03/02/2026
GLP-1 receptor agonist weight-loss medications: powerful potential, but only if we get the rollout right.
There’s a lot happening around these drugs right now, including Pharmac’s move toward funding Wegovy (link to article in the comments).
There’s no doubt this new generation of weight-loss medications offers real benefits. For many people, they lead to substantial weight loss and meaningful improvements in cardiometabolic risk factors. From a public-health perspective, funded access has the potential to be genuinely game-changing.
But the evidence is clear on one critical point: what happens when these drugs are stopped matters ... a lot.
A large systematic review in The BMJ shows that when weight-management medications are discontinued, weight is rapidly regained and cardiometabolic benefits are lost, often faster, and to a greater extent, than after behavioural weight-management programmes (link in comments).
This creates a real risk if rollout occurs without safeguards: sarcopenic obesity, where weight regain occurs predominantly as fat rather than muscle, potentially leaving people with poorer physical function and worse metabolic health after stopping treatment.
Weight-loss medications should not be framed as a standalone solution. The strongest long-term outcomes are most likely when they are embedded within a comprehensive metabolic-health approach that prioritises sustainable lifestyle change alongside pharmacotherapy.
Medications can be powerful tools, but only when used as part of a long-term strategy, not a short-term fix.
