GLP-1 Medications for Long-Term Weight Loss

Q: What side effects should I be aware of when using GLP-1 medications for weight loss?

GLP-1 medications like semaglutide (e.g., Ozempic ®, Wegovy®, Rybelsus ®) and tirzepatide (e.g., Mounjaro ®, Zepbound ®) are generally considered safe and easy for most people to tolerate. That said, some individuals might experience side effects, particularly in the early weeks as their bodies adapt. Common issues include nausea , vomiting , bloating , constipation , or diarrhoea . Mild reactions at the injection site, such as redness or swelling, can also happen. More serious side effects, though less common, can include low blood sugar (especially if combined with other glucose-lowering medications), pancreatitis , gallbladder complications , or kidney issues . Some users might notice changes in their appearance, like skin laxity or differences in hair and nail texture. Rare cases have raised concerns about thyroid-related issues in animal studies, so those at risk may need extra monitoring. If you're exploring GLP-1 therapy, Trimly provides personalised, doctor-led care to help you navigate side effects and stay on track with your weight loss goals.

Managing long-term weight loss is challenging, but GLP-1 medications offer a promising solution. Originally designed for Type 2 diabetes, these drugs now play a key role in addressing obesity. Clinical trials show they can help users lose up to 22.5% of their body weight over 72 weeks by reducing hunger, increasing fullness, and slowing digestion. Beyond weight loss, they also improve blood sugar control, lower cardiovascular risks, and may even prevent diabetes.

Key Points:

Effectiveness: Semaglutide (2.4 mg weekly) leads to an average weight loss of 14.9%, while tirzepatide can achieve 22.5%.
Mechanism: Targets hunger and fullness signals in the brain and slows gastric emptying.
Health Benefits: Reduces major cardiovascular events by 20% and improves metabolic health.
Usage: Requires gradual dose increases and medical supervision to minimise side effects like nausea or constipation.
Long-Term Commitment: Weight regain is common after stopping treatment, highlighting the need for ongoing support.

In Singapore, GLP-1 medications are available through prescription, often combined with lifestyle changes like a balanced diet and regular exercise. Programmes like Trimly offer doctor-supervised plans starting at $350+ per month, ensuring personalised care for sustainable weight management.

Is GLP-1 Therapy a Lifelong Commitment or a Temporary Fix?

Clinical Evidence for GLP-1 Medications

GLP-1 Medication Weight Loss Results and Clinical Trial Outcomes Comparison

Key Trials and Results

Clinical studies provide strong evidence for the effectiveness of GLP-1 medications in weight management and metabolic health. Take the STEP 5 trial, for example. Over two years (104 weeks), participants taking semaglutide 2.4 mg weekly achieved an average weight loss of 15.2%, compared to just 2.6% in the placebo group. Impressively, 77.1% of semaglutide users achieved at least 5% weight loss, while only 34.4% of those on placebo hit the same mark.

The SELECT trial, which spanned 208 weeks, showed sustained results, with participants maintaining a 10.2% weight loss, compared to 1.5% in the placebo group. The trial investigators highlighted:

"Weight loss was sustained over 4 years... semaglutide produced clinically significant weight loss and improvements in body measurements".

Meanwhile, tirzepatide, a dual GLP-1/GIP agonist, delivered remarkable outcomes in the SURMOUNT-1 trial. After 72 weeks on the 15 mg dose, participants shed 17.8% of their body weight, showcasing its effectiveness across different populations, including Asian groups[13, 15].

Beyond weight loss, these studies underscore broader health benefits, making GLP-1 medications a promising option for long-term health improvements.

Health Benefits Beyond Weight Loss

GLP-1 medications go beyond helping with weight reduction - they also deliver notable metabolic and cardiovascular advantages. In the SELECT trial, participants saw a 20% reduction in major adverse cardiovascular events (MACE), such as heart attacks and strokes, which is particularly valuable for those at cardiovascular risk.

Research from the National University of Singapore highlights how these medications address multiple metabolic factors, including blood pressure and lipid levels. The NUS team noted:

"The superiority of tirzepatide and GLP-1 RA in inducing weight loss and their ability to target multiple metabolic parameters render them promising candidates".

Additionally, long-term data shows encouraging results in diabetes prevention. Over three years, tirzepatide reduced the risk of progressing from prediabetes to type 2 diabetes by a staggering 94%. Similarly, the STEP 5 trial revealed that 80% of participants with prediabetes at the start of the study returned to normal blood sugar levels after two years of semaglutide treatment.

Patrick Welch, PharmD, BCACP, an Advanced Clinical Pharmacist, summarised the wider benefits:

"These medications improve overall health by lowering blood pressure, improving cholesterol levels, and reducing diabetes risk".

What to Expect When Using GLP-1 Medications

Weight Loss Timeline

When starting GLP-1 medications, it's essential to begin with a low dose. This helps your body adjust and minimises any discomfort. During the first month, weight loss might be modest, but many people notice a reduction in food cravings. The more noticeable weight loss typically kicks in between weeks 8 and 12, as the medication reaches its therapeutic levels. By this stage, most patients see a weight reduction of about 5–10% of their body weight. For instance, clinical studies show that using Wegovy alone can lead to approximately 6% weight loss in 12 weeks, while combining it with structured programmes can increase this to around 13%.

Weight loss usually continues steadily over the following months, with most people reaching a plateau around the one-year mark. The STEP 5 trial revealed that participants achieved an average weight loss of 15.2% by week 104. Similarly, high-dose semaglutide has been shown to result in an average reduction of about 15% over 16 months. The SELECT trial further highlights that this weight loss can be maintained long-term, with participants sustaining a 10.2% average reduction over four years (208 weeks).

As you progress through your weight loss journey, it’s important to stay informed about potential side effects and how to manage them to maintain your treatment plan successfully.

Side Effects and Safety

In Singapore, GLP-1 medications are prescription-only and require close monitoring by a doctor. The treatment follows a "start low and go slow" method, where doses are gradually increased over several months. This approach not only supports optimal weight loss but also helps to minimise potential side effects, as supported by clinical evidence.

The most common side effects are gastrointestinal issues, such as nausea, vomiting, diarrhoea, and constipation. These are generally mild to moderate and often improve within a few weeks as your body adapts. To manage nausea, avoid strong odours and opt for light, frequent meals. For constipation, increase your fibre and fluid intake and incorporate light activities like walking into your routine. Lisa Catanese, ELS, offers practical advice for managing nausea:

"nausea can be managed by avoiding strong smells and eating crackers, mint, or ginger-based food or drinks about a half hour after taking a GLP-1 drug".

Regular follow-ups with your doctor are essential. These check-ins allow your healthcare provider to monitor your progress, adjust your dosage, and address any concerns promptly. This personalised, doctor-led approach is a key part of GLP-1 treatment in Singapore. Eligibility for these medications is generally based on a BMI of 30 or higher, or 27 and above if you have weight-related conditions such as hypertension.

While serious side effects are uncommon, they do require immediate medical attention. Contact your doctor if you experience severe and persistent abdominal pain (which could indicate pancreatitis), yellowing of the skin or eyes, or an inability to pass gas or move your bowels. If you’re planning to undergo surgery, inform your doctor about your GLP-1 medication, as it may need to be paused a few days beforehand due to its impact on digestion.

Combining GLP-1 Medications with Lifestyle Changes

Diet and Exercise

GLP-1 medications deliver the best results when paired with intentional dietary choices and regular physical activity. Since these medications curb appetite, it's important to make every meal count. Focus on lean proteins like fish, chicken, tofu, and beans to maintain muscle mass, which can make up 25–40% of the total weight lost while on GLP-1 medications. Dr. Zhenqi Liu, a Professor of Medicine at the University of Virginia, highlights the importance of this approach:

"Some patients told me that they felt that they were losing muscle or muscle was slipping away from them while they were on these medications. This is a serious concern."

Adding fibre-rich foods such as oats, quinoa, and vegetables can help manage constipation and stabilise blood sugar levels. Since GLP-1 medications slow down digestion, smaller and more frequent meals are recommended to avoid discomfort like excessive fullness or nausea. Additionally, cutting back on high-fat, fried, and spicy foods can help minimise gastrointestinal side effects like nausea and heartburn.

For the best outcomes, combine a balanced diet with regular exercise. A well-rounded fitness routine should include both aerobic activities (like brisk walking or cycling) and strength training (using weights, resistance bands, or bodyweight exercises). Aim for 150 minutes of moderate aerobic exercise and two strength-training sessions per week.

An example of how exercise can enhance medication results comes from the S-LiTE study conducted at the University of Copenhagen. This study followed 109 participants with obesity from December 2018 to December 2020. One year after stopping treatment, those who combined supervised exercise with liraglutide maintained an additional 5.1 kg of weight loss and achieved a 2.3% greater reduction in body-fat percentage compared to those who relied on medication alone. Simon Birk Kjær Jensen from the University of Copenhagen remarked:

"The addition of supervised exercise to obesity pharmacotherapy seems to improve healthy weight maintenance after treatment termination compared with treatment termination of obesity pharmacotherapy alone."

These lifestyle adjustments, when paired with professional medical guidance, can significantly improve long-term weight loss outcomes.

Medical Support for Long-Term Success

While diet and exercise are key, ongoing medical support plays a crucial role in sustaining weight loss over time. Regular doctor-led monitoring ensures a safe and effective treatment journey. Gradual dose adjustments can help enhance weight loss while reducing potential side effects. Clinicians track important health metrics such as waist circumference, blood pressure, glucose levels, and lipids to monitor progress.

Obesity is a chronic condition, and the body often resists weight loss by increasing appetite and slowing metabolism once treatment stops. Rasminder Kaur and Tham Kwang Wei explain this challenge in SMA News:

"Discontinuing GLP-1 RA leaves our patients unsupported in their battle against the inevitable weight regain that occurs as a consequence of physiological forces, such as an increase in appetite and reduction in metabolic rate."

For those seeking comprehensive support, Trimly offers Ministry of Health-approved, doctor-led weight loss programmes entirely online. These personalised plans include both oral and injectable GLP-1 options, starting at $350+ per month. The service also provides free unlimited follow-ups, ensuring you stay on track with the healthy habits needed to maintain your progress.

Conclusion

GLP-1 medications have shown to be highly effective in managing weight when integrated into a well-rounded treatment plan. Clinical studies highlight impressive results: semaglutide can lead to up to 15.8% weight loss, while tirzepatide has demonstrated reductions as high as 22.5% at peak treatment levels. Even in long-term scenarios, the benefits remain evident. For instance, the SELECT trial revealed that patients on semaglutide maintained an average weight loss of 10.2% over nearly four years, alongside a 20% decrease in major cardiovascular events.

These findings emphasise that achieving and maintaining weight loss is a long-term effort. Chronic obesity requires a sustained approach that combines medication, proper nutrition, regular exercise, and consistent medical guidance. GLP-1 medications work by suppressing hunger, promoting feelings of fullness, and slowing down the digestive process.

"Anyone starting medication for a chronic condition - including obesity and diabetes - should consider it a long-term commitment." - Rekha Kumar, MD, Head of Medical Affairs, Found

However, without ongoing medical support, weight regain is a common challenge. For example, the STEP 1 trial found that nearly two-thirds of the weight lost was regained within a year after stopping treatment. This underscores the importance of a continuous, doctor-led approach to sustaining health improvements.

For individuals in Singapore seeking professional, structured weight loss support, Trimly offers MOH-approved programmes that are fully online. With personalised treatment plans, options for both oral and injectable GLP-1 medications starting at $350+ per month, and unlimited free follow-ups, Trimly provides the expert care needed to help you reach - and sustain - your weight loss goals.

FAQs

How do GLP-1 medications support long-term weight loss?

GLP-1 (glucagon-like peptide-1) medications are designed to assist with long-term weight loss by imitating the body’s natural hormones that control hunger and feelings of fullness. These medications work in three key ways: they reduce appetite, enhance the sensation of being full, and slow down the rate at which the stomach empties. Combined, these effects help reduce daily calorie intake and improve insulin sensitivity, paving the way for consistent weight loss over time.

Clinical studies back up their effectiveness. In one 68-week trial, participants achieved an average weight loss of 10% of their body weight. Another study, spanning 104 weeks, reported an average weight reduction of approximately 15%. These findings highlight how GLP-1 medications can provide a reliable approach to managing weight over the long term.

In Singapore, Trimly offers doctor-led GLP-1 programmes tailored to individual needs. Whether through injectable or oral options, Trimly delivers personalised treatment plans along with continuous telehealth support. This allows patients to achieve sustainable weight loss conveniently from their homes.

What side effects should I be aware of when using GLP-1 medications for weight loss?

GLP-1 medications like semaglutide (e.g., Ozempic®, Wegovy®, Rybelsus®) and tirzepatide (e.g., Mounjaro®, Zepbound®) are generally considered safe and easy for most people to tolerate. That said, some individuals might experience side effects, particularly in the early weeks as their bodies adapt. Common issues include nausea, vomiting, bloating, constipation, or diarrhoea. Mild reactions at the injection site, such as redness or swelling, can also happen.

More serious side effects, though less common, can include low blood sugar (especially if combined with other glucose-lowering medications), pancreatitis, gallbladder complications, or kidney issues. Some users might notice changes in their appearance, like skin laxity or differences in hair and nail texture. Rare cases have raised concerns about thyroid-related issues in animal studies, so those at risk may need extra monitoring.

If you're exploring GLP-1 therapy, Trimly provides personalised, doctor-led care to help you navigate side effects and stay on track with your weight loss goals.

Why do I need medical support when using GLP-1 medications for weight loss?

Medical supervision is essential when taking GLP-1 medications because these treatments require precise dose adjustments and continuous monitoring to ensure they are both safe and effective. Common side effects, like gastrointestinal issues or fluctuations in blood sugar levels, need to be addressed promptly. Regular check-ins also allow healthcare providers to track long-term health indicators such as blood pressure, cholesterol levels, and overall cardiovascular health.

In Singapore, Trimly provides personalised, doctor-led care for individuals using GLP-1 medications. Their service includes regular virtual consultations, unlimited follow-ups, and convenient medication delivery right to your doorstep. With Trimly, you’ll have expert guidance tailored to your unique needs, ensuring a safe and sustainable approach to achieving your weight-loss goals.