Key Takeaways:

• Weight loss medications, such as the class of medications known as GLP-1 receptor agonists, have been shown to result in weight loss.

• Not all the weight lost is fat – some are lean mass, which includes muscle.

• Studies showed that despite losing lean mass, those who took the weight loss medication had lower risk of heart disease and better physical function.

• It is important to have a team of medical specialists involved when you take weight loss medication so its overall effect on your health – including muscle loss and kidney function – can be observed.

Many weight loss medications such as the class of medications known as GLP-1 receptor agonists, or GLP-1 RAs have soared in popularity in the recent year. This group includes semaglutide, liraglutide, and dulaglutide.

These GLP-1 receptor agonists work by acting on the receptor for a certain hormone produced in the gut. They help to control blood sugar and weight in several ways, including:

• Increase production of the hormone that lowers blood sugar level, especially after taking food.

• Reduce production of the hormone that increases fasting sugar, optimizing fasting sugar levels.

• Slow gastric emptying and decrease appetite, which makes you eat less, feel full longer, lose weight and also slow down the release of glucose from your food.

• Overhaul “hunger and craving hormones”, working on the reward center of the brain, reducing cravings.

In Singapore, several GLP-1 RAs are already approved for use. There are those approved only for treating diabetes: Ozempic, which is given by injection once a week, and Rybelsus, which is a tablet (semaglutide); dulaglutide (Trulicity); and liraglutide (Victoza). 

Then there are those specifically approved for weight loss. For weight loss, Singapore has only approved liraglutide (under the brand name Saxenda) and a form of semaglutide called Wegovy.

Are weight loss medications really effective?

GLP-1 RAs have been shown to result in weight loss, which may in turn help to reduce the risk of diabetes complications. 

In multiple clinical studies of Saxenda, using the medication consistently resulted in weight loss of 4 to 6 kg. Nearly two-thirds of patients lost at least 5% of their body weight, and nearly one-third lost at least 10%.

Meanwhile, with Wegovy, patients achieved 5%–20% or greater weight loss. Further, Wegovy was found not only superior at reducing body weight compared with other antidiabetic medications, but also cardioprotective.

*Results based on clinical trials. Individual outcomes may vary.

Weight loss medications are effective because they act on a biological level. When coupled with a healthy diet and regular exercise, weight loss medication can help you lose weight effectively and safely, overcoming biological factors – all while allowing you to keep it off. 

Remember though that the use of prescription medications for weight loss requires a discussion with a qualified medical doctor regarding the risks and benefits, before any decision can be made on whether the medication would be appropriate for you. 

NOVI Optimum Plus can help you start your weight loss journey. The program includes: a specialist doctor’s consultation and support; 4-week or 12-week supply of medication (GLP-1 RA such as liraglutide or semaglutide); and coaching and regular reviews by your health coach.

Not all weight lost is fat

These weight loss medications are effective in helping patients lose weight. However, not all the weight lost is fat – some are lean mass, which includes muscle. 

The lean mass loss is generally from muscle loss, which could be detrimental since lean mass is healthier and associated with better metabolism. Therefore, the more muscle you have on your body, the better your resting metabolic rate is, meaning more energy expended at rest. Loss of lean muscle mass could make it more difficult to lose weight, causing a weight loss plateau. Further, lean body mass loss could increase the risk of sarcopenia or low muscle mass and impaired muscle function.

Losing weight has complex effects on the body and the more weight you lose during a short period of time, the more muscle mass you’ll lose. This is because when the body is not getting the energy it needs from food, it gets from energy reserves stored as fat, then from muscle. The body may need to pull more energy from muscle if they are losing a significant amount of weight over a very short period of time.

That is why it is important to focus on slow, consistent weight loss – rather than a dramatic weight loss. 

Is muscle mass important?

Yes. However, despite these concerns about muscle mass loss, people may have healthier body composition (ratio of lean mass to fat) at the end of their weight loss period. 

Further, in a 2021 clinical trial testing the weight loss effects of Wegovy, it was found that about 40% of the weight participants lost tended to be lean mass, including muscle. However, at the end of 68 weeks, those who took the weight loss medication had lower risk of heart disease and better physical function compared to a placebo group. Studies for the medication tirzepatide (sold under the brand name Mounjaro) showed similar results. There was a reduction in lean mass at a similar rate as in lifestyle-based obesity treatments. 

Maintaining muscle mass when losing weight

Of course, there are ways to maintain muscle mass when losing weight. Among the recommendations are to:

1. Consume enough protein. Protein is the building block of muscles. Protein is essential for muscles to build and repair itself. Here are some high protein snacks great for building muscle mass.

2. Exercise. Exercise, particularly strength/resistance training, is critical in helping you increase or maintain lean muscle mass during weight loss. Resistance-type exercises, added on top of your aerobic activity, also support strong, healthy bones.

Weight loss medications have side effects. Although they can be unpleasant, these effects are generally not dangerous and can be reduced through small adjustments to your lifestyle. Some of the more common ones include:

• Nausea and vomiting

• Abdominal pain and bloating

• Indigestion or acid reflux (heartburn)

• Constipation or diarrhea

• Weakness during exercise

• Headache

Benefits of a Medically Supervised Weight Loss Program

It is important to have a team of medical specialists involved when you take weight loss medications so its overall effect on your health can be observed – from helping manage the side effects of GLP-1 RAs or weight loss medications, to monitoring muscle loss and kidney function.

Furthermore, studies show that more than 33.5% of people regain their lost weight within 12 months. Sustained weight loss requires ongoing clinical supervision, specific counseling, and regular medication to support healthy lifestyle behaviors and positive weight regulation on a biological and genetic basis. 

NOVI Optimum Plus is a medically supervised weight loss program that includes guided lifestyle interventions to maximize and sustain weight loss. With this program, you will receive support and guidance from NOVI’s specialist doctors and coaches.