At the time, I saw them as a “shortcut”—a way to bypass the fundamental habits I’ve spent 15 years teaching.
I was wrong to see it in such black-and-white terms.
After watching the science evolve and seeing the real-world impact on those who struggle with physical barriers, I have shifted my perspective. While I still believe the “natural” route—focusing on behavioural change—is the gold standard for those with full mobility, I now see these medications as a net positive for society when used as part of a comprehensive strategy.
Levelling the Playing Field for Limited Mobility
The primary reason for my shift is NEAT (Non-Exercise Activity Thermogenesis). For a healthy individual, NEAT accounts for a massive chunk of daily calorie burn. But for clients with severe mobility issues or those recovering from catastrophic injuries like an ACL rupture, that “energy out” side of the equation is severely compromised.
In these cases, pharmacological assistance isn’t a shortcut; it’s a stabiliser. Recent data indicate that GLP-1 therapy is associated with significantly greater reductions in BMI compared to physical activity alone in certain populations (Vembu et al., 2026). It helps maintain the energy balance when the physical body is temporarily unable to do the heavy lifting.
The “Muscle Tax” and the Chef’s Perspective
As a former chef, my biggest concern with rapid weight loss is the loss of lean muscle mass. Clinical studies have shown that while semaglutide leads to significant weight loss, approximately 29.8% of that loss can come from muscle mass if not managed with lifestyle interventions (OAE Publishing Inc., 2026).
If the drug is handling the caloric deficit, our PT sessions in Sevenoaks become more important, not less. My protocol for anyone on this journey is non-negotiable:
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High Protein Intake: Vital for muscle protein synthesis to prevent “wasting.”
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Strength Training: The essential signal your body needs to keep muscle while losing fat.
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Nutrient Quality: Using my culinary background to ensure every calorie is high-density (fruit and veg) to maintain immune function.
The Exit Strategy: Returning to “Natural Living”
The “jab” should often be a bridge, not a permanent crutch. One of the biggest risks is the rapid weight regain seen upon discontinuation—often returning to baseline within 1.5 years (West et al., 2026).
When a client heals from an injury and regains mobility, we go back to basics. I prepare them mentally for the fact that their appetite will return. During this transition, we emphasise:
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Diligent Calorie Tracking: To recalibrate their internal “sensors” for the first few weeks of natural living.
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Volumetric Eating: Prioritising nutrient-dense, low-calorie foods to manage hunger.
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Habit Resilience: Re-establishing the discipline that medications can sometimes mask.
A Word of Caution
I am a Personal Trainer, not a doctor. These are powerful medical tools with potential side effects, including gastrointestinal issues (Bracchiglione, 2025). You must seek professional medical advice before considering this route.
My goal has always been to help my clients live longer, healthier lives. If these medications enable a client with a chronic injury to reduce joint load and improve heart health, then it is a win. The “natural” way is still the best teacher of discipline, but for some, the jab is the tool that finally gets them to the starting line.
References
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Bracchiglione, J. (2025). Semaglutide for adults living with obesity. Cochrane Library.
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OAE Publishing Inc. (2026). Effects of once-weekly semaglutide on regional body composition. Metabolism and Target Organ Damage.
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Vembu, K., et al. (2026). Unveiling the Impact of Lifestyle Interventions on Weight Reduction. PMC.
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West, et al. (2026). Molecular and Metabolic Mechanisms Influencing Long-Term Weight Regulation. Genetics and Molecular Research.
