Who Should Take Weight Loss Injections, and Who Shouldn’t?

Introduction 
Potential Candidates
Individuals Who Should Avoid Them 
Scientific Evidence 
Expert Opinions 
Conclusion 


Weight loss injections have gained significant attention in recent years as a potential tool for managing obesity and associated metabolic conditions. Many of these injections belong to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists, which include drugs such as semaglutide and liraglutide.1 Unlike older weight loss treatments that often produce modest effects, GLP-1 receptor agonists have demonstrated notable efficacy in reducing body weight when combined with lifestyle interventions like diet and exercise.

Diabetes blue Insulin or Semaglutide Injection pen closeup.Image Credit: MillaF/Shutterstock.com

Introduction

As obesity rates continue to climb globally, these injectable medications have gained popularity among individuals seeking a more structured medical approach to weight management. However, misconceptions and uncertainties persist regarding their safety, appropriateness, and long-term implications.1,2

This article evaluates weight loss injections (such as semaglutide) by examining who may benefit, who should avoid them, and the potential health implications based on current scientific evidence.

It also will help gain a clearer understanding of whether weight loss injections are a suitable option for their unique healthcare needs. The interplay between medical therapy and individualized lifestyle modifications remains crucial for achieving lasting health outcomes.

How Does Semaglutide Work to Lose Weight?

Potential Candidates

Potential candidates for weight loss injections typically exhibit a body mass index (BMI) of 30 kg/m² or higher or a BMI of at least 27 kg/m² with one or more obesity-related comorbidities such as type 2 diabetes or hypertension.3

Clinicians also consider factors like age, medical history, and the patient’s ability to commit to recommended lifestyle changes when determining eligibility. These injectable medications may be beneficial for individuals who have struggled to achieve meaningful weight loss through traditional methods alone.

For instance, research shows that patients who incorporate semaglutide or liraglutide alongside dietary modifications can experience more significant weight reduction than those relying on diet and exercise alone.4

Candidates may also benefit from improvements in glycemic control, blood pressure, and lipid profiles, thus reducing the risk of complications like cardiovascular disease. It is important to note, however, that these injections are not a “magic bullet” for weight loss.

Adherence to medical guidance and ongoing lifestyle interventions remain vital for achieving and maintaining results. Ultimately, determining candidacy involves a comprehensive evaluation by healthcare professionals, taking into account both physical and mental health components to ensure safe and effective use.5

Individuals Who Should Avoid Them

Despite their potential benefits, weight loss injections are not suitable for everyone. Individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 are generally advised against using GLP-1 receptor agonists due to a theoretical risk of thyroid C-cell tumors.

Furthermore, some patients may experience side effects such as gastrointestinal discomfort, including nausea, vomiting, and diarrhea, which can be problematic for those with pre-existing digestive issues.

Pregnant or breastfeeding individuals should also avoid these medications, as there is insufficient evidence regarding their safety in these populations. In addition, patients with a history of severe allergic reactions to any component of the injection formulation must abstain from using these drugs.

Healthcare providers typically conduct a thorough medical assessment before prescribing weight loss injections, which may include evaluating liver and kidney function, screening for gallbladder disease, and assessing any relevant mental health concerns.

For instance, some studies indicate that individuals with uncontrolled eating disorders or severe depression might require more specialized interventions before considering pharmacological weight loss solutions. By identifying contraindications and risks, healthcare professionals can help reduce the likelihood of adverse events and ensure a safer path toward weight management.4-6

What's Next for Semaglutide? Beyond Diabetes and Weight Loss

Scientific Evidence

According to scientific literature, weight loss injections have been found to be effective for both short-term and long-term weight management.

In a randomized controlled trial, participants who used semaglutide in conjunction with lifestyle interventions lost nearly 10-15% of their baseline body weight, compared to 2.5-5% in the placebo group. Similar findings have been reported for liraglutide, which demonstrated significant weight reduction over a span of 56 weeks.7

The mechanisms of action involve delaying gastric emptying, reducing appetite, and improving insulin sensitivity, thereby helping individuals consume fewer calories. In addition to weight loss, these medications have been associated with better glycemic control, as evidenced by decreases in hemoglobin A1c levels, and potential cardiovascular benefits.8

Nevertheless, concerns remain about the durability of these effects once medication is discontinued. Some studies suggest that patients may regain weight if they stop treatment abruptly without a comprehensive maintenance strategy in place.

Ongoing research aims to clarify optimal dosing regimens, address questions about long-term safety, and explore combination therapies that might enhance outcomes further. 4-6

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Expert Opinions

Endocrinology experts generally emphasize the importance of a holistic approach

when considering weight loss injections. According to the American Association of Clinical Endocrinologists, pharmacotherapy should be integrated with nutritional guidance, physical activity, and behavioral support to maximize outcomes.9

Endocrinologists highlight the need for vigilant monitoring of patients, especially during the initial phases of treatment, to manage potential side effects and assess therapeutic response.

Nutritionists often stress the importance of dietary quality and the establishment of sustainable eating habits, noting that weight loss medications can serve as an adjunct but not a replacement for core lifestyle modifications.5,9

Meanwhile, primary care physicians are frequently tasked with evaluating the broader context of a patient’s health, coordinating care to ensure comorbid conditions such as hypertension or dyslipidemia are simultaneously addressed.3

Many healthcare professionals agree that patient education is paramount, as misunderstandings regarding drug mechanisms or unrealistic expectations can undermine success. In practice, a multidisciplinary team potentially including mental health counselors, dietitians, and exercise physiologists often collaborates to support individuals who opt for weight loss injections.

This integrated model aims to improve adherence, minimize risks, and maintain health improvements over the long run.5,9​​​​

Conclusion

Weight loss injections, specifically GLP-1 receptor agonists like semaglutide and liraglutide, offer a promising avenue for individuals who have struggled with obesity and its associated health complications.

Scientific research indicates that these medications can lead to meaningful weight reduction and metabolic improvements when paired with lifestyle interventions. However, their use is not universally appropriate, as certain medical conditions and personal histories may contraindicate treatment.

Furthermore, side effects such as gastrointestinal discomfort underscore the necessity of close medical supervision. While many experts champion the role of weight loss injections as part of a comprehensive, patient-centered strategy, they also emphasize that medication alone is seldom sufficient to produce sustained change. Personalized attention to diet, exercise, and emotional well-being remains an integral component of long-term success.

As ongoing studies continue to shed light on optimal dosing schedules, safety profiles, and combination therapies, individuals considering these treatments should consult qualified healthcare professionals for a thorough evaluation.

Ultimately, informed decision-making based on current scientific evidence, expert advice, and personal health status can help patients determine whether weight loss injections are the right choice. Through a blend of medical innovation and lifestyle commitment, many individuals may find a viable path toward healthier, lasting weight management.

Weight loss injections are increasingly accessible but expensive, although some insurance plans may offer coverage. GLP-1 receptor agonists require patient education on injection technique and needle disposal. Regular medical follow-up is crucial to adjust dosages and monitor side effects. Ongoing research explores next-generation obesity treatments, including novel medication combinations and extended-release formulations.

Personalized medicine, integrating genetic, metabolic, and lifestyle data, is a key goal. Concurrently, public health strategies remain essential in addressing environmental and behavioral factors that contribute to obesity. By uniting innovative therapies with broader policy measures, the healthcare community aims to optimize and sustain weight management over time.

References

  1. Zheng, Z., Zong, Y., Ma, Y., Tian, Y., Pang, Y., Zhang, C., & Gao, J. (2024). Glucagon-like peptide-1 receptor: mechanisms and advances in therapy. Signal Transduction and Targeted Therapy9(1), 234.https://doi.org/10.1038/s41392-024-01931-z
  2.  ​​​​​Popoviciu, M. S., Păduraru, L., Yahya, G., Metwally, K., & Cavalu, S. (2023). Emerging role of GLP-1 agonists in obesity: a comprehensive review of randomised controlled trials. International journal of molecular sciences24(13), 10449. https://doi.org/10.3390/ijms241310449
  3.  Jensterle, M., Rizzo, M., Haluzík, M., & Janež, A. (2022). Efficacy of GLP-1 RA approved for weight management in patients with or without diabetes: a narrative review. Advances in therapy39(6), 2452-2467.https://doi.org/10.1007/s12325-022-02153-x
  4.  Horn, D. B., Almandoz, J. P., & Look, M. (2022). What is clinically relevant weight loss for your patients and how can it be achieved? A narrative review. Postgraduate medicine134(4), 359-375. https://doi.org/10.1080/00325481.2022.2051366
  5.  Qi, Q. Y. D., Cox, A., McNeil, S., & Sumithran, P. (2024). Obesity medications: a narrative review of current and emerging agents. Osteoarthritis and Cartilage Open, 100472. https://doi.org/10.1016/j.ocarto.2024.100472
  6.  ​​​​​​Chao, A. M., Tronieri, J. S., Amaro, A., & Wadden, T. A. (2022). Clinical insight on semaglutide for chronic weight management in adults: patient selection and special considerations. Drug design, development and therapy, 4449-4461.https://doi.org/10.2147/DDDT.S365416
  7.  Pi-Sunyer, X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., ... & Wilding, J. P. (2015). A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine373(1), 11-22. https://doi.org/10.1056/NEJMoa1411892   
  8.  ​​​​​Drucker, D. J. (2018). Mechanisms of action and therapeutic application of glucagon-like    peptide-1. Cell metabolism27(4), 740-756. https://doi.org/10.1016/j.cmet.2018.03.001​​​​​​​ 
  9. ​​​​​​Garvey, W. T., Mechanick, J. I., & Einhorn, D. (2014). The American Association of Clinical Endocrinologists and the American College of Endocrinology: 2014 advanced framework for a new diagnosis of obesity as a chronic disease. Endocrine practice: official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists20(9), 977. https://doi.org/10.4158/EP14280.PS

 

Further Reading

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Last Updated: Feb 27, 2025

Vijay Kumar Malesu

Written by

Vijay Kumar Malesu

Vijay holds a Ph.D. in Biotechnology and possesses a deep passion for microbiology. His academic journey has allowed him to delve deeper into understanding the intricate world of microorganisms. Through his research and studies, he has gained expertise in various aspects of microbiology, which includes microbial genetics, microbial physiology, and microbial ecology. Vijay has six years of scientific research experience at renowned research institutes such as the Indian Council for Agricultural Research and KIIT University. He has worked on diverse projects in microbiology, biopolymers, and drug delivery. His contributions to these areas have provided him with a comprehensive understanding of the subject matter and the ability to tackle complex research challenges.    

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