+44 7893 947543
Mon - Fri 09:00 - 17:00
Obesity is defined as the excess accumulation of body fat to the extent that it may have negative effects on health. It is a leading cause of morbidity and is increasingly linked with increased risk of multiple medical conditions, including cardiovascular, metabolic disease and elevated rates of some cancers.
It is recognised as a multi-system disease, caused by a combination of genetic factors, mental health conditions, urbanisation (including ultra-processed diets) and endocrine disorders.
There is increasingly strong evidence that intensive lifestyles interventions alongside anti-obesity medications can help enhance short term weight loss whilst also maintaining long lasting results.
The newer medications Mounjaro and Wegovy have been recently licenced for weight loss in the UK and have shown ground-breaking results. Helping to suppress appetite and reduce gastric emptying via its action on GLP1, and in Mounjaro’s case a beneficial dual action of GLP1 and GIP works synergistically to improve insulin sensitivity and appetite reduction.
However, patients must be mindful as weight regain following cessation of treatment with GLP1 agonists is common. A study done in 2019 demonstrated that one year after withdrawal of once-weekly subcutaneous Semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss,
Interestingly, the findings of the 72-week SURMOUNT-3 study, provided evidence that Tirzepatide (Mounjaro) led to additional weight loss in people who’d already lost 5% or more of their body weight due to lifestyle interventions before starting the drug.
Showing that behaviour changes seem to enhance the effects of the medication,
How does Intensive lifestyle intervention work?
“To change your body, you must first change your mind” Toni Sorenson
Accountability is key to maintaining lifelong changes in weight loss. Ensuring patients are mindful of their calorie intake through documenting through apps/food diaries is key to ensure they maintain a calorie deficit.
Often, I find patients are not eating mindfully, with binge or emotional eating being commonplace which often serves to sabotage their efforts.
Social support is also key to lifestyle adjustments, very little has been studied to the importance of this area. But there is definite evidence and I have personally noted anecdotally a huge impact from patients being involved in either a local support group or via social media.
Finally, mindfulness is important to integrate into any patient’s routine who is wanting to maintain weight loss following pharmacotherapy.
Mindfulness in the form of eating relates to reduction of emotional eating episodes, eating slowly with minimal distractions. This is thought to build the pre-frontal cortex, a region of the brain involved in willpower against eating unhealthy foods.
Mindful meditation with deep breathing causes the patient to relax causing a reduction in the stress hormone cortisol. This hormone works in several ways to cause weight gain, including increasing appetite, insulin production and fat deposition.
Thanks for reading, if you are interested in enrolling in our GP- led weight loss service please click the following link to book.
Our GPs are all SCOPE trained and will help to guide you through any queries you may have relating to your chosen GLP-1 medication, whilst also helping you via adjusting your lifestyle to maintain your weight loss long term.
Written by Dr Christian Winiger
Medical Director
DrOnline UK
https://www.nature.com/articles/s41366-024-01499-2
https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14725
https://newatlas.com/medical/lifestyle-intervention-plus-tirzepatide-leads-to-additional-weight-loss
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522530