Health

What you need to know before taking weight-loss drugs

Weight-loss drugs are not the quick fix solution that many people believe, especially if you hope to keep the pounds off in the long-term.

Sarah Le Brocq has direct experience of the transformative effects of weight-loss drugs. She has lived with obesity for most of her adult life and tried numerous diets. “Anything that came out, I thought, ‘I’ll try that because that might work for me’.” Unfortunately, the weight always came back, she told the BBC’s Inside Health.

After taking weight-loss drugs for more than two years, she has lost almost eight stone (51kg/112lb). “All of a sudden I wasn’t thinking about food anymore,” she says. “I’ve just got more energy, I’m doing things I couldn’t do before… it’s kind of given me a new freedom in life again.”

Millions of people like Sarah are now accessing medications like semaglutide and tirzepatide, better known by their popular brand names Ozempic and Mounjaro. The numbers of people on weight-loss medication is only likely to increase as new drugs appear on the market too, including pills rather than the current jabs.

It’s clear that these drugs are opening up a new era in the treatment of obesity. The condition, is now a “mitigatable” issue, David Cummings, professor of medicine at the University of Washington tells me. “They are the closest thing I’ve seen to miracle drugs”.

Other academics, however, warn that we risk losing sight of the need for behavioural change, especially as weight tends to be regained quickly when people stop taking the drugs.

So what should anyone planning to use weight-loss medication consider before they start?

How they work

Weight-loss drugs work by suppressing an individual’s appetite by mimicking hormones that tell our body when it is full. The most common are known as glucagon-like peptide 1, or GLP-1, and glucose-dependent insulinotropic polypeptide, or GIP.

The drugs bind to specialised molecules on the surface of our cells known as GLP-1 and GIP receptors, which play a key role in telling our body when it has had enough food.

Typically someone taking these drugs will begin to lose weight within the first few weeks. Although the drugs are only approved for weight loss in people with obesity, there is a rapidly growing private market for those not considered clinically obese.

Their popularity has been rising because they are extremely effective, with weight loss of between 14-20% in 72 weeks. But about 10-15% of people lose very little weight, so called “non-responders“.

GLP-1s are like “a chemical shield” that protects individuals against our “modern obesogenic environment, filled with cheap, calorie-dense foods”, says Naveed Sattar, a professor of cardiometabolic medicine at the University of Glasgow and leads the UK Government’s Obesity Healthcare Goals programme. He has also consulted on medical trials with several companies who produce weight-loss drugs but does not own any shares.

“There’s food everywhere,” he says – and within half an hour anyone “can pick up the phone and order 10,000 calories of food”.

If you stop, you’ll gain weight

If someone living with obesity starts to take weight-loss drugs, they need to consider that they may be on the drug long-term, says Cummings, who runs a weight management programme for individuals with obesity who have BMIs of 50 and above.

A common question he is asked by his patients before they start taking a weight-loss drug is how long they will be on it. Typically, they stop taking the drugs after about a year, he says. One analysis of scientific studies involving more than 9,000 patients indicated the average treatment duration was 39 weeks. People believe they can continue to lose weight using their willpower, he says, but the evidence suggests that is not the case.

People stop for various reasons, either due to the expense of treatment, their insurers stopping coverage or individuals not wishing to be on drugs for a prolonged period of time, Cummings has found.

And when people do stop the drugs, their weight tends to rebound. A recent study found that weight regain happens up to four times more quickly after stopping weight-loss drugs compared to someone ending a weight-loss programme that focuses on changing their behaviour.

Another study found that those on weight-loss drugs gained 1.5kg (3.3lbs) eight weeks after they stopped the medication, with their weight continuing to climb with the more time that passed. The same study also found that other health concerns, such as high blood pressure, also returns. New research has also found that people who stop taking weight-loss drugs gain back around 60% of the weight they lost a year later.

It returns quickly because of something researchers call “food noise“, which consists of persistent and intrusive thought around food, says Sattar.

Hormones play a role too. When an individual tries to lose weight, it triggers a powerful hormonal response that tells your body to regain the weight you lost. Cummings explains that because of this, the brain interprets a calorie drop as an energy deficiency, so after stopping weight-loss drugs, hormones that stimulate appetite increase while the rate at which you burn energy – the metabolic rate – decreases. “If these biological defences are strong enough, they can blunt the drug’s effectiveness,” he says.

Lifestyle change

Sattar has observed that for a small proportion of people who make lifestyle changes, it may be possible to reduce the dose or use the drug intermittently instead. Some really do make “fundamental changes in their diet”, he says.

“Others might need it at a lower dose than they would when they started. But the majority will probably still need some dose of the drug because the [food] environment is still the same.”

There’s also increasing concern that individuals are taking weight-loss medication as a substitute for making life-style changes – even though evidence shows that modifying lifestyle in combination with weight-loss drugs is what will lead to greater weight loss.

Experts have recently cautioned in a scientific review of the evidence that when there’s a lack of behavioural and lifestyle support for those on weight-loss drugs, it can leave individuals vulnerable to nutritional deficiencies. “We need to make sure people are getting enough protein and are getting all the vitamins and minerals they need,” says Marie Spreckley a nutrition and behavioural scientist at Cambridge University and lead author of the report. “You don’t want to have longer-term unintended consequences, like frailty and muscle loss. We don’t want to replace one health concern with another.”

Because these medications cause a dramatic appetite reduction, patients tend to eat less overall, she and her colleagues note. This can lead to a “missed opportunity” if patients are not supported long-term and their food choices remain poor.

No quick fix

The World Health Organization has therefore stated that medication alone won’t “reverse the obesity challenge”. Early interventions, screening and creating healthier environments are also needed, the organisation has stated in its guidelines on using GLP-1 drugs.

This is easier when people are still taking the drugs, Sattar says. “You have more mental space to think about your diet.”

But behavioural change is extremely challenging, says Amanda Daley, a professor of behavioural medicine at Loughborough University in the UK. She says there needs to be better communication with patients about how quickly they can regain weight once they stop taking GLP-1 medication.

Obesity is a chronic, relapsing condition, she says, which means it cannot be “cured” with a drug alone. That’s why additional support and “wraparound care” is key to ensure patients make dietary changes as well as increasing their physical activity.

It’s unclear whether private providers are providing this crucial additional support, she says, which she finds concerning since so many people access the drugs privately and it is hard to monitor continuation of care.

Micro-nudges help change behaviour

To overcome some of this – researchers at Stanford have looked at how they can help support and encourage lifestyle changes. In one recent study, researchers tested whether small nudges – or “microsteps” – could help encourage healthy behavioural change for those taking GLP-1 medications.

The tiny changes focused on nutrition, physical activity, sleep and stress management. Crucially, the microsteps were small and manageable, such as swapping sugary drinks for water, no longer drinking coffee after lunch, taking a deep breath when stressed or popping outside for five minutes.

They found these helped improve behavioural expectations. It’s this “expectation” that’s a first necessary step for behavioural change, says Maya Adam, a clinical associate professor of paediatrics at Stanford School of Medicine, who was involved in the study.

“Achieving your best health involves a lot more than pharmacotherapy alone,” she says. “We found that giving people these little nudges may be very effective.” She calls these steps “too small to fail” because even small daily changes and habits make a real difference over time.

Side-effects

These kind of interventions are crucial to help give people the tools they need to enact change, Daley says, especially considering the known side effects. These include gastrointestinal issues. There has also been an observed increase in pancreatitis and gallstones. Muscle loss is another concern, especially among individuals who are not exercising. Recently a study found links to bone and joint conditions too.

While we now have several years of data on the effectiveness of GLP-1 drugs, we don’t yet know what the long-term outlook will be or whether the results will wear off over time. There is also a lack of data on how these drugs affect pregnancy outcomes or future generations, as the advice is not to take weight-loss drugs during pregnancy.

But given the negative health outcomes for those living with obesity, the side effects pale in comparison, both Sattar and Cummings say. This is particularly the case for individuals with multiple weight-related conditions. Heart disease, cancer and stroke are the leading causes of death worldwide – and all are linked to obesity.

A changing landscape

What is clear is that the landscape for weight-loss medication is rapidly evolving.

There are other health benefits too beyond weight loss. In one major study involving two million people, the drugs were linked to better heart health, fewer infections, lower risk of drug abuse and lower incidences of dementia. It’s also been shown to improve sleep apnoea, arthritis and substance abuse.

BBC

Health

Beyond Uniforms and Lunchboxes: Is Your Child Healthy and Ready for School?

By Dr. Mamata Bothra, Specialist Pediatrician and Neonatologist, International Modern Hospital, Dubai

With schools reopening on August 25, parents across the UAE are busy preparing uniforms, books, shoes and lunchboxes. But before the school bag is packed, it is worth asking one more important question: Is my child healthy and ready for the new academic year?

As a pediatrician and neonatologist, I encourage parents to use the remaining days before school as an opportunity for a simple health review. This does not mean carrying out a long list of unnecessary medical tests. Instead, it is about identifying any health concerns that could affect a child’s learning, energy, development or overall well-being.

Start with vaccinations and medical needs

Begin by checking your child’s vaccination record. Make sure all routine vaccinations are up to date and that no recommended doses have been missed. Parents should also speak with their child’s doctor about the seasonal influenza vaccine.

If your child has a chronic medical condition or requires regular medication, ensure prescriptions are current and that the school has the necessary medical information, medicines and emergency action plan.

A routine pediatric check-up can also be valuable, particularly if your child has not been assessed recently. During the appointment, the pediatrician can evaluate growth, height, weight, blood pressure, physical development, nutrition and general health.

It is also an opportunity to discuss concerns that may have been postponed during the holidays, including recurrent headaches or abdominal pain, constipation, frequent infections, breathing difficulties, snoring, fatigue, poor appetite or unexplained changes in behaviour and school performance.

Preventive pediatric visits should not focus solely on vaccinations. They also provide an opportunity to discuss a child’s learning, behaviour, development, emotional health and any age-appropriate screening needs.

Does your child need tests for iron or vitamin deficiencies?

Iron deficiency deserves particular attention because it can affect a child’s energy, concentration and neurodevelopment. However, this does not mean that every healthy school-aged child needs to undergo a large “vitamin panel” before returning to school.

The decision to perform blood tests should be based on the child’s age, diet, growth, symptoms and individual risk factors.

Children who follow restrictive, vegetarian or vegan diets, have poor nutrition, consume excessive amounts of milk, have a chronic illness or are not growing as expected may require further assessment. Persistent tiredness, pale skin, weakness and difficulty concentrating can also indicate the need for medical evaluation.

When testing for possible iron deficiency is clinically indicated, particularly in adolescents, a complete blood count and serum ferritin test may be useful.

Similarly, testing for vitamin D, vitamin B12 or other nutritional deficiencies should be guided by the child’s medical history, diet, symptoms and clinical examination—not performed routinely for every child.

Do not overlook vision and hearing

A child who cannot see the board or hear the teacher clearly may appear inattentive when the real problem is sensory.

Possible signs of a vision problem include squinting, sitting very close to screens, rubbing the eyes, experiencing frequent headaches, holding books unusually close, struggling to read, turning the head to one side or showing an unexplained decline in school performance.

For hearing, parents should watch for frequent use of the word “What?”, increasing the television volume, difficulty following instructions, failing to respond when called or a history of recurrent ear infections.

Not every concentration problem is an attention disorder. Before labelling a child as inattentive, we should first make sure the child can see clearly, hear properly and sleep well.

Dental health affects learning too

A dental check-up is worthwhile if your child has not visited a dentist recently, particularly if there is toothache, sensitivity, bleeding gums, persistent bad breath or visible tooth decay.

Dental pain can interfere with eating, sleeping, concentration and school attendance.

Parents should also remember that a school lunchbox does not need to become a travelling sweet shop. Encourage children to brush regularly with fluoride toothpaste and limit frequent sugary snacks and drinks.

Reset the body clock before school begins

If your child’s bedtime has gradually moved towards midnight during the holidays, do not expect them to fall asleep at 9pm on the night before school.

Start adjusting bedtime and wake-up time gradually before classes begin. School-aged children generally require nine to 12 hours of sleep each night, while teenagers usually need eight to 10 hours.

Insufficient sleep does not always appear simply as tiredness. In some children, it may cause irritability, hyperactivity, poor concentration, mood changes or behavioural difficulties.

Prioritise balanced food and hydration

A nutritious breakfast and balanced diet can help children begin the school day with energy and concentration. Aim to include a variety of protein, whole grains, fruits and vegetables while reducing highly processed food and sugary drinks.

Hydration is especially important in the UAE’s climate. Send your child to school with a water bottle and encourage regular drinking throughout the day rather than waiting until they feel very thirsty. Water should remain the main drink.

A practical back-to-school health checklist

Before August 25, parents should consider the following questions:

Vaccinations: Are all routine vaccinations up to date?
Growth: Is my child’s height and weight progressing appropriately?
Iron and nutrition: Is there a dietary risk or unexplained fatigue that requires assessment?
Vision: Can my child see the board and read comfortably?
Hearing: Can my child hear clearly and follow instructions?
Dental health: Is there any pain, sensitivity or untreated dental problem?
Sleep: Has my child’s routine returned to school timings?
Food and water: Is my child eating a balanced diet and drinking enough water?
Chronic conditions: Are medicines, prescriptions and school action plans updated?
Development and behaviour: Have there been changes in learning, concentration, mood or behaviour that require attention?

Parents do not need to panic or turn the back-to-school season into a medical examination marathon. The objective is not to find a problem in every child. It is to ensure that an existing concern does not go unnoticed.

A new uniform may prepare a child for the classroom, but adequate sleep, balanced nutrition, clear vision, good hearing, healthy teeth and timely medical care prepare that child to learn.

This year, before asking, “Have you packed your school bag?”, perhaps ask one more question:

“Are you healthy, rested and ready for the year ahead?”

Health

Back to the Heat: Why Returning to the UAE Can Leave Holidaymakers Feeling Exhausted

Returning to the UAE after spending several weeks in a cooler destination can leave some travellers feeling unusually tired, sluggish or generally out of sorts. According to a family medicine specialist, this is often part of the body’s natural process of readjusting to extreme heat and humidity.

Dr. Renuka Ramasamy, Specialist in Family Medicine at International Modern Hospital Dubai, explains that spending time away from a hot environment can temporarily reduce some of the body’s heat adaptations.

“When someone spends a couple of weeks in a much cooler climate, some of the body’s adaptation to extreme heat can begin to diminish,” she says. “Heat acclimatisation influences how efficiently we sweat, regulate our core temperature and manage the cardiovascular strain caused by hot weather.”

These adaptations can start declining within days or weeks when a person is no longer regularly exposed to high temperatures. When they return suddenly to the UAE’s summer conditions, their body must work harder to maintain a safe and stable core temperature.

More blood is directed towards the skin to release heat, sweating increases and the cardiovascular system must compensate for the additional strain. As a result, some people may initially feel unusually tired, physically heavy, less energetic or generally unwell.

“It is essentially a period of re-acclimatisation,” Dr. Ramasamy explains. “Fortunately, someone who was previously accustomed to the UAE climate will generally readjust more quickly than a person experiencing this level of heat for the first time.”

Heat, dehydration and disrupted routines

The sudden change in temperature is rarely the only reason people feel unwell after returning from holiday. Heat, humidity, dehydration, poor sleep and changes to daily routines can combine to make the transition more difficult.

In hot and humid conditions, sweating and fluid loss increase. At the same time, high humidity makes it harder for sweat to evaporate from the skin, reducing the body’s ability to cool itself efficiently.

Even relatively mild dehydration can contribute to fatigue, headaches, dizziness and difficulty concentrating.

“Travel may also disrupt sleep, meal times, exercise habits and normal daily routines,” Dr. Ramasamy says. “People can arrive home already tired or inadequately hydrated and then immediately expose their bodies to considerable heat stress.”

Certain groups are more vulnerable to the effects of high temperatures. These include older adults, young children, pregnant women, outdoor workers and people undertaking strenuous outdoor exercise. Individuals with chronic medical conditions and those taking medications that affect hydration, sweating or temperature regulation should also be particularly cautious.

Give the body time to readjust

During the first few days back in the UAE, people should allow their bodies to gradually readjust instead of immediately returning to a demanding routine.

Drinking water regularly throughout the day is important, rather than waiting until intense thirst develops. People who are sweating heavily may also need to replace electrolytes. However, those with heart or kidney conditions, or who have been advised to restrict their fluid intake, should follow their doctor’s individual recommendations.

Restoring a regular sleep and meal schedule as soon as possible can also support recovery. Fruits, vegetables and other water-rich foods may help maintain hydration, while excessive alcohol consumption should be avoided because it can worsen dehydration.

Exercise should initially be lighter, particularly when performed outdoors. Strenuous physical activity should be avoided during the hottest part of the day, and both the intensity of exercise and the amount of time spent outdoors should be increased gradually as heat tolerance returns.

“The body needs time to readjust,” Dr. Ramasamy says. “People who are not fully acclimatised should reduce the intensity and duration of outdoor exercise during their first week back in a hot environment.”

When symptoms require medical attention

Although mild tiredness and reduced energy may be part of normal re-acclimatisation, people should not automatically dismiss more serious symptoms as a consequence of returning from holiday.

Significant dizziness, fainting, confusion, persistent vomiting, severe weakness or other concerning symptoms may indicate heat-related illness and require prompt medical assessment.

“It is important to distinguish normal readjustment from possible heat illness,” Dr. Ramasamy warns. “Severe or persistent symptoms should not simply be attributed to coming back from holiday.”

For most healthy people, careful hydration, adequate sleep, lighter exercise and gradual exposure to outdoor heat can make the transition back to the UAE climate safer and more comfortable.

Dr. Renuka Ramasamy
Specialist in Family Medicine
International Modern Hospital Dubai

Health

NMC Speciality Hospital, Al Nahda successfully treats Rare case of Guillain – Barré Syndrome in an 11 – Month old Infant

Dubai, UAE – A multidisciplinary medical team at NMC Specialty Hospital, Al Nahda has successfully treated an 11-month-old infant diagnosed with Guillain–Barré syndrome (GBS), specifically acute motor axonal neuropathy (AMAN), variant, enabling the infant to make a complete recovery.

The infant, who was previously healthy, was brought to NMC Specialty Hospital after developing severe irritability and an inability to bear weight following a recent viral illness. Recognising that these symptoms could indicate a serious underlying neurological condition, specialists initiated a comprehensive assessment, leading to the diagnosis of acute motor axonal neuropathy (AMAN), a rare variant of Guillain–Barré syndrome.

Guillain–Barré syndrome is an autoimmune neurological disorder in which the body’s immune system mistakenly attacks the peripheral nervous system. While it can affect individuals of all ages, it is rarely reported in infants younger than one year often making diagnosis particularly challenging.

The case was led by Dr. Krupa Torne, Paediatric Neurologist, and involved close collaboration among experts from Paediatrics, Neuroradiology, Neurophysiology, Physiotherapy and Nursing. The coordinated efforts of the multidisciplinary team enabled a prompt diagnosis and immediate initiation of treatment with intravenous immunoglobulin (IVIG) therapy, which is considered one of the most effective interventions for Guillain–Barré syndrome when administered early.

“The rarity of Guillain–Barré syndrome in infants can make diagnosis difficult, as symptoms may initially be mistaken for more common childhood illnesses,” said Dr. Krupa Torne. “In this case, the early recognition of neurological symptoms, combined with rapid multidisciplinary assessment and treatment, played a crucial role in achieving an excellent outcome. It highlights the importance of maintaining a high index of suspicion for neurological conditions even in very young children.”

Following treatment, the infant was closely monitored and underwent physiotherapy to support recovery and mobility. Over the following weeks, the infant demonstrated steady neurological improvement, regaining strength and motor function.

At the eight-week follow-up appointment, the infant was able to walk independently and showed a completely normal neurological examination, marking a full recovery.

The successful outcome underscores the importance of access to specialist paediatric neurological expertise and integrated multidisciplinary care in managing complex and rare childhood conditions.

“This case reflects the strength of collaborative care and the advanced capabilities available at NMC Specialty Hospital, Al Nahda,” said Dr. Torne. “When specialists across disciplines work together seamlessly, we can deliver timely, evidence-based treatment that significantly improves outcomes for our youngest and most vulnerable patients.”

The infant’s parents expressed their heartfelt gratitude to the entire medical team, acknowledging the compassionate care, clinical expertise and unwavering support that helped their infant make a full recovery.

NMC Specialty Hospital, Al Nahda continues to provide comprehensive paediatric care supported by advanced diagnostic capabilities and specialised clinical expertise, helping patients with both common and complex conditions achieve the best possible outcomes.