08-05-2025
I've seen a friend fall off the Wegovy wagon – it isn't pretty
A dear friend dropped by Woods Towers last weekend and what I witnessed in my kitchen was nothing short of terrifying.
The woman who had barely allowed so much as a Hobnob to pass her lips this entire year had suddenly morphed into The Tiger Who Came to Tea, breakfast, dinner and the rest.
To explain, Genevieve (not her real name) is one of those high fliers who's busy and buzzy and seldom alights anywhere for long. Late-night takeaways and shop-bought sandwiches are not the best for healthy living, and in recent years her weight had crept inexorably upwards to the point where she felt in genuine despair.
'Fat jabs' such as Wegovy and Mounjaro were like (low-calorie) manna from heaven, and since January she's been on Wegovy, prescribed by her private GP.
Wegovy and Mounjaro are given as weekly injections via pre-filled pens that can be self-administered into the upper arm, thigh or stomach. They work as an appetite suppressant by mimicking a hormone called glucagon-like peptide-1 (GLP-1), an intestinal hormone that is released after eating, and typically makes people feel fuller.
Not a shy dieter by any means, Genevieve is upfront – evangelical even – with her social circle about the difference it has made. The 'food noise' has been silenced; her energy levels have risen; even her joints ache less.
I have found myself getting quite envious, truth be told, even though I'm not a realistic candidate for something so drastic. Slow and steady works fine for my metabolism – although it's shocking how a few days of overindulgence immediately shows.
Anyway, Genevieve, who is in her early 50s, never goes near the scales interestingly. When her doctor records her weight loss every month, she looks away. 'Proof that I do, actually, have some willpower,' she laughs. Instead, she measures her progress by her waistband and the reflection in her full-length mirror.
And she looks amazing, no doubt about it; younger, sleeker, slimmer. Her clothes hang better and she radiates a sort of bien dans sa peau confidence.
But on Friday evening, when she swung by ostensibly for a (small) glass of wine and some nibbles, she transformed into a sort of demented wolverine. She demolished the crisps, reached for the nuts, then, when I invited her to stay for supper, hoovered up pasta bake and made short shrift of the leftover bread and butter pudding (a variation on Nigella's deluxe version made with brioche; the fruit marinated in Grand Marnier).
I had to say something. She was clearly relishing food for the first time in five months, but there was an edge of mania to her hunger. What on earth was going on?
'I was travelling for work and then I took a few days' leave, but I forgot my Wegovy pen so I missed my injection,' she admitted. 'It's been 10 days and now I feel ravenous, all the time. It's like my body is insisting I cram as much food as I can into it so I can get back to my old weight. The rebound effect is both horrible – and fascinating.'
Later that evening she would be clambering back on the Wegovy wagon so she was able to intellectualise the (temporary) fixation on food and wasn't unduly concerned. But we both agreed it was a troubling insight into the way weight-loss injections function – they might dramatically alter your eating habits while you're on them, but after that you're effectively back to square one.
That's why reputable clinicians are trying very hard to impress upon people the work they need to do while the drugs manage their appetite. Unless you alter your lifestyle by taking exercise, choosing healthy options when you do eat, and, perhaps most important of all, addressing the reasons why you over-consumed snacks or carbs or burgers in the first place (boredom, stress, an addiction to ultra-processed foods) you are unlikely to maintain your weight loss.
Just this week WeightWatchers, which is based in the US, revealed it is filing for bankruptcy, having fallen victim to the fat jab quick fix. But as more of the population on both sides of the Atlantic start taking these medications – under current government plans they will eventually be offered at pharmacies for the £9.90 cost of an NHS prescription – the long-term consequences need to be scrutinised.
Unless we accept that, like statins, users will need to be on semaglutide forever and they have indeed been developed as a lifelong medication, there will have to be a massive public health push to build better eating habits when people stop taking them.
A report by CNN last November revealed that one in eight adults in the US had used a weight-loss drug. But an analysis of US pharmacy data show that only one in four patients was still taking them two years later – and although no details were given about the reasons for quitting, it is worth remembering that, unlike Britain, the US healthcare system is based on insurance policies.
Other studies in the US show that most people who come off Wegovy regain almost all the weight they shed, although crucially there's around a 5 per cent permanent loss, which does have a positive effect in continuing to ward off prediabetes but does little for morale.
I have a hunch that here in the UK we will be crying out for the sort of habit-changing programmes offered by WeightWatchers and others, those systems that support healthy lifestyles and promote discipline – but it may be too late if they all go belly-up. As my friend Genevieve conceded: '.'
