GLP-1 Weight-Loss Jabs: What We’re Not Being Told

By Rob Verkerk PhD, executive & scientific director, ANH

In less than five years, GLP-1 receptor agonist (GLP-1 RA) drugs like Ozempic, Wegovy and Mounjaro have rocketed from niche diabetes treatments to global blockbusters hailed as “miracle weight-loss jabs”. With governments, celebrities, and social media influencers all on board, the injectable drugs are now being prescribed at scale, including across the UK and EU, with potential expansion into pharmacies and over-the-counter sales globally, with the World Health Organization (WHO) stamp of approval. Last week, the Tony Blair Institute (TBI) advocated that 15 million Brits should receive the jabs in the post over the next two years. While it would cost 6% of the NHS budget in the first year, the think tank’s modellers found break-even would occur “within 10 years” with “cumulative fiscal benefits estimated at £52 billion by 2050”, mainly by keeping people in work longer.

Yet amid the euphoria, questions are growing louder—and with good reason. Are we witnessing another pharma-fuelled bubble, one that downplays real risks, oversells benefits, and ushers in lifelong medicalisation for millions under the banner of obesity management? At ANH, we believe in informed health freedom—and that means asking critical questions when the mainstream fails to.

UK drug regulator advice to health professionals

UK data reported by The Independent suggests that only around 4,000 people a month get weight-loss jabs on the NHS, while around 1 million Brits buy them privately, including online. This might suggest many who use the jabs are not able to exercise properly informed consent prior to their use. As a result, we thought it appropriate to start by summarising the advice given by the MHRA to health professionals. This advice dated 24 October 2024 (at the time of writing), warns as follows:

Common Side Effects

The MHRA notes that gastrointestinal side effects are prevalent, especially at the start of treatment or after dose increases.

These include:

• Nausea
• Vomiting
• Diarrhoea
• Constipation

These symptoms can persist for several days and may affect more than 1 in 10 patients. They can lead to dehydration, which, if severe, may result in kidney damage requiring hospitalization. Patients are advised to stay well-hydrated by drinking plenty of fluids to mitigate this risk.

Serious Side Effects

While less common, the MHRA highlights several serious side effects:

• Pancreatitis: Inflammation of the pancreas, presenting with severe abdominal pain.
• Gallbladder Disease: Including gallstones, which may require medical intervention.
• Serious Allergic Reactions: Such as anaphylaxis, which is a medical emergency.
• Delayed Gastric Emptying: GLP-1 RAs can slow stomach emptying, increasing the risk of residual gastric contents during surgery, potentially leading to pulmonary aspiration under general anaesthesia or deep sedation.

Additional Considerations

• Hypoglycaemia: Particularly in non-diabetic patients or when combined with other glucose-lowering agents.
• Misuse and Unregulated Sources: The MHRA warns against obtaining GLP-1 RAs from unauthorized sources, such as unregistered online pharmacies, due to risks of counterfeit products and misuse.

Recommendations for Healthcare Professionals

• Prescribe GLP-1 RAs only within their licensed indications and under appropriate medical supervision.
• Educate patients on potential side effects and the importance of adhering to prescribed dosages.
• Advise patients to report any adverse effects promptly.
• Encourage reporting of suspected adverse reactions through the Yellow Card scheme to monitor medication safety.

For comprehensive details, please refer to the MHRA’s full advisory: GLP-1 receptor agonists: reminder of the potential side effects and to be aware of the potential for misuse.

The TBI report released last week (see above) was somewhat coy about side effects highlighting primarily the pancreatitis and gallbladder inflammation risks, but did point to a study that showed “recent data collected through the Yellow Card scheme in England showed higher-than-expected deaths in patients taking GLP-1s.”

The promise – but at what price?

No one can deny the dramatic weight loss some users experience. Social media feeds are full of it. For individuals with intractable obesity and associated complications, these injections may indeed represent a lifeline. But the public is being sold a simplified story—one of effortless slimming without the caveats.

Here’s what’s often left out, even from the MHRA advisory to health professionals:

• Many users regain the weight within a year of stopping the drug, according to multiple studies, including a recent systematic review and meta-analysis published in Obesity Review.
• Muscle loss accounts for a stunning 15–40% of the total weight lost—raising the indirect risk of frailty, immune dysfunction, bone health issues, and long-term metabolic instability.
• Emerging data suggest nutrient deficiencies, mental health changes including increased risk of depression, anxiety and suicidal behaviour, and potential thyroid cancer risks, especially with prolonged use.

All of this is aside from the common and serious side effects that regulators like the UK’s drug regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), has told health professionals to inform their patient about. These are summarised below.

How unique is Sharon Osborne’s case?

Sharon Osbourne, the 71-year-old television personality and former host of The Talk and X Factor judge, has openly discussed her challenging experience with the weight-loss drug Ozempic (semaglutide).

Osbourne began using Ozempic in late 2022 and reported losing 42 pounds within four months. However, she soon found herself weighing under 100 pounds, a weight she considered too low for her 5’2″ frame. She expressed concerns about her gaunt appearance and the difficulty she faced in regaining weight after discontinuing the medication.

In interviews, Osbourne described experiencing persistent nausea during the initial weeks of treatment, stating, “You don’t throw up physically, but you’ve got that feeling.” She also warned about the ease of becoming reliant on the drug for weight loss, particularly among teenagers, emphasizing the potential dangers of such dependency.

Reflecting on her journey, Osbourne told People magazine she has decided to step away from weight-loss medications and cosmetic procedures, focusing instead on accepting her natural body. She has become an advocate for cautious use of weight-loss drugs, highlighting the importance of medical supervision and the risks associated with rapid weight loss.

Osbourne’s candid revelations serve as a cautionary tale about the potential side effects of GLP-1 receptor agonists like Ozempic, underscoring the need for informed decision-making and professional guidance when considering such treatments.

But let’s remind ourselves, many health professionals are not aware of the full catalogue of issues that can result, partially because these are being downplayed, and also because it’s early days for most of them so their own clinical experience with long-term use is limited.

Expansion plans

The UK government, in partnership with pharma giant Eli Lilly, the maker of Mounjaro, is rolling out a major five-year trial (SURMOUNT-REAL UK), potentially paving the way for long-term NHS coverage of GLP-1 RAs. Pharmacists in England may soon be allowed to administer these injections directly. NICE guidance has opened the door for their use beyond diabetes and morbid obesity, with heart disease prevention floated as the next target.

Meanwhile, the World Health Organization has done a U-turn on GLP-1 Ras and is reportedly preparing to support their global use—despite rising concerns from independent scientists and medical ethicists.

This growing momentum is, in our view, occurring without adequate emphasis on lifestyle integration, patient education, or long-term risk transparency. That makes genuine informed consent nearly impossible.

Obesity: Disease or Opportunity?

At the heart of this issue is a profound reframing: obesity is no longer seen as a modifiable condition, but a chronic disease. This isn’t a formal classification because obesity is not classified as a disease by federal law. However, it’s widely treated as such by key agencies (FDA, CDC, NIH) and professional organizations (AMA, AHA, Endocrine Society). This de facto disease classification of obesity in the U.S. is now spreading internationally, positioning GLP-1 jabs as a primary treatment option, not an adjunct.

It also has enormous economic consequences:

• Pharma analysts at Goldman Sachs project a $100 billion global market for weight-loss drugs by 2030.
• With obesity affecting around 1 billion people worldwide, the potential user base is staggering.
• The result? Lifelong patients on expensive weekly injections—some retailing at over £700 per month—creating an unprecedented revenue stream for manufacturers like Novo Nordisk and Eli Lilly.

Safety signals in the shadows

Here’s what the promotional headlines often obscure:

• Pancreatitis and gallbladder disease are listed side effects, particularly with rapid weight loss.
• Acute kidney injury has occurred due to dehydration from persistent vomiting—a common symptom.
• Mood changes and suicidal ideation have been reported and are flagged in some labels; anecdotal reports are rising.
• Thyroid tumours were originally observed in rodents, with more recent evidence showing increased incidence among GLP-1 RA users in a French study on humans, prompting caution for those with a personal or family history of thyroid cancer.
• Micronutrient shortfalls in B12, calcium and iron are emerging as underappreciated issues due to reduced food intake and absorption changes.
• Slow gastric emptying can result in a range of nutritional, gastrointestinal, and functional risks (e.g., gastroparesis)—particularly with prolonged use or in vulnerable populations.
• Microbiome changes, some of which may be advantageous, others detrimental

Some of these risks may be rare—but long-term data are scarce, especially beyond three years of use. As we’ve learned from other drug classes (like PPIs and statins), early regulatory approval is not a long-term safety guarantee.

The adverse brain- and mood-related effects are interesting, likely being the result of GLP-1 RAs affecting the brain. Frank Duca, Ph.D., associated professor at the University of Arizona in Tucson makes the point that GLP-1 medications act directly on the brain, whereas natural GLP-1 is broken down within minutes of being produced by the intestines, meaning it likely never reaches the brain.

The muscle problem few are talking about

In our view, one of the most overlooked dangers of GLP-1 RA drugs is their impact on muscle mass. Appetite suppression and energy restriction often lead the body to metabolise lean muscle tissue —not just fat. Muscle is one of the most important reserves for mitochondria—our key energy-producing organelles.

Loss of muscle can:

• Reduce mitochondrial reserves and ATP (chemical energy) production
• Weaken the immune system
• Increase the risk of respiratory complications
• Impair metabolic flexibility
• Increase the risk of falls and fractures
• Reduced bone mass and health exacerbated by lack of physical activity

GLP-1 RA-induced muscle loss may be especially concerning in older adults already at risk of sarcopenia (age-related muscle loss), yet this risk remains under-communicated to patients and physicians alike.

But it’s not just the older folk who are at risk. Those on low protein (e.g. vegan) diets and who don’t do much in the way of resistance (weight) training, are also likely to be affected more by muscle loss.

We’ve been following the development of powered and passive (unpowered) ‘exoskeletons’ or ‘exosuits’; wearable, external robotic devices designed to support or enhance human movement by mimicking, augmenting, or assisting natural joint and muscle function. Could these be the perfect pairing for GLP-1 RA ‘long-termers’ who’ve lost too much muscle to able to function autonomously?

The erosion of informed consent

Perhaps the most urgent issue is ethical. The widespread promotion of GLP-1 RAs is not being matched by equal investment in nutrition and lifestyle education or support. Nor is it framed as a temporary aid to kick-start metabolic recovery.

Instead, the narrative seems to imply that lifelong injections are the only viable solution for weight control—a position that conveniently marginalises holistic approaches.

For many people, GLP-1 RAs appear like the only option left for them because they were never told there were viable, natural alternatives to raise natural GLP-1. These include:

• intermittent fasting
• low carb-diets/higher protein/higher healthy fat consumption
• eating plenty of polyphenols, bitter compounds and Omega-3 fatty acids
• resistance training
• moderate-intensity aerobic exercise (ideally for periods of 90 minutes or more that ensures stored glycogen is burned and fat burning is initiated)
• sleep optimisation, and
• stress management.

To get the best results, combining as many of these strategies gives you the best chance of using natural GLP-1 to restore blood sugar, metabolic flexibility and normal weight, while increasing the lean (muscle) mass to body fat ratio.

>>> Find out more about healthy eating patterns that drive metabolic flexibility and manage blood sugar naturally in our book, Reset Eating.

When drugs are pushed as first-line interventions without these alternatives being properly explored, informed consent is reduced to pharmaceutical consent.

Better balance, better health

To be clear: ANH is not opposed to the use of GLP-1 RAs where they are truly needed. But public health policy mustn’t be led blindly by pharmaceutical interests, and it must strike a balance between short-term efficacy and long-term wellbeing.

That means:

• Clearer disclosure of known and emerging risks
• Better integration with nutrition, movement, and behavioural therapies
• Formal recognition and communication of muscle loss and nutrient depletion risks
• Stronger support for individual-led, lifestyle-first health pathways

GLP-1 jabs are most definitely helping some. But they should never be prescribed or sold as a substitute for health sovereignty—the ability to understand, choose, and participate in your own wellness journey.

If you, or a loved one, is using a GLP-1 RA…

Consider the following, and decide along with the advice from a suitably qualified and experienced health professional:

• Prioritise protein: Aim for 1.2–1.6 g per kg body weight daily to minimise muscle loss.
• Strength train regularly: At least 3x weekly to retain lean mass and metabolic function.
• Track body composition using body composition scales (e.g. Tanita, Omron), using weighing scales that also estimate fat, muscle, water, and visceral fat.
• Work with a health professional who understands both the pharmacology, nutrition and lifestyle strategies necessary for long-term success.

What will the GLP-1 litmus test reveal?

The global embrace of GLP-1s is a litmus test for the future of medicine. Will we continue down a path of overmedicalisation—or will we reclaim a model of health that respects biology, context, and choice?

At ANH, we’re betting on the latter.

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This article (GLP-1 weight-loss jabs: What we’re not being told) was created and published by ANH International and is republished here under “Fair Use” with attribution to the author Rob Verkerk PhD

Featured image: Reddit