My Best Weight

My Best Weight A NEW approach to managing weight - Our clinic provides evidence based medical management for those

21/05/2026

🚨 TRIUMPH-1: Retatrutide represents the next major leap in obesity medicine.

Eli Lilly has announced topline Phase 3 results from TRIUMPH-1 — a large global randomized trial of retatrutide, an investigational once-weekly “triple agonist” targeting GLP-1, GIP and glucagon receptors.

🧪 Trial design:
• 2,339 participants
• Adults with obesity or overweight + at least one weight-related complication
• Participants did NOT have diabetes
• Randomized to placebo or retatrutide 4 mg, 9 mg or 12 mg
• 80-week double-blind trial
• Pre-specified extension to 104 weeks in participants with BMI ≥35

📉 Weight loss results at 80 weeks:
🔹 4 mg: -19.0% (~47 lbs / 21.4 kg)
🔹 9 mg: -25.9% (~64 lbs / 29.2 kg)
🔹 12 mg: -28.3% (~70 lbs / 31.9 kg)

That degree of weight loss approaches levels traditionally associated with bariatric surgery.

Even more striking:
✅ 45.3% of participants on 12 mg lost ≥30% body weight
✅ 27.2% lost ≥35%
✅ 65.3% moved below the BMI threshold for obesity (BMI

17/05/2026

New evidence is changing how we think about long-term obesity care.

We are proud that Prof Carel le Roux, Co-founder of .ie , is an author on a new international study that may change how we think about long-term obesity treatment.

At My Best Weight, our clinical care is shaped by the latest science — and by experts who are not only interpreting the evidence, but helping to create it.

The ATTAIN-MAINTAIN study, just published in Nature Medicine, explored a clinically important question:

Can people who have already lost weight with injectable obesity medications maintain those benefits after switching to an oral GLP-1 treatment?

The study included people previously treated with tirzepatide or semaglutide, who were then randomised to once-daily oral orforglipron or placebo.

The results were striking:

In participants switching from tirzepatide to orforglipron, mean weight reduction was largely maintained — from 22.0% at the end of SURMOUNT-5 to 16.8% after 52 weeks of ATTAIN-MAINTAIN.

In participants switching from semaglutide to orforglipron, mean weight reduction was almost fully maintained — from 16.5% at the end of SURMOUNT-5 to 15.1% after 52 weeks of ATTAIN-MAINTAIN.

When analysed as maintenance of prior weight reduction, participants maintained an estimated 74.7% of previous weight reduction after tirzepatide and 79.3% after semaglutide with orforglipron — compared with 49.2% and 37.6% with placebo.

That contrast is important.

Stopping active treatment led to substantially more regain.

Switching to oral orforglipron helped preserve much more of the health gain already achieved.

Importantly, cardiometabolic improvements such as waist circumference, HbA1c, lipids and blood pressure were also broadly preserved, and the most common side effects were gastrointestinal, mostly mild to moderate.

This matters because obesity is a chronic, relapsing disease.

The goal is not just weight loss — it is long-term health improvement and maintenance.

World-leading obesity care means more than following trends.

Follow the evidence, not Facebook.

15/05/2026

Public conversation around obesity medications and “muscle loss” often lacks important nuance.

Across weight-loss interventions — including lifestyle change, bariatric surgery, and pharmacotherapy — some reduction in lean or ‘fat-free’ mass is expected as part of normal physiology.

In obesity medication trials, approximately 25–39% of total weight loss has been reported as “lean mass” on DEXA scans.

But this number is often misunderstood.

DEXA-derived “lean mass” does not equal skeletal muscle alone. It includes all non-fat, non-bone tissue — including total body water, glycogen-associated fluid, organ tissue, extracellular fluid, and changes in fat stored within tissues. This means DEXA may overestimate true functional muscle loss.

Emerging MRI data suggest skeletal muscle reductions may be more modest than headlines imply, while reductions in visceral fat, liver fat, and intramuscular fat may improve overall body composition and metabolic health.

Weight loss can also influence bone density through mechanical unloading and hormonal adaptation, but current evidence has not demonstrated a consistent increase in fracture risk directly attributable to these medications. Longer-term data remain important, particularly in higher-risk groups.

The real clinical question is not simply “Is some lean tissue lost?”

It’s:
How much of that reflects true skeletal muscle?
Is strength and physical function preserved?
And is treatment being paired with strategies that protect muscle and bone?

This is why evidence-based obesity care should include:
• Adequate protein intake
• Resistance training
• Physical activity
• Monitoring of functional health
• Personalised medical oversight

Obesity treatment should not be reduced to simplistic narratives.

The goal isn’t just weight reduction.

It’s improving metabolic health, reducing disease burden, preserving function, and helping people live healthier, stronger lives.

Follow the evidence… not Instagram.

03/05/2026

The podcast I did with The 2 Johnnies now has 300,000+ listens… and it is still regularly brought up by patients in clinic.

For many people, there is still a deeply ingrained perception that seeking medical support for obesity is somehow “taking the easy way out” or “cheating.”

Yet we rarely apply that same logic to treatment for other chronic diseases.

Obesity is still too often viewed through stigma, misunderstanding, and moral judgement rather than evidence-based medicine.

Sometimes the biggest barrier is not treatment itself… it’s perception.

This conversation clearly resonated with many people for a reason.

Follow the evidence… not stigma.

If you haven’t listened to the full episode, it’s well worth going over to Spotify to check it out.

28/04/2026

Missed doses. Delays. Holidays. Supply issues.

These practical issues are often not well addressed in guidelines or product literature — but in the real world, they matter.

How treatment is paused, continued, or restarted can influence tolerability, quality of life, and long-term treatment success.

This is where clinical experience, evidence-based prescribing, and expert medical support genuinely matter.

Obesity care is not just about writing a prescription or starting treatment.
It’s about safely navigating the real-world challenges that inevitably happen along the way.

Always speak to your own prescribing clinician before making changes to treatment.

25/04/2026

What is ‘Microdosing’ of GLP1-like medications?.

In medicine, we already use low doses.
It’s called titration. It’s evidence-based.

What’s being promoted online is often something else.

‘Microdosing’ 💉obesity medications sounds harmless

It makes prescription drugs feel like supplements —
low-risk, optional, casual.

But that’s not what this is.

In some cases, it’s diet culture —
repackaged in clinical language.

A medical veil over cosmetic weight loss.

Follow the evidence — not Instagram.

11/04/2026

Menopause & Weight Gain - hear Dr Caoimhe Hartley separating fact from fiction in collaboration with My Best Weight

It’s one of the most common concerns amongst women, but the science is often misunderstood.

Menopause itself isn’t the main driver of weight gain - but it does influence where fat is stored and how it impacts health.
That shift toward abdominal (visceral) fat is what matters most metabolically.

And HRT?
Despite the headlines, it’s largely weight neutral - but it may support body composition and symptoms that make weight management harder.

This is where nuance matters - focusing on weight alone misses the bigger picture.

👉 Health at midlife is about body composition, metabolic risk, and sustainable health behaviours - not just the number on the scale.

If excess weight is having a negative impact on health (this is how we now think of obesity - not just BMI and size) there are evidence-based treatments available.

Save this for later, and share with someone who needs a clearer understanding of what’s really going on.

04/04/2026

“Maybe it’s not smugness… maybe it’s relief.

No longer stuck in a struggle we’ve come to expect.

When obesity is treated, the constant mental load can ease — and people often feel more at ease.

That can look like confidence.
It can feel unfamiliar to others.

But improving health and quality of life is the point.

What do you think?

Thanks for letting me give my perspective on this Confession

01/04/2026

💊 Orforglipron (Foundayo)- approved by the FDA in the US: the first oral, non-peptide GLP-1 for obesity

NOT YET APPROVED OR AVAILABLE IN EU/IRELAND

A once-daily tablet designed to deliver clinically meaningful weight loss and metabolic benefit — without injections.

⸻

🧠 What is it?
• Oral GLP-1 receptor agonist
• No fasting requirements (vs oral semaglutide)
• Stepwise dose escalation (0.8 mg to 17.2 mg daily)
• For obesity ± type 2 diabetes

⸻

📊 What do the trials show? (ATTAIN)
• ~10–12% average weight loss (up to ~12.4%)
• ~60% achieve ≥10% body weight change
• ~40% achieve ≥15% body weight change

• HbA1c ↓ ~1.3–1.8% (T2D)
• Effective for weight maintenance after injectables

⸻

⚖️ Tolerability
• GLP-1 class profile - mostly GI issues
• Nausea, diarrhoea, vomiting, constipation
• ~5–10% discontinue (dose-dependent)
• No clear side effect advantage vs injectables
• Gradual escalation is key

⸻

🧩 Where does it fit?
• A lower-barrier entry to evidence-based treatment
• Option for those who don’t want injections
• Useful for earlier intervention or maintenance
• Less potent than tirzepatide — but clinically meaningful

⸻

🧭 Bottom line
This is about access and scalability — not a shortcut.
Obesity remains a chronic disease, and treatment still requires structure, support, and follow-up.

⸻

💬 Would you consider a tablet over an injection?

27/03/2026

“If the scale didn’t exist… how would you know your treatment was effective?”

I ask people to complete a detailed health questionnaire before their first visit, it’s not just about numbers - it’s about understanding impact on health, wellbeing and quality of life!

Response in obesity care isn’t defined by weight loss alone.

We care about:
• Real improvements in your health that you can feel, not just measure
• Moving more freely, with energy to engage fully in your life
• Living your life with freedom, not constantly thinking about weight & dieting
• Greater confidence in your long-term health and wellbeing.

This is about health. Function. Quality of life.
Not just weight.

👇 Tell me — how would you define response without using numbers or weight?

13/03/2026

Semaglutide & Vision 👀 Risk - what does the evidence actually show?

👁 NAION (non-arteritic anterior ischaemic optic neuropathy) is a rare condition caused by reduced blood flow to the optic nerve.

📊 It affects about 2–10 people per 100,000 each year (roughly 1 in 10,000–50,000 people).

Risk is already higher in people with:
- diabetes
- high blood pressure
- sleep apnoea
- cardiovascular disease
- smoking history
- certain optic nerve anatomy

🧾 A new study in the British Journal of Ophthalmology analysed 30+ million adverse-event reports submitted to the US FDA.

The researchers found NAION reports appeared more often in people taking semaglutide medicines. But this does NOT mean the true risk is 17× higher.

Pharmacovigilance databases:
• rely on voluntary reports
• can be influenced by reporting bias and media attention
• cannot calculate the true incidence
• cannot fully adjust for underlying health risks

They are useful because they can detect early safety signals for rare events.

Other studies have shown mixed results.

Some suggest a small relative increase, but the absolute risk remains very low.

Regulators estimate the possible medication-related risk at around 1 in 10,000 people.

➡️ Key takeaway
There is enough emerging evidence to raise awareness and continue monitoring.
But there is not enough evidence to conclude that semaglutide directly causes NAION.
As always, treatment decisions should balance potential risks with the well-established benefits of treating obesity and metabolic disease.

🔗 Study discussed: https://bjo.bmj.com/content/early/2026/03/02/bjo-2025-328483

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