Are GLP-1s Actually Safe? A Dietitian Explains Weight Loss & UPFs

takeaways

1. GLP-1 medications like Ozempic and Mounjaro replicate a naturally-produced gut hormone and are the strongest current option for obesity aside from bariatric surgery, but on the NHS they're licensed for a BMI of 35+ with comorbidities and only for two years.

2. Nicola describes GLP-1s as being misused by people with a BMI under 25 who want to 'shift a few pounds', and warns about counterfeit versions sourced on the black market at unknown doses.

3. Malnutrition and muscle loss are flagged as key risks, with the discussion covering aiming for around 1.6g protein per kg of ideal body weight, resistance exercise twice weekly, and avoiding very low calorie intakes to protect metabolic rate.

4. The drugs only work biologically and don't address environment, diet quality or psychological issues such as trauma, so weight can return when the medication stops if lifestyle and support aren't in place.

5. Not all ultra-processed foods are equally harmful under the NOVA definition; UPFs sit on a spectrum, with items like fortified plant milks, wholemeal bread and some dairy not linked to disease, while sugary drinks, processed meats and confectionery are the main offenders.

6. The overarching message is to move away from 'good' vs 'bad' food thinking towards an 80/20 balance, focusing on fibre, protein and whole foods rather than obsessing over single ingredients.

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