It has been just over a year since Scottish health authorities approved the use of semaglutide, the active ingredient in weight-loss injections such as Wegovy and Ozempic.
These so-called “slimming injections” have become a hot topic – not only in GP surgeries but also on social media and in group chats.
For now, much of the discussion happens in hushed whispers, as the injections are still seen as something to keep quiet about.
But that perception appears to be changing.
Promising almost immediate results and delivering an average weight loss of 10–15%, these medications are poised to become more widely used. Semaglutide has even been joined by tirzepatide, marketed as Mounjaro and Zepbound, which early studies suggest may be even more effective.
Currently, most people taking these medications purchase them from private clinics or high-street pharmacies, where a month’s supply costs about £200.
The NHS has so far been reluctant to prescribe these treatments, primarily due to cost considerations.
However, despite ongoing shortages of the drug, GPs may soon be eager to offer weight-loss injections to overweight patients.
These medications could help address the rise in obesity-related illnesses, which have pushed patient visits to record levels and placed further strain on the NHS’s already overstretched budget.
- If these injections become more widely available, how will they impact society?
- Will they transform how we think about food?
- And who stands to benefit the most from this modern weight-loss breakthrough?
As the whispers grow louder, we spoke to a range of five different voices to explore how this weight-loss revolution might reshape our world…
1. The expert
Professor Lora Heisler is the director of research at the University of Aberdeen’s Rowett Institute. Her research includes the study of semaglutide medications and GLP 1, the hormone that weight loss injections mimic to regulate body weight.
[Semaglutide] has been talked about at scientific conferences for my entire career, so it’s not new. But what is new is that it’s now being prescribed for obesity.
[And] for the first time, we have something that has the potential to really change obesity, to have a significant impact on the rates and prevalence of obesity.
But it’s not magic fairy dust. What the drug should be doing is helping people to adhere to diet and exercise, people who need to lose weight because of their BMI.
It’s a drug, it’s a medicine. It’s meant to improve health. It’s not meant as a cosmetic boost.
The NHS guideline is that people can take some semaglutide for two years, and after that point should be able to transition off it. Hopefully they have gained the behavioural patterns to eat the amount that that keeps their bodies in energy balance.
What are the side effects of weight-loss injections?
We know for sure that in some patients it causes nausea – a significant percentage of patients.
There’s some research – but again, more research is needed – that it is delaying gastric emptying. What that means is that when you eat something the food isn’t moved through the gut as quickly, so you just feel fuller quicker and maybe a little bit longer.
What are the cost factors behind prescribing semaglutide on the NHS?
It could cost the NHS in Scotland £33 million a year for treatment. But the cost of obesity to the NHS in Scotland is £600 million, and in the wider UK, it’s £6.1 billion per year. So that’s why government officials or other regulators are thinking of providing the medicines potentially more broadly.
2. The community worker
Laura Walker is the founder and CEO of the social enterprise Aberdeen Blueberry Wellness, which targets health and fitness in low-income communities.
As someone who works in deprived areas with major health issues, does semaglutide excite you?
It did initially, but I also see the side effects of it as well. Not everybody is having a great time on it and it doesn’t work for everybody. So it’s not a panacea.
I can understand why the drugs in [low-income] areas would be very effective. People believe that as long as they lose weight, everything will be perfect.
Well, I think we all know that it’s not about weight loss being perfect, it’s about everything else that goes along with it. People will have to have that support in the community or support from somewhere to be able to manage their lifestyle alongside it.
That’s hopefully where we can come in and say, right, well, there’s exercise here for free and this is the nutrition advice that we would give you for free. If that were to happen, we can put that in place in the likes of Tillydrone or Torry or wherever it is needed.
It is 100% going to become more common. This drug is not going away. But you know, when you do see celebrities, they’ve got the finance to have people to support them.
3. The user
We spoke to a 52-year-old Aberdeenshire mother of four who has been taking Mounjaro for almost four months. She has lost two stone, down from just over 13 stone. She asked to remain anonymous.
I was overweight, and I’ve also got high blood pressure, so it was more of a health issue for me, to get myself under control myself.
I’ve just found it hard to stick to diets. [But the weight-loss injection is] an instant thing. It’s a switch in your head that stops any urge for food, and it starts straight away. The first week I lost about half a stone. You think, well, maybe it’s a blip, but the scales just keep going down every day. It’s incredible. It feels like you’re cheating a bit.
[The programme I am on] they give you health coaches to talk to. There’s a group chat, and you get daily snippets of things to read. You’re not just shoved out there and told to fend for yourself.
Since I’ve been on it, I’ve probably not been out. Actually, that’s not true, I have been out. But I can’t drink alcohol AND eat. It’s one or the other, whereas before it would have been French martinis and all that.
If it has really high sugar content or high fat, you feel actually physically sick, or at least I do. The thought of a tasting menu now – like six or seven courses – I just know I wouldn’t manage. It would be a waste of money.
I’m hoping [my appetite] doesn’t just come back with a vengeance and I’m able to just keep it at bay. But I will join a gym once I finish this, and that will be continuation. Phase two.
4. The nutritionist
Laura Leslie is a clinical nutritionist in Inverurie who works with clients with eating disorders.
I don’t think it’s black and white. There are advantages if it’s right for you and your body, if you’re at a higher risk factor for health conditions.
But it’s my concern that it can be seen as a sticking plaster. There are so many underlying reasons for obesity and it’s not necessarily getting to the root cause.
If you’re not addressing that root cause, and you’re not building those healthy habits, as soon as you stop the medication, you’re likely to rebound.
It kind of scares me if it becomes more mainstream, because it’s so accessible. Who’s going to get their hands on it?
If you have someone who is obese or overweight, and their GP prescribes it as part of a holistic approach, that is very different to somebody sitting at home who is who is unhappy in their body and thinks they will be happier if they lose five kilograms.
In my experience, weight loss does not necessarily mean that they’re going to feel happier.
We also don’t know if it is going to affect our pleasure with food. And food should be pleasurable, right? For people with gastric bypasses, it’s very easy to stop going out for dinner with friends because they can’t eat what their friends are eating. So there’s our individual relationship with food, but also the wider impact that it has on our overall relationships or mental health.
5. The doctor
Dr Aileen Alexander is a former Aberdeen GP who left the NHS five years ago to launch Nourish Academy, a personalised weight-loss clinic.
Will GPs want to prescribe weight-loss injections?
Absolutely, because you’ve got 10 minutes [with the patient]. You want a solution as quickly as possible.
You want to be able to give something to people that’s tangible. And when you hand them their prescription, they’re happy. You’re happy. You’ve ticked the box, and at a cost saving to the NHS. If we can make people healthier by giving them drugs, it probably feels like the right thing to do from a cost-saving perspective.
And if you look at the scientific research, it makes sense. It makes people lighter, and also, there’s positive impacts on other factors such as insulin sensitivity, so it reduces risk of developing pre diabetes or type two diabetes… and also risks of cardiovascular illness, like heart attacks and strokes.
So on paper, they’re fantastic. My concern, though, is it doesn’t look at the bigger picture in terms of our behaviors around food. It doesn’t look at mental health and wellbeing, it doesn’t encourage people to exercise. It doesn’t support them with eating a higher quality diet of more whole foods. It completely bypasses that, while still having positive health impacts.
People feel full and they don’t have that same kind of food noise. But my question is always – Well, why do you have the food noise in the first place?
Why have the injections been so popular?
You’ve got an injection, or you’ve got a restrictive diet, like Weight Watchers or intermittent fasting – if I was that person I’d take the injection.
These people are desperate. They’ve been around the houses. They’ve tried all these diets. Their self-esteem is crippled, their health is at risk. So I can totally understand why people are pulled in.
I think we just need to be really cautious and tentative, because it isn’t just designed to be a drug that helps us lose weight, it’s designed to be a drug that helps us lose weight so we don’t develop the diseases associated with obesity.
So it’s exciting, because there’s so much opportunity. But I also think that a lot of the folks that are taking it are maybe not the best candidates.
And the reason the things they’ve tried before haven’t worked is, again, they’ve been transactional. They’ve been profit-driven, diet-orientated approaches that just haven’t given people the breadth of support that they need to change their lifestyle.
Will weight-loss injections make the weight-loss industry disappear?
I have absolutely no fear of that at all. There’s a big population of people who don’t want to take medications and want to cure their health properly. Also, we still need all of the support in addition to the medication.
It’s not an instead of, it’s not optional.
Conversation