Diabetes medicines, weight loss and long-term health

How are type 2 diabetes and obesity linked?

Type 2 diabetes is closely linked to insulin resistance. This is when the body’s cells don’t respond to insulin in the way they should. Insulin resistance often goes hand in hand with weight gain, overweight and obesity, and the relationship works both ways. Each condition can make the other worse.

Around 80 to 85% of people with type 2 diabetes are also overweight or living with obesity. Looking at it the other way around, people living with obesity have almost three times the risk of developing type 2 diabetes compared to people within a lower weight range.

Both conditions are complex and influenced by many factors, including genetics, hormones, lifestyle, and the body’s own systems for regulating hunger, fullness and energy balance. As fat mass and insulin resistance increase, it becomes harder for the body to regulate blood sugar as well as hunger and satiety signals. This can contribute to further weight gain and poorer metabolic control over time.

Weight loss and physical activity can improve insulin sensitivity and blood sugar control. That’s why these are often a central part of treating type 2 diabetes. Not for cosmetic reasons, but to reduce the risk of medical complications and support long-term health.

Are there diabetes medicines that can lead to weight loss?

Some medicines used to treat type 2 diabetes can, for many people, also contribute to weight loss. At the same time, there are other diabetes treatments that are weight neutral or may even lead to weight gain. That’s why it’s important to compare different options carefully when choosing treatment.

How someone responds to a medicine varies from person to person and depends on factors such as biology, dose, how consistently the treatment is used, and how it’s combined with lifestyle changes. Medicines such as semaglutide (a GLP-1 agonist) and tirzepatide (a combined GLP-1/GIP agonist) are the treatments that have shown the greatest average weight loss in clinical studies so far. Based on separate obesity studies, both have also been approved for the treatment of obesity in many countries.

Which types of diabetes medicines can support weight loss?

Some groups of diabetes medicines affect appetite regulation, fullness and blood sugar in a way that can make it easier to eat less without constant hunger. These medicines work through the body’s hormone systems and influence both appetite and blood glucose levels.

GLP-1 agonists and GLP-1/GIP agonists

GLP-1 receptor agonists, such as semaglutide, and combined GLP-1/GIP agonists, such as tirzepatide, mimic hormones in the body that help regulate appetite and satiety. For many people, this makes it easier to reduce energy intake without feeling hungrier. The effect varies between individuals. Some experience clear weight loss, while others see more modest changes. This is one reason why medical follow-up with a doctor and an individual assessment are essential for safe and effective treatment.

Weight loss with diabetes medicines – how big is the effect?

How much weight someone loses with medical treatment varies a lot. Starting weight, degree of insulin resistance, dose, length of treatment and lifestyle all play a role.

The amount of weight loss achieved can differ widely. Some people with diabetes notice more pronounced weight loss early on, while longer-term effects are often more gradual. Clinical studies show that people with type 2 diabetes using Ozempic lose around 5 to 7% of their body weight on average, sometimes more. With the higher doses of semaglutide used specifically for obesity treatment without diabetes (Wegovy), average weight loss is often greater, commonly around 10 to 15% of body weight with longer-term treatment.

For tirzepatide, which is a combined GLP-1/GIP agonist, studies have shown an even greater average effect on weight loss compared to semaglutide. In people with type 2 diabetes, tirzepatide has been associated with greater average weight loss and improved long-term blood sugar control compared to semaglutide. In studies of people living with obesity without diabetes, tirzepatide has led to weight loss of up to around 20% of body weight at higher doses and with longer treatment duration.

It’s important to remember that these are average results from clinical studies. Some people lose more, some less, and some respond very little.

Medical treatment can support weight loss, but it doesn’t replace the need for changes in diet, physical activity and habits. Research shows that medicines such as semaglutide and tirzepatide work best when combined with lifestyle changes.

Without support and follow-up, there is a risk that weight can increase again over time. That’s why long-term thinking is a key part of healthy, sustainable medical weight loss.

Can you use diabetes medicines for weight loss if you don’t have diabetes?

Some medicines originally developed for type 2 diabetes can also be used to treat obesity, but only when they have a separate approved indication for weight management. Ozempic and Wegovy contain the same active ingredient, semaglutide. Ozempic is approved for treating type 2 diabetes, while Wegovy is approved specifically for weight management.

Wegovy and Mounjaro or Zepbound may be prescribed for people without diabetes when the criteria for obesity treatment are met:

• BMI of 30 or higher, or
• BMI of 27 or higher together with weight-related health conditions.

These medicines should always be prescribed by a doctor and used as part of a long-term plan for health and weight management, including support for lifestyle changes. Using Ozempic off-label for weight loss should be avoided when approved obesity medicines are available.

Risks and side effects

Side effects are often more noticeable at the start of treatment, but for many people they ease over time as the body adjusts. The most common side effects with medicines containing semaglutide or tirzepatide are related to the stomach and gut, such as nausea, diarrhoea and constipation. Self-medicating without advice and follow-up from a healthcare professional carries risks and should always be avoided. What you eat can also affect both the risk and intensity of side effects.

These medicines also need to be used with caution in people taking oral medicines that require rapid absorption in the gut. Safety, existing medical conditions and individual risk factors should always be discussed with a doctor when treating type 2 diabetes or obesity with medication.

When might medical weight loss be an option?

Medical treatment for weight loss may be considered for people living with obesity, or for those who are overweight alongside health-related risk factors such as type 2 diabetes, marked insulin resistance, high blood pressure, sleep apnoea or other metabolic conditions. It can also be an option when previous structured attempts at weight loss haven’t led to the desired results despite appropriate support.

Before starting treatment, an individual medical assessment is always needed. This looks at both clinical factors and lifestyle in a careful, holistic way.

Yazen’s treatment philosophy is built on long-term thinking, medical safety and individual adaptation. The goal isn’t quick fixes, but better, sustainable health that can be maintained over time.

Summary

Diabetes medicines and weight loss are closely linked, but the relationship is more complex than headlines and social media posts often suggest. Type 2 diabetes, insulin resistance and obesity influence each other through several biological mechanisms. Weight loss can be a central part of treatment to improve blood sugar control and long-term health. Some diabetes medicines can support weight reduction by affecting appetite, fullness and hunger, but the effect varies between individuals and always requires medical assessment.

Medical treatment isn’t a shortcut or a replacement for lifestyle change. Sustainable weight loss relies on long-term support, regular follow-up and a whole-person approach to health. At Yazen, treatment is tailored to each individual, with a focus on medical safety, evidence, and results that are realistic and possible to maintain over time.

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