Question

This article looks into how weight-loss jabs work, medical implications, their pros and cons and considerations for people with ME/CFS.

Answer

In recent years, the rise of obesity has made weight management a pivotal topic, leading to various interventions ranging from lifestyle modifications to surgical procedures. One of the most noteworthy developments in the field of weight-loss is the introduction of weight-loss jabs: specifically injectable medications designed to help people gain a healthier weight.

Understanding weight-loss jabs

Weight-loss jabs refer primarily to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs, which include semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro) and liraglutide (Saxenda), mimic the action of the hormone GLP-1, which is naturally produced in the intestine in response to food intake. GLP-1 plays a crucial role in appetite regulation and insulin secretion.

How they work

• Appetite suppression: GLP-1 receptors help reduce appetite by signalling the brain to feel full faster and therefore result in reduced food intake. They also slow gastric emptying, prolonging the feeling of fullness after eating.
• Blood sugar control: These medications enhance insulin secretion and inhibit glucagon release which, together, lower blood-sugar levels. This can be particularly beneficial for people with type-2 diabetes and it also helps manage weight loss in non-diabetic individuals by regulating metabolism.
• Fat storage reduction: Weight-loss jabs may promote a shift in body composition by encouraging the body to use fat stores for energy, rather than storing excess calories as fat.

Eligibility criteria

Eligibility criteria for obtaining one of these weight loss injections on the NHS is under constant review and there are now plans to allow overweight people with a BMI of 27 or over who are at significant risk of having a heart attack or stroke to be eligible.

So do check the NHS website on obesity management for up to date information: https://www.nhs.uk/conditions/obesity/treatment

This is the current information from the NHS website on eligibility for semaglutide (Wegovy):

You'll only be prescribed semaglutide (Wegovy) if you have health problems due to your weight and you have a BMI of either:

• 35 or more, or 32.5 or more if you're of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin.

• 30 to 34.9, or 27.5 to 32.4 if you're of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, and you meet other criteria to be treated by a specialist weight management service

There are different eligibility criteria for the other weight loss injections that can be prescribed.

Eligibility criteria in the private medical sector may also differ from the NHS.

The pros and cons of using weight-loss jabs

Pros:

• Significant weight loss: Clinical studies have shown that patients using GLP-1s can achieve considerable weight loss, often exceeding 15% of their body weight over a year of use.
• Sustained results: Unlike some weight-loss methods that provide temporary results, studies suggest that weight-loss jabs can support long-term weight management as part of a sensible lifestyle approach, including a balanced diet and exercise (where possible for those with ME/CFS).
• Improved metabolism: Weight-loss jabs have been linked to better glycemic control and improved cardiovascular health markers, making them beneficial for overweight or obese patients with associated health conditions.
• Convenience: The injectable form may be preferable for patients who have difficulty adhering to daily oral medication.

Cons:

• Cost and accessibility: These medications can be expensive so, unless approved and prescribed by a GP, the cost can prevent some from being able to access them.
• Side effects: Gastrointestinal side effects can be distressing and may lead some people to discontinue use.
• Medical supervision required: Weight-loss jabs should only be prescribed by a healthcare provider after a thorough evaluation of the patient’s medical history and physical condition.
• Varied results: Not everyone responds to weight-loss jabs in the same way and some people may experience minimal weight loss or struggle with sticking to the treatment plan.

Considerations for people with ME/CFS

ME/CFS poses additional challenges when considering weight-loss interventions such as injectable medications.

Potential concerns

• Increased fatigue: Weight-loss jabs can initially exacerbate gastrointestinal symptoms, leading to increased fatigue and malaise. The body’s adjustment to these medications may require additional energy, which could put added strain on people with ME/CFS.
• Treatment interactions: People with ME/CFS often take multiple medications to manage a range of symptoms, such as sleep disturbances or pain, so there’s a potential for GLP-1s to complicate normal treatments for ME/CFS symptoms. A thorough consultation with a healthcare provider familiar with both conditions is essential.
• Psychological impact: Managing weight and body image can be particularly challenging for those with ME/CFS, especially if fatigue limits physical activity. The psychological burden of weight-loss efforts may add to the stress already experienced.
• Monitoring nutrition: People with ME/CFS often have dietary restrictions or need specific nutritional considerations to maintain their energy levels. This could mean that weight-loss due to appetite suppression could inadvertently lead to nutritional deficiencies. Careful nutritional monitoring and dietary management is therefore essential.
• Lack of research: Current clinical trials and studies predominantly focus on obesity, diabetes, and related metabolic conditions, with limited research specifically addressing how weight-loss jabs affect individuals with ME/CFS.

Recommendations

• If someone with ME/CFS is considering weight-loss jabs, here are several recommended steps:
• Ensure you have a detailed consultation with a healthcare provider familiar with both weight-loss treatment and ME/CFS to ensure that the benefits outweigh potential risks.
• Approach weight management with realistic expectations, remembering that your energy levels and physical capabilities may fluctuate.
• Develop a personal plan that includes dietary modifications, physical activity within manageable limits and then incorporate weight-loss jabs only if deemed appropriate.
• Regularly monitor any changes in your ME/CFS symptoms, overall health and energy levels to assess the impact of weight-loss jabs.
• Engage with support groups or counselling services that help individuals with ME/CFS to address the emotional challenges associated with both chronic illness and weight management.

Conclusion

Weight-loss jabs represent a promising avenue for managing obesity, offering appetite suppression and metabolism enhancement. However, people with ME/CFS should consider these treatments only with medical supervision. By establishing personal goals, weight-loss can be approached in a manner that respects the complexities of ME/CFS whilst also promoting a healthier lifestyle.

As research progresses, a deeper understanding of dealing with the links between weight-loss jabs and chronic fatigue could help those navigating their ME/CFS health challenges alongside the use of weight-loss jabs.

SEE ALSO: Weight-loss injections, Worried about weight loss, Diet and Nutrition: Malnutrition, Treatment: Drugs and Weight Gain

More Information:

• The ME Association also have a range of booklets free to download that may be of interest, including
  • Diet and nutrition
  • Food Fact Sheet: Long Covid and Diet
  • Food Fact Sheet: ME/CFS and Diet