Weight-Loss Injections: Losing Weight or Regulating the Body?
This question seems quite simple at first glance. And the answer is often ready: “Because they eat too much.”
Yet more than forty years of practicing medicine have taught me that this is often not true.
Sometimes a person does not gain weight because they eat too much. They start eating more because they have gained weight. Because it is not only appetite that has gone wrong. The language of the gut has changed. The rhythm of the hormones has been disrupted.
Sleep no longer restores. Muscle tissue can no longer produce energy. Cells no longer respond to insulin the way they used to. The autonomic nervous system keeps sending a constant “danger” signal.
This is what I call loss of regulation. Body weight is often only the visible face of this silent biological disorder.
Modern Medicine Has Developed Powerful Drugs
In recent years, drugs such as Ozempic®, Wegovy®, Mounjaro® and similar medications have opened the door to a new era in the treatment of obesity. These drugs did more than regulate blood sugar; by reducing appetite, they helped many patients lose a meaningful amount of weight. When used for the right indication, these drugs are a truly important gain. Denying this would not be scientific.
But there is another development that concerns me. Today these drugs have begun to be used, at times, by healthy individuals who only want to lose a few kilos. It is precisely at this point that we need to stop and think again.
The Scale Does Not Always Tell the Truth
Patients often say to me: “Doctor, I lost eight kilos.”
I ask a different question: “Well, was what you lost really fat?”
Because in the human body, not every kilogram means the same thing.
Muscle tissue…
Fat tissue…
Water…
Connective tissue…
They are all different.
Losing weight by losing muscle does not strengthen metabolism; on the contrary, it can make it more fragile. Sarcopenia, which develops especially at older ages, is not merely a cosmetic problem; it is a serious condition affecting many areas, from the risk of falls to the immune system, from quality of life to metabolic health.
Why Does Regulatory Medicine Think Differently?
I have never treated weight alone.
I try to treat the organism.
Because unless the gut flora is restored…
Unless chronic inflammation subsides…
Unless the mitochondria produce energy again…
Unless sleep deepens…
Unless the autonomic nervous system calms down…
A significant portion of the weight lost can come back.
That is why, in regulatory medicine, the goal is not merely to reduce fat tissue.
The goal is for the organism to be able to re-establish its own balance.
Medication Alone Is Not the Solution
Sometimes medication is needed. In fact, it is absolutely necessary. I have never hesitated to say so.
Obesity…
Type 2 diabetes…
Advanced insulin resistance…
Metabolic syndrome…
In these patients, GLP-1-based treatments can be very valuable. But we cannot substitute a drug for lifestyle. A drug is a bridge. It is not the road itself.
Metabolism Cannot Heal Until the Gut Does
One of the most important truths I have seen in the clinic over the years is this: If the gut does not work well, metabolism does not work well either.
When the microbiota is disrupted, not only digestion but also the immune system, hormonal balance, inflammation, insulin sensitivity and even the appetite centers begin to be affected. That is why weight management often begins not with the stomach but with the gut.
Real Success Is Not How Many Kilos You Lose
I believe modern medicine should now ask a different question. Instead of “How many kilos did the patient lose?”,
“Was the patient able to preserve their muscle?”
“Has their energy increased?”
“Has their gut improved?”
“Can they sleep?”
“Has their inflammation decreased?”
Because if these have improved, the weight lost is likely to stay off.
What I Oppose Is Thoughtless Use
I am not against weight-loss injections. I am against thoughtless use. Every powerful treatment is a great opportunity in the right patient. In the wrong patient, it can turn into an unnecessary risk.
For this reason, I think it is important that everyone considering these drugs first be evaluated by an Endocrinology and Metabolism Specialist. If unexpected symptoms appear during treatment, the physician who planned the treatment must always be consulted before the medication is stopped or continued.
Because for me, real success is not the number on the scale.
Real success is a person who preserves their muscle, whose gut works well, who sleeps well, has high energy, is metabolically balanced and has regained their joy in life.
And perhaps most importantly:
A person does not become healthy merely by losing weight. They reach their ideal weight because they are healthy.
You can find neural therapy and Hüseyin Nazlıkul's other treatment methods here.