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Dr Catherine Conlon Ozempic is not the holy grail when it comes to tackling obesity

On World Obesity Day, the public health doctor says while much is changing around drugs and weight loss, we cannot lose sight of the need for access to affordable, healthy foods.

LAST UPDATE | 4 Mar

BARELY A WEEK goes by these days without headlines dedicated to the topic of weight loss drugs like Ozempic.

This week, Kathryn Thomas has explored the topic of the new ‘weight loss wonderdrugs’ in her new two-part documentary, The Skinny Jab Revolution on RTÉ.

It’s true, the understanding of obesity and the complex physiological and emotional underlying causes behind it is changing, and the latest drugs play just one part in moving us along to better health. 

kathryn-thomas-rte-stars-launch-the-new-autumn-2012-season-at-rte-studios-dublin-ireland-08-08-12 Kathryn Thomas looks at the weight loss drugs on the market for her new RTÉ documentary. Alamy Stock Photo Alamy Stock Photo

Those revolutionary obesity drugs like Ozempic and Wegovy have become widely available, albeit with restrictions on the Irish market. They work in the management of obesity as well as type 2 diabetes, and pre-diabetes combined with risk factors for heart disease.

While the hysteria over these drugs starts to abate and a more balanced approach to a lifetime response to obesity is beginning to emerge, the evidence suggests that these treatments, while transformative for some, are not the holy grail they first appeared.

At the same time, new products are appearing on the takeaway food market that show promising results in the ability to provide really healthy food, entirely devoid of ultra-processing that is both affordable, tasty and very very cool.

Has the prospect of a paradigmatic shift in the unhealthy food market finally arrived?

Many experts in this field are keen to enforce the message that patients must understand that they will need to accept they will be taking these drugs for life, not for a quick journey into weight loss.

One of the biggest challenges with semaglutide (Ozempic and Wegovy being the main brands) and the new wave of obesity drugs, such as tirzepatide (Mounjaro) and retatrutide, is the ‘rebound’ that occurs when patients come off the drug. There is some evidence that ‘weight cycling’ can occur — people go back to where they were before they started medication and further weight gain is accompanied by an accumulation of more fat and less muscle.

The long-lasting benefits of obesity treatment drugs against other chronic illnesses such as cardiovascular disease, and kidney disease, as well as the disruption of cravings for alcohol or opioids are also unclear. Preliminary animal studies suggest that cravings for addictive substances return when obesity treatments are stopped.

Success rates

The effectiveness of obesity treatments also varies. While average weight loss with semaglutide and tirzepatide is between 15 and 20%, clinical trials show that a proportion of patients will lose less than 5% of their starting weight on semaglutide. Consultant endocrinologist at Galway University Hospital, Francis Finucane, suggests that about one in ten people do not lose any weight at all.

cologne-germany-03rd-feb-2025-illustration-a-man-takes-the-weight-loss-injection-mounjaro-with-the-active-ingredient-tirzepatide-credit-oliver-bergdpaalamy-live-news Alamy Stock Photo Alamy Stock Photo

Even when patients continue to take obesity treatments, it appears from early data that most people hit a plateau at about 18 months after commencing treatment, when their metabolism compensates by slowing down and weight loss stops. The evidence suggests that the potency of the GLP-1 drugs wears off and patients may start to regain some weight while still taking the drug.

Finally, the issue of muscle loss while on obesity treatment is a concern. Recent evidence suggests that muscle mass reduction is a significant issue in some participants in clinical trials. This is important in patients as they age because maintaining muscle as well as bone strength is key to healthy ageing and maintaining independence into elder years.

So, obesity treatments are not the holy grail, or at least not yet.

Regulation of the food market

What is urgently needed, in alignment with new wave obesity treatments is realignment with of the food market to ensure that healthy food is accessible and affordable.

various-of-american-food-french-fries-hamburgers-nuggets-hotdog-chips-popcorn-sauces-on-a-white-background-top-view-panorama-with-copy-space Highly processed junk food is often cheaper than healthy food. Alamy Stock Photo Alamy Stock Photo

Three key steps to make this aspiration vision a reality would include:

  • A ban on the marketing of unhealthy food on all digital and physical infrastructure
  • A salt and sugar reformulation tax on junk food with revenue directed towards making food accessible and affordable in disadvantaged communities
  • Ensuring that free school meals comply with national food standards.

These steps are all under consideration, but robust policy is needed to push the food market away from highly processed takeaway food towards healthy sustainable food at an affordable price.

Healthy affordable delicious takeaway food

Against all the odds, one country seems to have achieved just that. A relatively new entry on the food scene that is causing a stir in Spain is Honest Greens – marketed as a ‘revolutionary healthy restaurant concept that claims to provide real food, lifestyle and technology.’

ingredients-for-vegetable-salad-delicious-healthy-food-vegan-concept-on-a-light-background-top-view-panorama-with-copy-space Alamy Stock Photo Alamy Stock Photo

It all started with three people whose paths crossed in Spain. Christopher Fuchs from the US, Rasmus B from Denmark and Benjamin Bensoussan from France, all entrepreneurs and lovers of good food, were frustrated by their inability to find food that was healthy and delicious but also quick and affordable. They decided to set out on a journey to create it themselves.

The preparation took three years while they travelled the globe looking for design inspiration. Their diverse backgrounds, ranging from working in the kitchens of the best Michelin star restaurants, founding technology start-ups to working as waiters, all helped to shape the project.

The result is food prepared from scratch with fresh, responsible ingredients.
Fresh, locally sourced food is served in unique locations with warm atmosphere, good music, friendly staff and a welcoming community. Now, Honest Greens are all over Barcelona, Madrid, Valencia, London, Lisbon, Paris and Porto. They have yet to arrive in Ireland. There are a growing number of food outlets in Ireland already operating with similar approaches, offering affordable, organic and healthy takeaway food, and it’s a very positive and welcome change.

the-honest-greens-restaurant-on-gran-via-7-in-madrid-with-a-line-up-outside The Honest Greens restaurant on Gran Via 7 in Madrid, with a line-up outside. Alamy Stock Photo Alamy Stock Photo

If all this healthy food talk sounds a bit aspirational, prepare to be amazed. Two of my adult children live in Spain and rave about the healthy takeaway options, for little more than the price of a Coke, cheeseburger and large fries. It is an unbeatable formula and one that I would love to see grow further in Ireland.

And it is possible. Since the introduction of the sugary drinks tax in 2018, the sugar content of soft drinks has dropped by about a third and the percentage of drinks falling into the sugar tax has plummeted. In other words, the sugar tax is incentivising the drinks’ industry to reformulate to healthier drinks with less sugar.

The same could happen with a tax on junk food. Ideally, a junk food tax could be used to subsidise the cost of healthier food options and support local producers to both grow and sell these items at affordable prices.

Cork Food Policy Group

In fact, the supports for this concept of relying on local producers is already in place in Cork. The Cork Food Policy Group (CFPG), chaired by Janas Harrington, Senior Lecturer in the Department of Public Health, UCC is a partnership between representatives of the community, food retail, farming, restaurant/catering, environmental and health sectors as well as local authorities in Cork.

The CFPC aims to create an environment that has nourishing food for all while building a sustainable, resilient food system sourced from a thriving local and diverse food economy.

A key strategy to increase urban food growing include supports for small food producers to be able to access land near the city to grow their own food. All of this is neatly in alignment with the strategy of Honest Greens – supporting local producers to produce quality food within their local community.

The pathway to healthy, sustainable affordable food is here. Companies like Honest Greens are showing that there is a huge market for this kind of innovation once the product and price are right. In Cork, all the supports are already in place to allow an innovative, entrepreneurial foodie to turn this vision into a reality.

We’ve had enough of cheap junk food and relying on drug treatments as the answer to everything. Time to transform the market and people’s health by making healthy takeaway food affordable, accessible and cool.

Dr Catherine Conlon is a public health doctor and former director of human health and nutrition, safefood.

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