We’ve heard of diets, cleanses, surgeries, 8-week challenges and a million other fads not even worth revisiting, but the latest weight loss approach to enter the chat is weight loss injections.
And while the idea of an injection for weight loss certainly sounds extreme, these medications don’t hold a candle to the invasive nature and serious risks of weight loss surgery, which is fast on the rise for Australian women.
In recent years, the number of weight loss surgeries in Australia has more than doubled, and alarmingly, adverse effects of weight loss surgery occur in as many as 12% of cases.
So it’s no wonder the medical community is more commonly prescribing these medications as an alternative for surgery, but do they work? And what exactly is the science behind these treatments?
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Why Are Weight Loss Injections Trending?
Weight loss injections aren’t exactly new, they’ve just more recently been approved for medical weight management in Australia, which might be why they’re just now being talked about.
For years, Australian doctors and endocrinologists have been prescribing weight loss injections for their ability to improve blood sugar levels and lower the risk of heart attack, stroke, or death in adults with type 2 diabetes and known heart disease.
While being used to treat diabetes, people on this class of medication – called glucagon-like peptide 1 (GLP-1) agonists – were also found to lose weight and experience other health benefits.
So in 2017, the Therapeutic Goods Administration (TGA) approved a medication called liraglutide for weight management for people with a BMI of ≥27), who also have weight-related medical problems, or those living with obesity with a BMI ≥30.
Perhaps the reason why weight loss injections are now trending, though, is because of (surprise, surprise) TikTok, where a number of people using the drug have taken to sharing their own weight journeys, sparking mass intrigue.
What Actually Are Weight Loss Injections And How Do They Work?
The only weight loss injection available in Australia is called liraglutide, which is sold under the name Saxenda. It looks like a small injection pen and it contains glucagon-like peptide 1 agonists that work within the body in a few ways.
First, liraglutide works on the reward centre of the brain, stopping appetite signals and mimicking the same hormone that tells the body you are full. It also works to slow the rate at which the stomach empties, which prolongs the feeling of being full.
There are additional positive effects on the liver and pancreas, like increasing insulin secretion, stabilising blood sugar levels, increasing glycogen stores and reducing glucose production.
Basically, when people are using this medication, they keep food in their stomachs for longer and feel less hungry as a result.
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But why does this work for people living with obesity? Dr Joanna Sharp, women’s health GP and consulting doctor with women’s health platform Juniper, an online weight management clinic for the treatment of obesity in Australia, explains.
“We know that for some people when they diet and reduce their food intake drastically, it can lead to an initial weight loss but also a slowing of their metabolism and great difficulty keeping the weight off,” says Dr Sharp.
“They can also feel like their hunger is sabotaging their progress, and this is due to leptin resistance. These medications work to reverse this trend in the way that it works through GLP-1 analogues and leptin levels.”
In a large-scale study published in the International Journal of Obesity, this class of medication saw patients lose on average 12% of their body weight in one year when paired with behavioural changes. Which was twice as much weight loss than participants making lifestyle changes alone.
Why Would Someone Use Weight Loss Injections?
Weight loss injections may be recommended by a GP or endocrinologist for people who live with obesity, diabetes, or a chronic health concern as a result of being overweight.
It’s not usually recommended as a first option, but may be offered to people who have tried a number of lifestyle changes in the past with limited success, or as an alternative to bariatric surgery.
“In a significant number of cases, GLP-1 antagonists have been found to reverse pre-diabetes in high-risk patients.
“It’s also known to treat obstructive sleep apnea, improve blood pressure, cholesterol, waist circumference, improve symptoms of perimenopause in women, and improve patients’ quality of life – both physically and psychologically,” Dr Sharp tells us.
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Do Weight Loss Injections Actually Work?
Weight loss injections, or rather GLP-1 antagonists, are effective on their own in terms of weight loss and weight management, but in order for people to see lasting results, lifestyle changes need to be made too.
“In order for a patient to maintain a lower body weight after coming off the medication, they’ll have needed to form sustainable long-term habits while on the medication,” says Dr Sharp.
“Changes to one’s diet, movement, sleep, and stress are essential for lasting weight loss beyond medication.”
With obesity now considered a chronic disease in Australia, and with 67 per cent of Australian adults overweight or obese, weight management programs using these medications have become more widely available.
The platform Dr Sharp consults with, Juniper, is one that prescribes weight loss medication while also providing online support from health coaches and dietitians, weekly text-based check-ins with GPs, and a private community.
Why Do Some People Struggle More With Weight Loss Than Others?
As for why weight management is an issue for some and not others? Well, there are a few competing theories.
Some studies suggest weight is genetic. More than 400 different genes have been implicated in the causes of overweight or obesity, with these genes affecting appetite, satiety (the sensation of fullness), metabolism, cravings, body-fat distribution, and eating as a coping mechanism for stress.
Studies suggest that as much as 80% of our weight may be genetic, which would explain why some people have more trouble than others maintaining their weight.
The more popular theory amongst the medical community today centres around a person’s ‘set point’. “Your ‘set point’ is the weight your body fights to maintain,” says Dr Sharp.
“Set point theory says that each of us has a preset weight baseline hardwired into our DNA. The idea is that some of us have higher weight set point than others, and our bodies fight to stay within these ranges.”
Weight loss medication may be prescribed to people whose set point sits higher than others’, because the effects of the medication can lower a person’s set point over time and pause the fight within the body that keeps a person’s weight at a baseline.
When Is Weight Care Treated As a Medical Issue?
In 2009, obesity was recognised as a disease in Australia. And with the approval of weight loss medications, doctors are able to provide care plans for people who wish to treat weight management in this way.
It’s not for everyone – and while there’s, of course, never a need to make weight changes unless someone wants to for their own reasons (whether it’s health-related, prevention, or otherwise), there are now tens of thousands of people using these medications in Australia.
“I see in patients an improvement in conditions such as diabetes and blood pressure as well as their mood. We often treat patients who have been battling with their weight for years and developing associated conditions along the way,” she says.
“We also see people who have been through bariatric surgery but find they need help to prevent the weight creeping back on.”
