When someone starts taking popular new weight-loss drugs like GLP-1 agonists (the same type as Ozempic or Wegovy), they often focus on the number on the scale. But a new agreement between doctors, dietitians, and patient groups says there's much more to think about.
Three major organizations — the European Association for the Study of Obesity (EASO), the European Federation of the Associations of Dietitians (EFAD), and the European Coalition for People Living with Obesity (ECPO) — have released shared safety guidelines published in The Lancet Diabetes & Endocrinology. An international team of 26 experts led by Dr. Laurence Dobbie of King's College London wrote the report together.
The guidelines come because these drugs have transformed how obesity is treated, but they can also bring risks that need careful watching.
One surprising finding: when people lose weight with these drugs, between 24% and 30% of that weight loss is actually muscle, not fat. This matters because muscles help keep us strong, steady, and independent — especially as people get older. The report suggests a practical goal: for every 4 kilograms lost, aim for at least 3 kilograms of fat and no more than 1 kilogram of muscle loss.
The guidelines strongly emphasize the role of dietitians (trained nutrition professionals) throughout treatment. They help make sure patients get enough protein, vitamins, and minerals while on the medication, which can cause nausea and reduce appetite. Dietitians also teach skills for long-term healthy eating and communicate in a supportive, weight-inclusive way.
The report also flags psychological impacts. While many people feel better mentally after losing weight, some have underlying mental health challenges that can resurface during major life changes like significant weight loss. The guidelines recommend checking for these risks before and during treatment, including screening for alcohol use disorders.
Finally, the guidelines address a troubling fairness gap. Obesity affects minority ethnic groups and lower-income communities more often, yet these same groups often have the least access to specialist care and these newer medications. The report calls for attention to these inequalities.
The hope is that by following these guidelines, patients can get the full benefits of these powerful new drugs while avoiding their potential downsides.