Strona główna zdrowie Ultimate guide to weight-loss jabs: Top experts answer every question, from what...

Ultimate guide to weight-loss jabs: Top experts answer every question, from what REALLY happens to your body, the upsides and downsides, to how to pick the right one for you

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They’ve been dubbed 'game-changers’ in the world of obesity, making the seemingly impossible, possible – significant weight loss with minimal effort.

They are, of course, the new weight-loss injections – there are five so far: Ozempic and Wegovy (which both contain the active drug semaglutide); Mounjaro (tirzepatide), as well as Saxenda and Victoza (both contain liraglutide). There are at least another 20 in the pipeline.

The appeal is obvious: their results are phenomenal. Some patients taking tirzepatide (the active ingredient in Mounjaro) lost up to 22.5 per cent of their body weight in just 16 months, according to a major study published in the New England Journal of Medicine in 2022.

Meanwhile, 91 per cent of the study participants lost at least 5 per cent of their weight (on average, 11.6lb).

High-profile Ozempic success stories such as Stephen Fry and Oprah Winfrey have helped drive the surge in interest in these drugs.

Not surprisingly there’s been a 62 per cent increase in Google searches for 'weight-loss injections’ in the past year.

’With one in four adults in the UK living with obesity, there’s a definite place for weight-loss medication – we’ve been using them for exactly that in the NHS since 2015,’ says Dr Foteini Kavvoura, a consultant endocrinologist at the Royal Berkshire NHS Foundation Trust.

’It obviously improves your health short-term, and these medicines may also lower the risk of serious health conditions, such as kidney disease, heart disease, heart failure and stroke. It can have a knock-on effect on mental health, as well, enabling people to go back to work.’

Oprah Winfrey at the Golden Globes in January 2024. She has been deemed an Ozempic success story

Oprah Winfrey at the Golden Globes in January 2024. She has been deemed an Ozempic success story

Stephen Fry in 2020. He was an early user of Ozempic for weight loss after his doctor in the US gave it to him

Stephen Fry in 2020. He was an early user of Ozempic for weight loss after his doctor in the US gave it to him

’But they aren’t a quick fix,’ adds Dr Kavvoura. 'Despite the hype, weight-loss injections can cause unpleasant side-effects in some, such as nausea, vomiting and diarrhoea.’

Indeed, there’s been a surge in bad reactions to the jabs as well as hospital admissions, says the watchdog Medicines and Healthcare products Regulatory Agency.

They’ve also now been linked to the first death in the UK – tirzepatide was recorded as a contributing factor in the death of nurse Susan McGowan, 58, from North Lanarkshire.

’These drugs have been around for nearly 17 years to treat type 2 diabetes and extreme side-effects are very rare,’ says Alex Miras, a consultant in endocrinology at Imperial College Healthcare NHS Trust in London.

’But it’s important to remember they are medications specifically designed to treat diabetes and obesity, not as just a cosmetic tool for someone to lose a few kilograms: they should only be taken under medical supervision.’

Yet increasingly people are buying the jabs online.

’You not only risk being scammed but also getting medication that isn’t what it says it is, and the implications of that can be serious,’ says Professor Miras. Then there’s the lack of data on how safe this medication is for people who aren’t obese and have type 2 diabetes.

So where does that leave people struggling with weight gain?

In the latest in our series of essential health guides, we’ve joined forces with experts to help you navigate the hype about weight-loss jabs, so you can decide what’s best for you…

How the jabs work

The active ingredient in the various weight-loss injections may vary, but the way they work is essentially the same, as Professor Miras explains: 'They help you feel fuller for longer and reduce your appetite.’

The jabs mimic a key hormone, glucagon-like peptide-1 (GLP-1), which is naturally produced by the intestine when you eat. It helps the body produce more insulin, reduces sugar in the bloodstream and slows down the speed at which food is digested.

This helps control blood sugar levels. In fact, these drugs were first developed for diabetes, but weight loss as a side-effect was noted.

’This weight loss isn’t just because the gut slows down, but also because of the way the drug acts on the brain,’ explains Professor Miras. 'We think it works on the brain’s reward pathways to dampen down the appeal of cakes and chocolate, for instance.

’GLP-1 also sends messages to the brain to say that we’re full.’

This affects appetite, and people eat less – typically 1,200 to 1,500 calories a day for a woman and 1,500 to 1,800 calories a day for men, hence the weight loss.

’But eating less food means, in some cases, that dietary supplements may be necessary, adds Dr Kavvoura. 'Many people are already deficient in vitamins when they’re obese, because of a poor diet. If they don’t change their eating habits, they eat less but still poorly and the risk of deficiencies only increases.’

And for some people these jabs simply don’t work – 14 per cent of people in a trial published in the New England Journal of Medicine in 2021.

’Why this happens we don’t know,’ says Professor Miras, 'but if you haven’t lost at least 5 per cent of your body weight after taking the full dose for three to six months, you’ll probably need to change the treatment or look to other ways to lose weight.’

There has been a 62 per cent increase in Google searches for 'weight-loss injections' in the past year

There has been a 62 per cent increase in Google searches for 'weight-loss injections’ in the past year

How can I get Ozempic?

The new jabs are available on the NHS if you meet strict criteria: a BMI of 30-35 and over (or 27.5 for some ethnic groups), with at least one weight-related condition such as high blood pressure.

You can get these jabs privately; the eligibility is less strict, as it’s according to the drug’s licence not the NHS criteria – a minimum BMI of 27 with at least one obesity-related complication.

’But with Ozempic and Mounjaro, you also have to have type 2 diabetes because they’re only licensed for this,’ says Professor Miras.

However, some people clearly are getting hold of these jabs just for weight loss. And it may be that Mounjaro will soon be licensed for this anyway – final guidance from the National Institute for Health and Care Excellence (NICE) on this is expected next month.

If you’re considering a private clinic, look for one that offers support and lifestyle advice. Check the clinic has been inspected by the Care Quality Commission for safety: cqc.org.uk.

Should I buy online?

The demand for weight-loss jabs has far outstripped supply and in June the World Health Organisation issued a global alert about the risks of fake semaglutide.

’Always go to a registered online pharmacy,’ says Laura Wilson, director of the Royal Pharmaceutical Society in Scotland.

’Look for the green cross badge, like you see on prescription bags from a pharmacy. Next to this badge will be the words 'Registered Pharmacy’ and a registration number. This means it’s been inspected by the General Pharmaceutical Council and meets their strict regulations. If you can’t see these words, check they’re registered at pharmacyregulation.org.’

She adds: 'If there’s no physical address or phone number; and if you can’t call and ask questions, then don’t buy from them.

’Alarm bells would also be ringing if you’re offered these medications without a prescription.’

Reputable pharmacies will get you to fill in online forms about your weight, medical history and any current medications – they may also ask you to upload pictures. This information will be reviewed by doctors to see if you meet the criteria set out in the drug’s licence. They may offer further periodic check-ins or even face-to-face consultations.

’If these processes aren’t followed, just move on, as who knows what’s going to arrive on your doorstep,’ says Laura Wilson.

How do I self-inject?

If you’re receiving medication through the NHS or privately, you will be shown how to inject them first-time round – but instructions are included with the jabs.

’The actual process is simple and nothing to get worried about,’ explains Dr Ralph Abraham, a consultant in endocrinology and diabetes at the London Diabetes Centre.

The needle, which is 3-4mm long, smaller than a drawing pin, is very fine, which reduces discomfort.

It goes just under the skin, in an area of fatty tissue. The most common location is the abdomen, though you can also use the thigh or upper-arm. Vary the location to prevent bruising or skin damage. Ensure you have a new needle for each injection; if it’s unsealed or damaged, use another one.

Sharon Osbourne has said she¿d ¿lost 3st in four months [on Ozempic]. Too much'

Sharon Osbourne has said she’d 'lost 3st in four months [on Ozempic]. Too much’

How to avoid looking too thin

While using a fat jab may do wonders for the waistline, there’s one part of your body that may not benefit: your face.

The speedy weight loss the drugs can deliver can extend to a dramatic reduction in facial fat, leading to so-called Ozempic face: the loss of plumping fat can make wrinkles more prominent and the face look sunken and pinched, with sagging skin around the jowls, and sunken-looking eyes.(Sharon Osbourne has said she’d 'lost 3st in four months [on Ozempic]. Too much’).

The net result? 'Patients who undergo huge weight loss can seem up to five years older than similarly aged people’, according to a paper in Plastic and Reconstructive Surgery – Global Open earlier this year. Yet those 'prescribing Ozempic seldom counsel patients about the potential impact on the face’, reported another journal, Facial Plastic Surgery in 2023.

The authors, from the University of Kansas School of Medicine in the US, proposed 'dermal fillers, skin tightening techniques and surgical interventions’ for the 'restoration of facial volume’. Steps to help avoid the problem include eating protein with each meal (to shore up the skin structure) and switching medications if weight loss is too rapid.

Who CAN’T have the jabs 

ANYONE OVER 75: Due to a lack of clinical trials on the over-75s, these drugs may not be suitable. 'Losing muscle mass and fat is an additional concern in this age group – it can lead to weakness, poor balance and frailty,’ says Dr Fareeha Rizvi, an endocrinologist at Barts Health NHS Trust.

IF YOU’RE PREGNANT OR BREASTFEEDING: Guidelines note you should stop taking these drugs two months before getting pregnant. 'Women on these medicines should use a non-oral form of contraception, as they can hinder the absorption of contraceptive pills,’ says Dr Foteini Kavvoura, an endocrinologist at the Royal Berkshire NHS Trust.

YOU’VE HAD PANCREATITIS OR GALLSTONES: They may increase them, see below.

What really happens to your body when you’re on Ozempic  

The upside 

CURB SWEET CRAVINGS…

Semaglutide (the active drug in Ozempic and Wegovy) reduces the desire for sweet foods, reported researchers at the University Medical Centre in Ljubljana, Slovenia, earlier this year – improving taste sensitivity and increasing activity in the brain’s reward centre.

Studies have shown that people who are obese perceive tastes as less intense, so they need more of a food for the brain to register it. 'This adds to the theory that semaglutide helps people perceive sweet foods in the same way as those who aren’t obese, and not crave them,’ says endocrinologist Dr Foteini Kavvoura.

Dr Foteini Kavvoura, an endocrinologist at the Royal Berkshire NHS Trust

Dr Foteini Kavvoura, an endocrinologist at the Royal Berkshire NHS Trust

…AND FOR ALCOHOL

Along with hunger, you may find your desire for alcohol diminishes. A recent study at the University of Northern Carolina found heavy drinkers given semaglutide reduced their alcohol intake significantly compared with a placebo group. The drug seems to dampen down the brain’s reward system, says Professor Alex Miras, a consultant in endocrinology at Imperial College Healthcare NHS Trust in London.

…AND CIGARETTES

Semaglutide may help reduce your desire to smoke. A 2024 study in the journal Annals of Internal Medicine based on data from around 6,000 people taking semaglutide found that those who wanted to quit were 32 per cent less likely to need medication or counselling to help them. Again, this could potentially be because of the drug’s impact on the brain’s reward system.

MAY SLOW DEMENTIA

This year, an Imperial College London study of 200 patients with mild Alzheimer’s disease suggested that liraglutide (brand name Saxenda) may reduce cognitive decline by 18 per cent after one year. As well as reducing inflammation, it may somehow reduce the toxic effects of the plaques in the brain linked to the disease, or improve how the brain’s nerve cells communicate, researchers said.

GLP-1 drugs may help with Parkinson’s, too. A 2024 trial in the New England Journal of Medicine found patients with early Parkinson’s taking an older GLP-1 diabetes drug called lixisenatide experienced no worsening of motor symptoms over a year compared with patients on a placebo.

IMPROVES HEART HEALTH

Semaglutide may reduce the chance of heart disease even if you don’t lose weight on it. Research by University College London, with 17,000 people who’d had a previous cardiac event such as a heart attack and who were overweight or obese, found they had a 20 per cent lower risk of another such event if taking semaglutide.

’The drug may reduce low-level inflammation in blood vessels that can cause them to become blocked and this heart benefit is independent of weight loss,’ says obesity expert Professor Miras.

PROTECTS KIDNEY FUNCTION

As with hearts, semaglutide may help protect kidney function independent of weight loss in people who are overweight or obese.

In a study presented at the European Renal Association Conference in Sweden this year, patients with kidney disease taking semaglutide had a 24 per cent lower risk of needing dialysis or dying over the three-and-a-half-year trial – possibly due to its effect on inflammation.

…And the downside 

NAUSEA

Around 30-40 per cent of people taking GLP-1 drugs experience nausea, says diabetes expert Dr Fareeha Rizvi – this may be because of their effect on brain areas that control appetite. 'This is usually mild and transient, but it can lead some patients to discontinue treatment.’

DIARRHOEA/CONSTIPATION

Gastrointestinal problems are common and are the reason up to 10 per cent of patients stop the injections. They tend to occur more frequently with higher doses, or when changing to a new dose. These side-effects are caused by the drugs slowing down transit through the gut.

EGGY BURPS

A common side-effect is burping, sometimes with an unpleasant smell. This may be due to the drug slowing the digestive system down and leaving food to linger for longer than normal, says endocrinologist Dr Ralph Abraham.

’The drug itself may also increase levels of sulphur-producing bacteria in the gut by altering the microbiome [the community of microbes there].’

Dr Fareeha Rizvi, an endocrinologist at Barts Health NHS Trust

Dr Fareeha Rizvi, an endocrinologist at Barts Health NHS Trust

PANCREATITIS

Some animal studies suggest that GLP-1 medications increase pancreatic inflammation, leading to acute pancreatitis, a medical emergency.

’This may be related to the overgrowth of cells in the pancreas,’ says Dr Rizvi. While there’s little evidence that they do this in humans, 'if you have sudden severe and constant pain in your stomach area, with or without vomiting, seek urgent medical attention’, she warns.

GALLSTONES

Rapid weight loss can increase the risk of gallstones, hardened deposits that form as the gallbladder doesn’t empty properly – this appears to be true with weight-loss medication, too. A 2022 review in the journal JAMA Internal Medicine found that GLP-1 treatment was associated with a 27 per cent greater risk.

PARALYSED GUT

GLP-1s have been linked to an increased risk of stomach paralysis, or gastroparesis (where the passage of food passage slows down, leading to nausea, vomiting, gut pain, bloating and heartburn), according to 2023 research by the University of British Columbia based on 16 million people. This is a chronic condition that can’t usually be cured.

DEPRESSION

The UK drugs watchdog, the MHRA, has received more than 100 reports since 2019 linking semaglutide to depression. However, obesity expert Professor Alex Miras believes this would not be directly due to the medication, but to the change in eating habits. 'Psychologically some people just don’t respond well to this: usually these are people for whom food is an emotionally regulating substance which reduces stress among other things.’

MUSCLE LOSS

Weight loss doesn’t discriminate between fat and muscle: research in the journal Lancet Diabetes & Endocrinology suggests muscle loss from GLP-1s ranges between 25 to 39 per cent of the total weight lost. Muscle is vital, particularly as we age, for maintaining our balance and strength. It’s also important for maintaining weight loss – muscles burn calories when we’re at rest.

How to find the right injection to suit you

Semaglutide is used in Wegovy and Ozempic, and liraglutide is the active ingredient in Saxenda and Victoza

Semaglutide is used in Wegovy and Ozempic, and liraglutide is the active ingredient in Saxenda and Victoza

There are two active ingredients used in the jabs – semaglutide (in Wegovy and Ozempic) and liraglutide (Saxenda and Victoza), which mimic the effects of GLP-1.

Tirzepatide (in Mounjaro) mimics both GLP-1 and another hormone, glucose-dependent insulinotropic polypeptide (GIP).

’For all these medications, the treatment is started at a low dose and gradually increased, every month, until either the maximum dose or maximum tolerated dose is reached,’ says Alex Miras, a consultant in endocrinology at Imperial College Healthcare NHS Trust in London.

’That way the side-effects are reduced, too. Going too fast to a high dose can cause major side-effects and people stop taking the medication.’

He adds: 'However, not everyone needs to reach the maximum dose, they should only stay on the dose that is enough to improve their health.’

The jabs here come as a weekly self-injection using a pre-filled pen – except Saxenda, which is a once-daily injection.

Ozempic 

While both Ozempic and Wegovy are made by Novo Nordisk, Ozempic is only licensed for diabetes and is prescribed at a lower dose. So for weight loss, you’d have to be prescribed it privately.

HOW MUCH YOU MAY LOSE IN A YEAR: The average weight loss (for non-diabetics) is 8 per cent of your body weight on the maximum dose.

DOSE: It starts at 0.25mg, increasing to a maximum of 1mg.

COST? From £149 per month on lowest dose (0.25mg); £165 per month for high dose (1mg).

Wegovy

Licensed specifically for weight loss and the dosage of semaglutide is higher than for Ozempic.

HOW MUCH YOU MAY LOSE IN A YEAR: On average, 16 per cent loss of body weight if on the maximum dose.

DOSE: Dosage starts at 0.25mg, increasing to a maximum dose of 2.4mg.

COST? For the lowest (0.25mg) dose, expect to pay from £130 per month; on highest dose (2.4mg), from £269 per month.

Mounjaro

Manufactured by Eli Lilly, this injection contains tirzepatide and is licensed for weight loss.

HOW MUCH YOU MAY LOSE IN A YEAR: On average 22 per cent of body weight if you are taking the maximum dose.

DOSE: This starts at 2.5mg up to a maximum dose of 15mg.

COST? From £130 per month on the lowest dose, then from £180 per month on the highest dose.

Saxenda

This is licensed for weight-loss: it contains liraglutide which works like semaglutide.

It is also available as a diabetes treatment, under the brand name Victoza, at a lower dose.

HOW MUCH YOU MAY LOSE IN A YEAR: On average 8 per cent of body weight if taking the high dose.

DOSE: Dosage starts at 0.6mg and up to a maximum 3mg.

COST? From £140 per month on lowest dose, and from £239 per month for the highest dose.

Generic, unbranded liraglutide is set to be released, so it may be possible to get it for cheaper.

Battling weight gain if you stop  

A 'weight-loss plateau is common in many weight-loss methods,’ says obesity expert Professor Alex Miras. He explains that the medications work on the brain to change your body’s weight 'set point’ – turning down the thermostat that controls body weight until it reaches this new set point.

’What we do then – patients going cold turkey, gradually reducing the dosage, or, continuing indefinitely – is decided on an individual basis,’ adds diabetes expert Dr Fareeha Rizvi. The problem is that 'unless you have also been able to change your habits around food and activity this means the weight is likely to return’, she says.

A 2021 study at the University of Liverpool showed that after 68 weeks the average patient had lost more than 15 per cent of their body weight, but within 12 months of semaglutide treatment ending, they regained two-thirds of this. The weight regain is typically faster than the time it took to lose the extra pounds – 'people put most of it back on in the first three to six months’, says Professor Miras.

’Only a small proportion, 5-10 per cent, are able to maintain all the weight they lost on the medication with diet and lifestyle changes alone.’

Obesity expert Dr Ralph Abraham adds: 'This is why my private diabetic patients are on weight-loss injections long-term. But we don’t fully know the risks long-term as the drugs haven’t been around that long.’

Some people (around 5 per cent) reportedly struggle to put weight back on after the jabs. But it’s not clear if this is the case or if they’re the minority who are able to maintain weight loss without the drugs.

I lost 4st with Mounjaro – now my hips hurt less  

Diana Collette, 65, now weighs 9st after taking Mounjaro

Diana Collette, 65, now weighs 9st after taking Mounjaro

Diana Collette, 65, a mother-of-two, lives in Hampshire with husband Terry, 68, and the pair run a family business. She says:

I piled on weight in lockdown – I’m 5ft and weighed around 9st but during lockdown I had changes to my HRT and it threw my hormones out of kilter, and I put on 4st.

It was upsetting as I’ve always been fit and healthy. And as the weight piled on, I began to lose confidence.

My daughter then announced she was getting married and I didn’t want to be a big 'mother of the bride’ so, two years ago, ahead of her wedding in September this year, I started trying to lose the weight.

I tried low-carb, low-calorie diets, intermittent fasting and saw a health coach on the NHS. Even she said she didn’t know why I wasn’t losing weight, as I was doing all the right things.

My 'mild’ hip and knee problems were now causing me a lot of grief. So earlier this year, I resorted to the internet looking for answers and came across myjuniper.co.uk – I liked that it offered a programme where you’d be monitored and assessed throughout. The firm offered me Wegovy and Mounjaro – I chose the latter as it seemed to have quick results.

I started on a 2.5mg dose and lost around 1st in six weeks: the dose was gradually increased until it reached 10mg.

The drug seemed to affect how I felt about food – I used to have chips on my plate but the thought of them became abhorrent. It was the same with alcohol. I was also less hungry.

After six months I was 8st 8lb, a little too light for me, so I’ve put on a few pounds. I’m happier at 9st.

I had a few side-effects, like a little nausea, but they were manageable.

Two months since I stopped the jabs my appetite is still reduced. I’m exercising as much as possible and my hip and knee problems have improved.

It’s vital you eat protein 

Weight-loss jabs work, in part, by curbing your appetite.

And due to the fact you’ll be eating less, 'you have to prioritise certain nutrient-rich foods as your calorie intake is naturally lower’, advises Charlotte Foster, a dietitian at Barts Health NHS Trust, with an interest in weight loss.

’Focus on fruits, vegetables and wholegrains. Make sure the foods are low in added sugar, salt, saturated fats and cholesterol.’

She adds: 'But what’s really important is protein – needed for both building and repairing muscle.’ This is because people on weight-loss jabs can lose signficant amounts of muscle mass.

’Choose lean meats and poultry, seafood, eggs, beans, peas, soy products, nuts and seeds. A rough guide is 1g per kilo of body weight,’ she suggests.

Obesity expert Professor Alex Miras says: 'Exercise is also important in limiting muscle loss – especially through strength training, such as weightlifting, squats, press-ups and stair climbing.’

’Super’ jabs on the horizon

The new drugs coming soon won’t just be about improving weight-loss rates but, more importantly, lessening side-effects, says Giles Yeo, a professor of molecular neuro-endocrinology at the University of Cambridge.

There are more than 20 known to be in development, and dozens more to come.

Currently there’s a lot of hype around CagriSema, a weekly jab combining semaglutide with cagrilintide (this mimics amylin, a hormone that helps you feel full after eating). Data due out next month is expected to show weight loss of 25 per cent in a year.

Another drug, retatrutide, is showing similar results, an average 24 per cent weight loss – but in just 24 weeks, reported the New England Journal of Medicine last year.

It mimics GLP-1 and two other hormones, GIP and glucagon – this triple hit not only delivers the message in bulk, but means you need less of the active ingredient for each hormone, reducing side-effects. Indeed trials show constipation, nausea and diarrhoea are less severe.

But there’s a potential blockbuster on its way: MariTide, a monthly injection.

An early-stage trial in Nature Metabolism this year showed that those on the highest dose of the drug lost an average of nearly 5 per cent of their body weight after seven days and 14.5 per cent after 12 weeks.

’In just three months achieving what takes two years on Wegovy,’ says Professor Yeo.

And patients kept the weight off for up to around five months after their last dose.

He adds: 'If this is successful, we’re now able to imagine a situation where people could have six months of monthly injections then, if necessary, go for top-up doses once or twice a year – like the flu jab.

’All these options are fantastic,’ says Professor Yeo. 'But there’s the issue of cost, particularly relevant for the NHS.’

However, this will change: the EU and US patents on semaglutide (Wegovy and Ozempic) expire in 2031 and 2032 respectively.

’Firms are no doubt preparing similar versions for when the protections lift, then the prices really will plummet,’ adds Professor Yeo.

Would pills, diet shakes or even a balloon op work better? 

Our expert guide to the most popular alternatives to jabs for those struggling to lose weight.

Weight-loss tablets

Semaglutide, the active ingredient in Wegovy and Ozempic, is available in a once-a-day pill called Rybelsus, for diabetes, although it can be prescribed off-label for weight loss privately.

It’s given in a much higher dose than Wegovy (14mg compared with 2.4mg) because it’s taken orally and much of the drug itself is destroyed by stomach acid.

In one study in 2022, people taking Rybelsus lost 17.4 per cent of their body weight after 68 weeks – similar to the effects of the jabs. (It has similar side-effects, too.)

Berberine, a compound found in goldenseal, is a popular weight-loss remedy in the US – it’s thought to affect fat distribution. A review in 2021 found that it reduced body weight by an average 5.7lb (2.6kg). Experts say larger studies are needed. 

Orlistat (brand names, Xenical or Alli) works by stopping dietary fat being absorbed in the gut and has to be taken alongside a low-fat diet, to avoid side-effects such as stomach pain and diarrhoea.

Available since 1998, this can be prescribed by your GP if you have a BMI of 28 and above and other risk factors such as high blood pressure.

’Its effect is small compared to the newer weight-loss injections,’ adds endocrinologist Dr Foteini Kavvoura. A 2004 review by Aberdeen University concluded that adding orlistat to a low-fat and low-calorie diet improved weight loss by 3.26kg in 24 months.

Xenical costs £58 for 84 pills. Alli is available for £55. Non-branded orlistat costs £50.

Soup/shake diet

The NHS is currently rolling out its new Type 2 Diabetes Path to Remission Programme, which provides patients with three months’ worth of low-calorie, nutritionally complete diet replacement products (soups, shakes and bars), plus support and monitoring.

Participants have typically lost an average of 7.2kg after one month and 13kg in three months.

Another option is at thefast800.com, with tailored meal plans you prepare yourself (including calorie-controlled soups and shakes) and support (£119 for 12 weeks).

Swallow a balloon

This 20-minute procedure requires no surgery and is available on the NHS. 'The balloon, which can be swallowed or inserted, is filled with sterile saline and remains in your stomach – historically for six months although some brands can remain for up to a year,’ says Professor Chetan Parmar, a consultant bariatric surgeon at the Whittington Health NHS Trust in London.

A 2020 study, in the Annals of Translational Medicine, reported weight loss of 7-10kg after six months. Privately, the procedure costs from £2,000.

Bariatric surgery

There’s been a big drop – 25.6 per cent – in patients undergoing weight-loss surgery for obesity, according to new US figures.

But it’s still the most effective treatment for obesity and is more cost effective than a lifetime of weight-loss medication, says Professor Parmar.

A 2018 study in JAMA Surgery found that patients lost an average of 28 per cent of their body weight after a gastric bypass – and, importantly, most maintained their weight loss in the three to seven years afterwards, regaining on average just 3.9 per cent.

Bariatric surgery, which is available on the NHS if you meet the criteria, reduces the amount of food you can eat.

The most common ops are gastric bypasses or a sleeve gastrectomy (the stomach is reduced to a 'sleeve’ shape).

Privately, a gastric bypass costs around £10,000; a sleeve gastrectomy is priced around £9,000.

Jabs didn’t work for me – but surgery has!

Carlene Taylor, 44, got a gastric sleeve fitted in Turkey in September and has already lost 2st 7lbs

Carlene Taylor, 44, got a gastric sleeve fitted in Turkey in September and has already lost 2st 7lbs

Carlene Taylor, 44, has three grown-up children and works for a charity and lives in Southampton. She says:

Honestly, I wish I’d never tried weight loss jabs – I’d be slimmer and richer.

I’ve been on the larger side most of my adult life but diets never worked so, in 2022, when I saw people on TikTok talking about Saxenda I thought it was worth a go.

I weighed 16st and at 5ft 4in had a BMI of 38 – 'obese’ – but my GP said I didn’t qualify for weight management help, so I bought Saxenda from an online pharmacy. I tried it for six weeks and lost a stone. My appetite vanished but it cost £57 for 14 days’ worth and I couldn’t afford it. I then put the stone back on faster than I lost it.

A few months later, I saw influencers talking about a black market version of Wegovy, which was £40 a week online. After the first jab I was vomiting for days. I also had the worst headaches and didn’t leave the house for days.

But I was so desperate to lose weight I persisted and, after eight weeks, lost a stone. But the side-effects were so awful I stopped – and piled on 2st in weeks.

A few months later, I decided to try an online pharmacy for Ozempic. It cost £160 a month but by now I was 16st – I lost a stone but I felt really light-headed. Also with three children I couldn’t afford it, so I stopped after a month. My hunger increased tenfold and I put on 2st.

By two years ago, I was over 17st 12lb, my heaviest.

In September, I had a gastric-sleeve op in Turkey. I saved every penny I could for months to pay the £2,200 cost.

I’ve already lost 2st 7lb in seven weeks. Yes it was surgery and I now have to take acid reflux pills as a result, but for me it was the right choice.

I know first-hand with the jabs that when you stop, the weight comes back on faster and harder.



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