinion would be that if an individual’s life is in a place of daily discomfort or despair due to weight, then potentially this route would be plausible.

Personally, I think this should be the last avenue that an individual goes down. We’re talking 50% body fat+, Type 2 Diabetes, fatty liver disease, visceral fat of 20, borderline cardiovascular disease, etc.

Typically, these individuals will most likely have struggled with weight for most of their lives, and the news of ‘Weight Loss Injections’ may quite possibly bring a glimpse of joy to what’s undoubtedly been a difficult path to navigate.

I’ve worked with clients that have struggled with weight from day one. They’ve followed the rules (for the most part) and put the exercise in, but it’s been a long and difficult road. Genetics—and, much more specifically, the genetic body type we are born with—will determine how easy or how difficult weight loss will be.

Most of us know someone who can eat rubbish all day and stay relatively lean; the same goes the other way.

This genetic composition in question, the ‘Endomorph’ body type, sees considerable consistency in the fat storage genes FTO & MC4R, thyroid hormones, and the glucose metabolism gene PPARG. This is most noticeable in the following characteristics:

1. Rounder, softer, and curvier body shape
2. Smaller skeletal structure relative to body mass
3. Slower metabolism (greater efficiency in storing excess energy as fat)
4. Medium to high muscle density (though more compact)
5. Higher proportion of slow-twitch muscle fibres

To this day, no one actually knows how far back this is traceable, but what we know for sure is the last 50 years have certainly not helped!

• 1954: End of food rationing in the UK – Adult obesity at around 0.5%
• 1965–1970: Emergence of processed foods and ultra-processed foods (UPFs), such as ready meals, crisps, sugary cereals – Adult obesity at 5%
• 1974: McDonald’s opens its first UK restaurant, marking the beginning of widespread fast-food & trans-saturated fat consumption plus the mass marketing of soft drinks and sugary snacks – Adult obesity at 7%
• 1980’s: Junk food boom and further mass marketing of sugary snacks, fast food outlets, and UPFs leads to a massive increase in adult obesity – Adult obesity now at 14%
• 1990’s: Expansion of multinational fast-food chains and snack brands like Coca-Cola, Mars, and Walkers crisps – Adult obesity now at 18–20%
• Early 2000’s: Ultra-processed foods constitute a growing share of household food purchases – Adult obesity now at 23%
• 2004: The World Health Organisation identifies obesity as a global epidemic.
• 2007: The UK introduces public health campaigns targeting obesity, including “Change4Life.”
• 2010’s: Ultra-processed foods account for over 50% of the UK diet.
• 2019: Over 60% of adults are overweight or obese.
• 2040: Predicted that at least 71% of the UK population will be overweight/obese, driven largely by processed foods, UPFs, disparity between socioeconomic groups, and sedentary lifestyles.

The other factor that has influenced the above statistics is the advancements we’ve made in technology. Quite simply and fairly logically, the more useful and effective technology becomes, the more inactive and thoughtless we become.

Sadly, obesity and socioeconomic poverty are inextricably linked. In England, a week’s food shop of good-quality meat, fish, fruit, and veg is about three times the price of an equivalent shop tilted towards processed/convenience-style meals.

A good thought to have when deciding what to eat is this: “Could I have had this as a food option 100 years ago?” If the answer is no, then you have your answer. Though no one is perfect, finding that elusive lifestyle balance is often the key—not just in healthy nutrition but in most things.