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WEIGHT loss jabs such as Ozempic, Mounjaro and Wegovy have offered a lifeline to those with diabetes and obesity.
But not everyone who takes the GLP-1 receptor agonists benefits equally, warn scientists.
The way GLP-1 receptor agonists work is by lowering blood glucose, which then modifies a person’s appetite leading to weight loss.
But not everyone experiences weight loss while taking them.
As part of their investigations, researchers looked at people’s relationship with food, and the influence this had on their treatment.
The scientists focused on three different types of eating behaviours linked to weight gain; emotional eating, where people eat in response to negative emotions rather than hunger; external eating, where people eat because the food looks great rather than because of hunger; and restrained eating, which can help with weight loss but can also lead to disordered eating.
The study monitored 92 individuals with diabetes in Japan over their first year of taking the drugs.
All three types of eaters showed a significant reduction in body weight, cholesterol levels, and body fat percentage over the course of the year.
But there were some differences in results.
People who overeat in response to the sight or smell of tasty food were most likely to respond well to the drugs in the long term.
But individuals who overeat for emotional reasons were less likely to.
“Pre-treatment assessment of eating behaviour patterns may help predict who will benefit most from GLP-1 receptor agonist therapy,” said Prof Daisuke Yabe of Kyoto University, senior author of the study published in Frontiers in Clinical Diabetes and Healthcare.
“GLP-1 receptor agonists are effective for individuals who experience weight gain or elevated blood glucose levels due to overeating triggered by external stimuli.
“However, their effectiveness is less expected in cases where emotional eating is the primary cause.”
After three months, participants reported more behaviours associated with restrained eating, and fewer behaviours linked to external or emotional eating.
By 12 months, a decrease in external eating was sustained.
But restrained and emotional eating behaviours returned to their baseline levels.
“One possible explanation is that emotional eating is more strongly influenced by psychological factors which may not be directly addressed by GLP-1 receptor agonist therapy,” said Dr Takehiro Keto of Gifu University, second author of the study.
“Individuals with prominent emotional eating tendencies may require additional behavioural or psychological support.”
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The researchers did point out participants who fell into the external eating group may have been especially highly motivated to try to improve their control over their diabetes, which may have resulted in greater weight loss.
“While our study suggests a potential association between external eating behaviour and treatment response to GLP-1 receptor agonists, these findings remain preliminary,” said Yabe.
“Further evidence is necessary before they can be implemented in clinical practice.
“Should future large-scale or randomised controlled trials validate this relationship, incorporating simple behavioural assessments could become a valuable component in optimising treatment strategies.”
Everything you need to know about fat jabs
Weight loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases.
Wegovy – a modified version of type 2 diabetes drug Ozempic – and Mounjaro are the leading weight loss injections used in the UK.
Wegovy, real name semaglutide, has been used on the NHS for years while Mounjaro (tirzepatide) is a newer and more powerful addition to the market.
Mounjaro accounts for most private prescriptions for weight loss and is set to join Wegovy as an NHS staple this year.
How do they work?
The jabs work by suppressing your appetite, making you eat less so your body burns fat for energy instead and you lose weight.
They do this my mimicking a hormone called GLP-1, which signals to the brain when the stomach is full, so the drugs are officially called GLP-1 receptor agonists.
They slow down digestion and increase insulin production, lowering blood sugar, which is why they were first developed to treat type 2 diabetes in which patients’ sugar levels are too high.
Can I get them?
NHS prescriptions of weight loss drugs, mainly Wegovy and an older version called Saxenda (chemical name liraglutide), are controlled through specialist weight loss clinics.
Typically a patient will have to have a body mass index (BMI) of 30 or higher, classifying them as medically obese, and also have a weight-related health condition such as high blood pressure.
GPs generally do not prescribe the drugs for weight loss.
Private prescribers offer the jabs, most commonly Mounjaro, to anyone who is obese (BMI of 30+) or overweight (BMI 25-30) with a weight-related health risk.
Private pharmacies have been rapped for handing them out too easily and video calls or face-to-face appointments are now mandatory to check a patient is being truthful about their size and health.
Are there any risks?
Yes – side effects are common but most are relatively mild.
Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea.
Dr Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia.
Evidence has so far been inconclusive about whether the injections are damaging to patients’ mental health.
Figures obtained by The Sun show that, up to January 2025, 85 patient deaths in the UK were suspected to be linked to the medicines.
