Dr. Federica Amati, a prominent nutritionist and researcher, has raised concerns about the widespread use and potential misuse of GLP-1 medications, commonly known as "fat-loss jabs," which have surged in popularity across the UK since the approval of Wegovy by the National Institute for Health and Care Excellence (NICE) in 2023. These drugs, which mimic the hormone glucagon-like peptide-1 to suppress appetite, are being employed by approximately two million Britons, largely outside the National Health Service (NHS), often obtained through private clinics and online sources at costs reaching £350 per month.
Amati, head nutritionist at the health science company Zoe and a lecturer at Imperial College London, warns that the rapid uptake of these medications, frequently without proper medical oversight or lifestyle guidance, presents significant risks. “We are living through a moment of genuine medical progress, but also deep confusion,” she said, emphasizing that the drugs’ effectiveness depends heavily on accompanying nutritional and behavioral support to avoid long-term harm.
GLP-1 medications were initially developed to help manage type 2 diabetes but have shown remarkable results in weight loss by enhancing feelings of fullness and improving blood sugar regulation. Amati describes their impact as revolutionary for diet-related chronic diseases, which account for one in five premature deaths globally. However, she cautions against their indiscriminate use by individuals seeking cosmetic weight loss or minor reductions without medical need.
A critical issue highlighted by Amati is the lack of structured guidance accompanying these prescriptions, leading some users to underconsume vital nutrients. Many patients reportedly rely on convenient, processed foods and drastically reduce meal frequency due to suppressed appetite, resulting in nutrient deficiencies, muscle loss, and bone density decline. Research from the University of Copenhagen supports these warnings, noting that users of GLP-1 drugs lose significant muscle mass alongside fat, raising the risk of frailty and fractures, particularly among older women.
Amati has encountered patients presenting with severe side effects including scurvy, osteoporosis, gallstones, anemia, mood changes, and hair loss, alongside common gastrointestinal symptoms like nausea and constipation. She stresses that these adverse effects often stem from improper usage and lack of dietary adjustments, rather than the drugs alone.
Moreover, the unregulated online market raises safety concerns over counterfeit products and inconsistent dosing. Amati calls this a potential public health emergency, exacerbated by aggressive marketing, celebrity endorsement, and social media advertising that downplay the necessity of professional medical supervision. She describes the current approach as “stupid” and risky, pointing out the contrast with other medications that require strict prescribing protocols.
Scientific understanding of GLP-1 drugs is still evolving. Not all patients respond equally, likely due to differences in gut-brain signaling and individual microbiomes, with hunger driven by complex hormonal and microbial interactions. Amati notes that other gut hormones beyond GLP-1 may play roles in appetite regulation, suggesting the need for future personalized treatments.
Despite her reservations, Amati acknowledges that GLP-1 medications offer significant potential when used correctly as part of a broader health strategy involving nutrition, exercise, and stress management. She advocates for evidence-based public health interventions and tighter regulation of access, similar to models in countries like France and Italy, to safeguard users and enhance outcomes.
Amati’s latest book, The Appetite Reset, seeks to provide guidance on safely navigating GLP-1 treatment, warning against the misconception that medication alone can replace mindful eating. “Every bite has to count,” she notes, urging a comprehensive approach to ensure long-term health rather than short-term weight loss.
Looking ahead, Amati envisions advances in genetic testing and microbiome-tailored therapies that could optimize treatment effectiveness and reduce side effects. However, she remains skeptical of claims that these drugs will singlehandedly eradicate obesity or diabetes without addressing broader lifestyle and environmental factors.
Her concerns also extend to the rising number of people discontinuing GLP-1 medications within a year and regaining weight, as well as the potential for increased eating disorders and adverse effects in vulnerable populations, including pregnant women. Amati urges policymakers and healthcare providers to act swiftly to implement stricter regulations and support frameworks to maximize the benefits of this medical breakthrough while minimizing harm.