Magic Shots or Diet in Disguise?

By 2026, it's likely that someone you know is using weight loss injections. Maybe you have a relative taking Ozempic or a friend who is using Mounjaro. Maybe you've heard talk about Saxenda or Zepbound. From our magazines to our Shabbos table

conversations, they’ve made themselves hard to ignore. The flood of talk around them may feel overwhelming, and it's tempting to frame weight loss injections as either a miracle cure or a moral failure. As is often the case in nutrition and health, the truth lives somewhere in the middle. As a HAES-aligned dietitian, I believe strongly in bodily autonomy, the right to make independent, informed choices about our bodies and health. I also believe that making a responsible choice requires a solid foundation of knowledge.

Weight loss injections belong to a family of drugs called GLP-1 receptor agonists, and they work by mimicking the hormone GLP-1 to stimulate insulin, slow stomach emptying, and reduce appetite. GLP-1 medications were originally developed and marketed to treat type 2 diabetes. They can improve blood sugar control by stimulating insulin production (the hormone that moves glucose from the blood into cells) and decreasing glucagon (the hormone that signals the liver to release glucose into the bloodstream). GLP-1s also slow gastric emptying and send “full” signals to the brain, which can reduce appetite.

While GLP-1s were created as diabetes medications, they gained celebrity status

because of a well-publicized side effect: weight loss. Studies show that some patients lose up to 20% of their body weight while on these medications. While that may sound enticing, it’s important to look beyond the headlines. Current research only follows GLP-1 use for about 2 to 3.5 years, meaning we lack solid long-term data. Newer studies from 2025 suggest that after two years, GLP-1s may become less effective for weight loss. Other research shows that after two years, approximately 25% of users regain all the weight they lost, with nearly another 25% regaining some of it. While the research is still young and evolving, GLP-1s are beginning to look less like a magic shot and more like another version of yo-yo dieting.

From a physiological perspective, GLP-1–induced weight loss isn’t so different from

traditional dieting. Appetite suppression leads to reduced food intake and rapid weight loss. Over time, many people stop the medication due to cost, side effects, burnout, or access issues, which is often followed by weight regain. If you’ve ever been caught in the yo-yo dieting cycle, you already know how this story goes: weight regain is frequently followed by another attempt to lose weight, and the cycle continues. While yo-yo dieting is often dismissed as frustrating but harmless, research tells a different story. Long-term weight cycling is associated with increased cardiovascular risk, insulin resistance, poorer metabolic health, and worsened mental health outcomes.

GLP-1s are well known for causing GI side effects such as nausea, vomiting, and

constipation. Rapid weight loss can also lead to hair loss and facial changes. One of the most concerning physical side effects is muscle loss. Rapid weight loss almost always includes loss of lean body mass, not just fat. Research suggests that 25–40% of the weight lost on GLP-1s may come from muscle, especially when protein intake is low or the patient isn’t engaging in resistance training. Muscle mass is critical for metabolic health, physical function, and longevity. Low muscle mass increases the risk of injury and frailty, especially as we age. Losing muscle in the pursuit of “health” is a bit like removing the engine to make a car lighter. In rarer cases, GLP-1s have also been associated with more serious concerns involving the gallbladder,

kidneys, or thyroid.

Another concern GLP-1s bring up is regarding mental health. GLP-1s can increase risk

of disordered eating and eating disorders by quieting biological hunger and fullness cues and giving external validation and normalization to restrictive eating patterns. For people with a history of an ED, chronic dieting, or body image struggles,GLP-1s can make disordered eating patterns worse by increasing food avoidance and losing trust in hunger and fullness, as well as by mimicking restrictive eating patterns.

GLP-1s are not villains. They can create positive health outcomes, especially for those

with diabetes. GLP-1s are also not a neutral wellness tool, and may not have positive health benefits for everyone. As individuals, we each have a right to choose whether a GLP-1 is the right fit for us, and it is important we have informed consent - the knowledge of the good and bad that any specific medication or medical procedure may cause. We can acknowledge that GLP-1s can do a lot of good - namely regulate blood sugar, and also can cause harm in the form of yoyo dieting, physical symptoms, muscle mass loss, and increased risk for EDs.

With this in mind, we can feel at peace making a decision that fits us best. Remember that health is not a number on a scale, but a holistic view of our physical, mental, and emotional health. GLP-1s are not inherently bad. For some people, especially those managing diabetes, they can offer real benefits. At the same time, they are not a one-size-fits-all solution. GLP-1s have inherent risks to long-term health and quality of life. Having informed consent doesn’t mean rejecting GLP-1s outright, but it does require discussion about limitations and potential harms. We can make an informed decision, without shame, and weight the costs vs benefits keeping in mind our own health, values, and experiences. Health cannot be reduced to a number on a scale. It is shaped by physical function, mental well-being, and our relationship with food and our bodies over time.