The roll out of GLP and GLP-1 drugs – often referred to as fat jabs or fat pills – is focusing the minds of exercise professionals the length and breadth of the UK.
Weight-loss drugs are not new to the NHS, but some newer medications – such as tirzepatide, marketed as Mounjaro, and semaglutide, marketed as Wegovy – have been making headlines for their effectiveness at aiding weight loss by reducing a patient’s appetite and following in the wake of other drugs such as Ozempic.
They were originally used to treat type 2 diabetes, but studies have shown their impact can result in a weight loss of up to 15-21% of a person’s body weight.
However, rapid weight loss can cause gallstones, sarcopenia, mental health issues and nutritional deficiencies, warns Diabetes.co.uk.
Forty exercise professionals from nine of Greater Manchester’s 10 boroughs gathered for a GM Active-organised insight into the subject from leading GP and TV medic, Hussain Al-Zubaidi, the lifestyle and physical activity lead for the Royal College of General Practitioners, and a regular guest on Channel 4’s ‘Steph’s Packed Lunch’.
Our thanks go to Dr Al-Zubaidi for a thought-provoking, insightful day, the content of which we hope to do justice to in this blog.
“The roll out of GLP-1s within primary care is very much the hot topic at the moment, says Dr Al-Zubaidi. It is going to transform how we deliver primary care – and a lot of other things. As we roll out GLP-1 therapies in primary care, we must resist the temptation to settle for the minimal scalable model of lifestyle support. I emphasise that people deserve better than that. Our patients deserve a comprehensive, multi-component approach – nutrition, behavioural and psychological support, sleep and stress management, physical activity, and addiction care all working in harmony.”
Dr Al-Zubaidi left us with six considerations for how the health and fitness sector can strategically support weight loss patients in the future and, just as important, how they can maintain a healthier weight. We’ll look at those considerations in more detail shortly, but first here are Dr Al-Zubaidi’s scene-setting themes – the biological and environmental drivers of obesity.
A 2019 study found that ultra-processed foods accounted for 57% of the average adult’s calorie intake in the UK. More recent studies, however, suggest a slightly lower percentage, with one 2025 study finding the figure to be 53% of total calorie intake, according to BBC.
Cortisol is another driver. Often called the stress hormone, it is released in response to stress to help the body respond to threats, but it also helps control blood sugar, reduce inflammation, and regulate blood pressure. But stress from poor sleep together with feast/famine instincts drive overeating and energy conservation, which leads to weight gain, added Dr Al-Zubaidi.
A third factor is genetics. Combined with environmental influences, polygenic obesity, a collection of over 150 genes that combine to create weight gain over time, can on average, result in a person carrying 13kg of weight more than is healthy.
Dr Al-Zubaidi’s view is GLP-1 is not enough in isolation and can only work long term with wraparound care, which calls for six pillars of strategic action:
A cohort of 220,000 NHS patients, based on clinical need, will be part of the roll out of tirzepatide (Mounjaro) over the next three years but as Dr Al-Zubaidi states, there is much more to be done instead of relying on drugs alone.
His wraparound care solution that includes physical activity and lifestyle, behavioural change and (good) habit formation, and nutrition and gut health could and should prove just as beneficial as Mounjaro alone.
The best activity is what’s known as incidental movement – walking, especially uphill, and doing chores, especially gardening if possible. People should target 300 minutes a week for weight loss and 60 to 90 minutes for weight maintenance. Isometric exercises, a type of static strength training, three times a day is recommended for tackling hypertension (high blood pressure). Preserving muscle mass, which is aided by protein intake, will also help patients, said Dr Al-Zubaidi.
Combining such activities as part of a behavioural change programme would be ideal but willpower is finite, he added, which needs frameworks to support the changes and encourage good habits.
Nutrition and gut health are the other pillars of weight loss and keeping it off. Improving your gut microbiome, the ecosystem of microbes that live in your intestines, by improving your diet is a factor and a healthy gut microbiome is boosted by physical activity. Patients should be encouraged to shift to whole foods, he said, recommending the Mediterranean diet rich in fruits, vegetables, whole grains, nuts, and olive oil, with moderate amounts of fish, poultry and dairy, and limited red meat consumption. The Mediterranean diet is rich in polyphenols, which are linked to potential health benefits, and by eating more it reduces the intake of sweet and ultra-processed foods.
Whilst we as a health and fitness sector can do everything within our gift to tackle and combat obesity, the desire and motivation to lose weight and maintain a healthier weight and lifestyle rests with the individual. You can lead a horse to water, but you can’t make it drink.
Data from NHS Digital (Health Survey for England), shows obesity among adults has increased steadily over the past 30 years and welcome changes to the policy landscape have been implemented to fight the good fight – but could more be done?
Advertising less healthy food or drink products on TV and online will be restricted to the post-9pm watershed from January 2026, which is welcome legislation.
So too, is the phasing out of BOGOF (buy one get one free) promotions for unhealthy food, which was introduced in October 2025 as part of new legislation to tackle childhood obesity. This affects supermarkets, large high street shops, and online retailers.
Rules requiring calorie information to be displayed on food labels and menus came into force for large businesses – those with over 250 employees – in 2022.
Smaller businesses have been encouraged to follow suit. But we agree with Dr Al-Zubaidi that encouragement doesn’t go far enough. The rules for smaller businesses should be enshrined in law too.
A final word from our chair, Andy King: “Thanks to Dr Al-Zubaidi – and the 40 committed professionals who took part in our event – GM Active is set fair to really understand how we can support those people who, through one way or another, have opted to utilise these tools to assist them to lose weight and help them to sustain their gains for the longer term through pragmatic and people-centred, wraparound support.”
For further enquiries, contact Nigel Wareing, Cornerstone DM: 07834 835922
Cornerstone DM is a GM Active Strategic Business Partner
