Welcome to 'the great weight loss plateau'.

In 2024, weight loss feels different.

With diabetes medication hailed as the 'miracle cure' for obesity and weight management, the drugs known as 'Hollywood's best kept secret' are now mainstream. 

However, while the future of weight loss might look unlike anything we've ever seen — it's beginning to feel a lot like it did in the past. Because like other forms of weight management, there's actually only so far you can go.

Enter: The great weight loss plateau.

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The force behind it? A drug called 'semaglutide'.

To bring you up to speed, many of these 'weight loss drugs' aren't actually intended for weight loss. The main ones we use here in Australia are actually designed for people suffering from diabetes, but are now being used to restrict hunger and lose weight.

In Australia, diabetes medication currently falls under the Pharmaceutical Benefit Scheme (PBS) for those with type 2 diabetes who meet specific criteria. While there are studies that suggest this medication can be helpful with weight management and people are using it for weight loss, a GP can only prescribe it under the PBS for diabetes management.

This means you're required to get a private script from your GP (you'll pay full price not have it subsidised by Medicare). The catch? Your pharmacy doesn't have to fill it — and if the recent shortage is anything to go by, they sometimes won't. 

To meet overwhelming demand, the weekly injectable is now slowly multiplying under different manufacturers, with pharmaceutical companies scrambling to become part of the race. In Australia there are two main brands of semaglutide medication leading the pack — one, a lower dosage being used as "off label". The other, a higher dosage that is theoretically (but not practically) available in Australia.

However, while the popular medication may be viewed as a one time 'cure' for unwanted weight gain, the fact is that we've only really begun to scratch the surface in terms of the long-term side effects. We know that once you stop injecting the medication, it stops working. There's also the realisation that while weight falls off quickly at the start, it gradually reduces and eventually just... stops. 

It's the same thing that happens with dieting and bariatric surgery. Because the fact is, everyone eventually reaches a particular level where they'll stay the same. 

Mamamia spoke with Australian GP and author of Fake Medicine, Dr Brad McKay, who told us that the amount of weight you can lose with medication depends on the dose, how often you take it and how your body reacts. 

"Semaglutide comes in different doses," he shared. "Bigger doses help more with weight loss, while smaller doses can help manage diabetes. Due to a shortage of semaglutide in Australia, obtaining it can be a challenge."

As we mentioned before, although both popular brands are approved for use in Australia, only the smaller dose has been practically accessible to the public.

Why do you hit a weight loss plateau? 

While taking these types of medications will result in weight loss, at some point the results will taper off and your body will stabilise and reach a point where it becomes difficult to lose anymore.

"If you didn’t eventually hit a weight loss plateau, you’d disappear!" said Dr McKay. "Hitting a weight loss plateau is inevitable, but what matters is the amount of weight you lose before reaching that plateau." 

This is not only happening because people are reaching a certain body weight but, as Dr McKay told us, with interruptions in supply and only small doses available, "many people haven’t been able to maximise their weight reduction."

However, as the higher dosage becomes more widely available around the country, Dr McKay expects the people who have already reached a plateau with a lower dosage will be able to continue their weight loss journey. 

How much weight can you lose?

When it comes to reaching weight loss plateau, Dr McKay said "studies consistently indicate that the most substantial period of weight loss takes place in the first six months."

"Incorporating diet and exercise with a small dose can lead to an approximate 10 per cent reduction in total body weight over a 12 month period. When a higher dose is used alongside diet and exercise, a 15 per cent decrease in total body weight over the same 12 months could be expected."

"In comparison, diet and exercise without using medication may only reduce total body weight by two per cent."

With this in mind, it's also important to consider that weight loss achieved through a combination of diet, exercise, and medication varies considerably from person to person. It's not a one-size-fits-all type of thing. 

"People living with diabetes who use semaglutide tend to lose less weight when compared to people without diabetes," said Dr McKay. "Significant weight loss occurs for some people within the first few weeks, while others may not see any noticeable changes."

Then there are the side effects — which also differ considerably. While some people experience slight nausea for a brief period, Dr McKay said others may face severe abdominal cramps, constipation, and frequent vomiting for many days after an injection.

Just take a look at some of the influencers and celebrities who have discussed their experience with using the medication — from Sharon Osbourne and Amy Schumer to Chelsea Handler.

However, many doctors are widely on board with the drug because for the right patient, it can dramatically improve a person's quality of life — and can be life-saving in its own way.  

"Using medication to achieve weight loss goals can be life-changing. However, it’s important to understand that ongoing medication is necessary to prevent weight gain from recurring," added Dr McKay.

Those who go off the medication after they hit their weight loss plateau, tend to regain the weight they lost. In fact, people who stopped taking it have been found to gain back about two-thirds of the weight they had lost. 

Meaning? While weight loss plateaus are inevitable, regardless of how you're trying to lose weight, for people who want to keep the weight off, these drugs are something of an indefinite prescription.

So, now what?

More weight loss drugs are coming. 

For medical professionals, who have been promised a miracle weight loss drug for decades, the evolution of this medication has been a game-changer. And it's unlike any weight loss medication we've seen in the past. 

"After decades of unsuccessful attempts at creating medications for weight loss, it’s encouraging to finally have some effective options," Dr McKay said.

"Other similar medications are in development and showing promising results with potential weight loss exceeding 25 per cent of total body weight. Further research aims to enhance the effectiveness of weight loss medications while reducing adverse side effects."

"While bariatric surgery is considered the gold standard for weight reduction, these surgical procedures are highly invasive and expensive. Being able to offer medications that are just as effective as surgery could make weight loss much more accessible and affordable for a broader population."

What are your thoughts on the above? Share them with us in the comment section below.

Feature image: Getty/Canva.