The 3-stage fat jab plan – how to maximise your weight loss, dodge nasty side effects, and stay slim for good
WEIGHT loss injections have become the holy grail in the fight against obesity, helping people shift the pounds they’ve been fighting for years.
But alongside the rapid weight loss are the drawbacks of jabs like Wegovy, Mounjaro and Ozempic; their side effects and fear of coming ‘off’ the injections.
The side effects can include nausea, vomiting, constipation, diarrhoea and a general unwell feeling – and the long-term side effects of the jabs are not known.
It’s something that Dr Jack Mosley, son of the late Dr Michael Mosley, explores in his new book, Food Noise: How Weight Loss Medications & Smart Nutrition Can Silence Your Cravings.
Dr Jack, a GP registrar and expert in weight loss jabs, wants to continue the work of his dad Michael, who died on June 5 last year while holidaying on the Greek island of Symi.
Michael was a prominent TV and radio doctor and founder of the Fast 800, a weight loss programme that focuses on fasting, the Mediterranean-style diet and making sustainable lifestyle changes.
Now, Jack is following in his dad’s footsteps, advocating for healthy weight loss.
He tells Sun Health: “Like dad, and my mum, Clare Bailey Mosley, I am medically trained.
“For years my focus has been on treating obesity – there’s no doubt some of my parents’ passion has rubbed off on me.
“I now work as a GP registrar.
“I was working in Australia when the new generation of GLP-1 (Glucagon-Like Peptide-1) weight loss medications began to make a splash on the global stage.
“The weight loss jabs looked like they would be a miraculous silver bullet in the fight against obesity.”
GLP-1 is a hormone that plays a crucial role in regulating blood sugar levels and appetite.
GLP-1 receptor agonists are synthetic drugs that mimic the action of GLP-1.
They are used in the treatment of type 2 diabetes and obesity due to their dual benefits in blood sugar control and weight management.
For weight loss, GLP-1s target appetite regulation centres in the brain, increasing the sensation of fullness and reducing hunger.
Dr Jack says: “The powerful effect of the GLP-1s on reducing appetite has highlighted for many an aspect of their internal monologue they always knew they had – food noise.
“Food noise is the voice in your head telling you to look for your next meal or snack.
“It is the craving that tells you to have that chocolate bar when you know you shouldn’t.”
For many, the silencing of ‘food noise’ is the kick start they need to slim down.
Oprah Winfrey said on her podcast that when she started taking GLP-1, she realised slim people didn’t have more willpower – they just don’t have ‘food noise’. She says the drugs quietened hers.
But it comes at a cost; eating less might see the fat fall off, but it also means people are at risk of not getting enough vital nutrients from food.
Jack said: “I share my dad’s view that these jabs are likely to be an effective hammer in the toolbox to combat obesity and obesity-related illnesses.
“However, I have concerns that widespread and unsupervised use of these jabs could create a whole new set of health problems.
“Entire populations may inadvertently switch obesity for a state where they are malnourished and frail.”
Are you eligible for fat jabs on the NHS?
You can get weight loss injections on the NHS but eligiblity hinges on criteria.
You’ll only be prescribed liraglutide (Saxenda) if all of these apply:
- you have a BMI of 35 or more, or you have a BMI of 32.5 or more and you’re of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin
- you have non-diabetic hyperglycaemia (high blood sugar)
- you’re at high risk of heart problems such as heart attacks and strokes, for example because you have high blood pressure (hypertension) or high cholesterol
And you’ll only be considered for semaglutide (Wegovy) if:
- you have health problems due to your weight and you have a BMI of either 35 or more or 32.5 or more if you’re of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin
- 30 to 34.9, or 27.5 to 32.4 if you’re of Asian, Chinese, Middle Eastern, Black African or African-Caribbean origin, and you meet other criteria to be treated by a specialist weight management service
Privately, the jabs cost anywhere from £150 to £260 a month.
But they aren’t available over the counter, you need to have a prescription to take them.
Your eligibility will still need to be assessed by a pharmacist or GP, according to Click2Pharmacy.
Jack also warns the high demand for weight loss jabs has made it a “free-for-all”.
“People with worrying obesity-related illnesses are self-administering the drug, and increasing their doses to eye-watering levels, without any kind of medical or nutritional advice or support,” he says.
“Naturally slim people are acquiring pen syringes from black-market suppliers, and using the appetite-suppressant properties to skip meals to get themselves ‘beach body ready’.
“Others go ‘on the pen’ to improve their gym-honed physiques, potentially jeopardising their health.
“These are serious medications and, at the time of writing, we have no long-term studies to show how safe they are to take at higher doses for any protracted period of time.
“I’m neither for nor against these medications, but as a doctor I will always urge caution.
“I believe there is a way to use these medications safely and effectively to lose weight – if that’s your chosen path – and keep the weight off.”
So how can you use these jabs safely?
Here, Jack shares his three-stage plan of using the jabs and coming off them.
STAGE 1: RAPID WEIGHT LOSS
WHEN you reach the right dose of the medications, your appetite will be suppressed.
I suggest eating 800 to 1,000 calories a day during this phase.
The jabs are likely to make you feel queasy at the thought of deep-fried food so listen to those messages and don’t fall into the trap of wasting your now tiny appetite on junk.
People who experience side effects such as vomiting and diarrhoea often say this happens when they eat too much unhealthy food.
Reduce your intake of starchy carbohydrates such as white bread, white rice and white pasta as they rapidly break down into sugars in the blood.
Prioritise two main nutrients – protein and fibre.
If you don’t eat enough protein (at least 60g per day) when you are on weight loss medications, your body will scavenge protein from your muscles, resulting in loss of lean muscle mass.
It is important to make protein, such as fish, chicken, cheese, eggs, nuts or tofu, a significant part of each meal.
Aim for 30g of dietary fibre every day to keep your gut microbiome happy and healthy too.
Do this by eating as many vegetables, beans, nuts and seeds as you can.
Add in wholegrains as well. Fibre is crucial for maintaining a functional digestive tract, which will mitigate any unwanted side effects, such as constipation or diarrhoea.
Base your eating on a lowish carbohydrate, Mediterranean-style diet, rich in olive oil, seeds, fruits, eggs, vegetables, pulses and fish, alongside moderate amounts of meat and dairy products.
This has been shown to promote weight loss, maintain muscle mass and keep you properly nourished.
Drink plenty of water. As you burn fat your body naturally loses fluid, particularly in the early days, so keep yourself well hydrated by adding an extra one to 1.5 litres of water a day, or more if it’s hot or you are exercising.
Be active too. Keeping active throughout this and every stage of the plan is important.
To avoid losing muscle, you need to incorporate some kind of strength training into your weekly routine.
Gyms normally have classes for a range of abilities.
Alternatively, you could buy a few dumbbells or just use your own body weight and exercise from the comfort of your own home.
STAGE 2: WEANING OFF THE JABS
AS you reduce your dose of the medication, you may notice a return of food noise. But don’t fall into the trap of old habits.
If you redouble your focus on a lowish carbohydrate, Mediterranean-style diet, packed with protein, healthy fats and plenty of vegetables, you shouldn’t be tormented by cravings.
Without the medication to dampen your appetite, you may feel hungrier on some days than others.
It can help to incorporate intermittent fasting – allocating two or three days each week to restrict your calorie intake or eating smaller portions (keeping calories to 800 to 1,000 per day), then eating larger portions on the other days.
This is low enough to mimic the effects of fasting, which aids weight loss, but without you having to feel too hungry.
Follow a pattern that suits you, from the more intense 3:4 pattern (four days fasting each week), to the 5:2 or 6:1.
Another intermittent fasting trick is time restricted eating (TRE) which extends your overnight fast by a few hours to harness all the benefits of fasting (and keeps your weight in check).
You might eat breakfast slightly later or have an early evening meal, or skip breakfast entirely and just eat two meals a day.
You could try a 12:12 pattern (12-hour overnight fast). If this is too easy, you could extend it to 14:10 (14-hour overnight fast).
Weigh yourself regularly. Studies show that keeping a close eye on your weight makes it much easier to nip small weight gains in the bud.
Throw in some extra fast days if you do notice your weight creeping up.
STAGE 3: LONG TERM SUCCESS
BY this stage, you have reached your weight loss goal and improved your metabolic health.
You may decide to stop the GLP-1 medications at this point. I believe coming off or reducing the medication should be a goal for most people.
If your weight does rebound substantially when you stop taking the GLP-1s and you are struggling, ask your healthcare provider about restarting the medications at a low dose – until you have things more under control.
Exercise and strength training should continue to be a non-negotiable part of your regime.
The Mediterranean-style diet should be the norm.
Here’s a summary of what foods to eat:
- Avoid processed junk foods – high in calories, low in nutrition.
- Eat plenty of protein – hold onto that precious muscle.
- Eat plenty of fibre – helps regulate your bowels, but also great for your gut and thus your body and brain.
- Eat healthy fats – such as oily fish, nuts, seeds and olive oil.
- Enjoy complex carbohydrates, such as wholegrains, beans and legumes.
- Eat a rainbow of colourful fruit and vegetables.
This maintenance phase can be dynamic.
Continue to weigh yourself regularly and bring back in a few fasting days if you feel the weight is starting to creep up again.
This is an edited extract by Natasha Harding taken from Food Noise: How Weight Loss Medications & Smart Nutrition Can Silence Your Cravings by Dr Jack Mosley (£16.99, Short Books), published on April 24.
How to blast belly fat WITHOUT going to gym or dieting
Chew your food
This mindfulness trick is used to focus your brain on the food you are eating – how it tastes and feels – rather than scoffing it in a hurry. If the brain does not register that you have eaten, you’ll soon crave more food.
Avocado a day
Eating avocado every day can fight visceral fat in women, which collects around the organs in the stomach and can lead to diabetes, heart attack, and some cancers, according to a University of Illinois Urbana-Champaign study of 105 people.
Avoid fizzy drinks
Losing belly “fat” may just be a case of preventing bloating, which can be onset by fizzy soft drinks. Instead, keep hydrated with water.
Reduce alcohol
Alcohol does no favours at all for our health or figures. It is ’empty calories’, meaning it contributes to your calorie intake without giving any nutritional benefit.
Hangovers can also lead you to eat more fatty foods, while putting you off exercising.
Sleep more
Various studies have shown that if you’re not sleeping well, it can cause weight gain.
People are more likely to crave junk food when they are sleep deprived because, not only are they in need of an energy boost, but their appetite hormones are all over the place.
Reduce stress
Stress causes an imbalance of hormones, particularly cortisol. This hormone has been linked with obesity and excess belly fat.
Find ways to reduce your stress to avoid the so-called ‘stress belly’.