Henrik Lundvall

Weight gain after stopping GLP-1 medication is common and is partly due to appetite regulation, hunger, and energy balance gradually returning to previous levels when treatment ends. Obesity is a chronic and complex disease where biological mechanisms affect hunger, satiety, and body weight over time.

When treating with weight loss medications like Wegovy (semaglutide) and Mounjaro (tirzepatide), it is important to consider how the medications can affect fertility and the efficacy of contraceptives. Medications such as semaglutide (Ozempic, Wegovy, Rybelsus) and tirzepatide (Mounjaro) can contribute to improved fertility in women with obesity, partly as a result of weight loss and improved hormonal and metabolic function. At the same time, they can affect the absorption and efficacy of oral contraceptives.

Rybelsus is an oral treatment option used for type 2 diabetes and which in some cases may be relevant within obesity treatment. The medication contains the active substance semaglutide – the same substance as in Ozempic and Wegovy – and works by mimicking the body's own satiety hormone GLP-1. This contributes to reduced appetite, increased feeling of fullness, and delayed gastric emptying.

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Mounjaro contains the active substance tirzepatide and is used for the treatment of adults with type 2 diabetes as a supplement to diet and exercise. The medication contributes to lowering blood sugar levels in a glucose-dependent manner.

Mounjaro is also used for the treatment of adults with obesity (BMI ≥30 kg/m²) or overweight (BMI ≥27 kg/m² with at least one weight-related complication). By affecting the body's appetite regulation, the treatment can contribute to weight loss through reduced energy intake.

Losing weight with hypothyroidism can be perceived as more difficult, even with healthy lifestyle habits. An underactive thyroid means lower levels of hormones that regulate metabolism, which can affect energy expenditure and stamina. However, the effect on body weight is usually moderate and varies between individuals. When hypothyroidism is treated and hormone levels normalize, the conditions for weight loss improve.

Understanding why the body does not always respond as expected to diet and physical activity is an important starting point for the right treatment. Lipedema and overweight can in some cases resemble each other, but are two different conditions with distinct underlying mechanisms. They can also occur simultaneously, which can further complicate the clinical picture.

The demand for medical treatment of obesity and overweight has increased significantly in recent times, which in turn has contributed to the emergence of a market where medicines are sometimes distributed outside established and regulated healthcare systems. Using these medications without a doctor's prescription, and without structured and continuous follow-up, entails significant medical risks.

Managing overweight is rarely a matter of willpower. The body's complex biological systems interact to regulate appetite, energy expenditure, and fat storage – often in a way that counteracts weight loss. Medical weight loss aims to influence these processes and create better conditions for sustainable results over time. Here, we go through how the medications work and who the treatment is suitable for.

Interest in new drug treatments for obesity has increased markedly in recent years. MariTide is a treatment under clinical development that could potentially contribute to an increased understanding of the body's weight regulation and broaden treatment options for obesity.