Just when we thought we had achieved some degree of weight inclusivity, weight is front-page news again, thanks to the emergence of the new generation of weight loss drugs such as Ozempic, Wegovy, and Mounjaro. But what's all the hype about? Are they really the GLP-1 wonder drugs that we keep hearing they are? And if we want to manage our weight naturally, are there any non-drug alternatives to weight loss?

Managing a healthy weight can be much harder for some people than others, but creating good health at any size is an achievable goal for most of us.

Stress and weight

Many of us are living with some form of chronic stress, and this can make it hard for us to maintain a healthy weight. For our ancestors, the only real chronic stress was a lack of food. If food is scarce, there is a biological advantage in being able to store fat efficiently. So many of us have adapted genes that make fat storage easy. This is great in times of famine, but not so great if you live in a world where, for most people, calories are easily available.

Also, because of this relationship with stress, the act of eating calms our nervous system. It signals that food is not scarce, that we are safe - and this is one of the reasons why many of us comfort eat or experience emotional eating.

For other people, however, stress suppresses the appetite. They are more prone to staying in the fight or flight state, and for them, gaining weight can be hard.

A naturopathic approach to weight management

A naturopathic approach to weight is to view obesity and underweight as symptoms of imbalance, rather than causes of ill health. We treat weight management holistically, bringing individuals back to balance to improve overall health, encourage better nutrition, reconnect people with their hunger and fullness cues, and eventually create an environment that allows for slow, sustainable weight loss or weight gain.

How to manage your weight with nutrition

Whether you want to lose weight, gain weight, or maintain your current weight, start by establishing healthy eating habits using whole foods as a way of life. This means eating foods in the most natural, unprocessed form possible.

Base your diet around vegetables and fruits as a source of fibre and antioxidants to reduce inflammation, balance hormones, and improve gut health (more about this later!).

Good quality protein—such as beans and pulses, nuts and seeds, line-caught fish, grass-fed meat, and organic eggs and poultry—will maintain muscle mass, balance blood sugar, and help reduce cravings.

Cold-pressed oils will help to reduce inflammation and ensure satiety.

Prioritise the most unrefined grains you can find (e.g., dark bread, wholemeal pasta, brown rice, quinoa), and try to avoid ultra-processed foods, processed meats, refined seed oils, and added sugars in all their forms. And treat ‘treats’ as treats—have them occasionally, not daily.

Eliminating refined carbs and processed sugars can rebalance your appetite. Your cravings will reduce, your energy levels will increase, and your mood will stabilise.

Most important of all, your gut microbiome will improve. Bacteria in the gut have a significant role in weight regulation: some influence hunger and fullness signals, others impact neurotransmitter production (like dopamine and serotonin), which can affect mood and eating behaviours, and some bacteria determine how many calories you absorb from your food.

Why slower is better

One of the reasons I don’t encourage rapid weight loss is because when you reduce caloric intake, stored fat gets used initially, but over time, your body adapts to managing on fewer calories, which slows down your metabolism. This makes further weight loss (or gain) harder. So, I would build up slowly—typically following this stage for about 2–3 months or until you feel really comfortable eating this way.

There are no weight-related goals - although for many people, their weight does start to shift. The emphasis is on the output, not the outcome.

I also encourage developing a reflective practice to become aware of situations you find easy or difficult, identify problematic foods, and establish strong, positive habits and strategies to deal with obstacles. You might want to work with a health coach or a buddy for support.

Movement, motivation, and mental health

It’s important to introduce accessible, enjoyable exercise. This is not really for the calorie-burning effect, which is minimal, but to help you feel more comfortable in your body and build self-trust. Movement boosts motivation, especially when combined with daily relaxation practices that calm your nervous system and help you feel safe.

Only when you are genuinely comfortable eating this way should you introduce targeted nutrition protocols to address underlying causes of weight retention or difficulty gaining weight. These may include insulin resistance, cortisol resistance, thyroid imbalances, gut dysbiosis, or leptin resistance.

A qualified nutritionist can help identify and treat these issues, or you can speak to your GP and ask for routine blood tests to get started.

Nutrition and long-term health

It’s not always quick - or even possible - to lose (or gain) weight using nutrition alone. But this approach is sustainable and can improve your overall health even if the number on the scale doesn’t move.

Whole-food nutrition supports:

• Balanced blood sugar and reduced risk of type 2 diabetes

• Lowered blood pressure

• Improved cholesterol

• Enhanced liver function

• Lower inflammation (linked to heart disease, autoimmune conditions, and some cancers)

• Better fitness, digestion, and mental wellbeing

So, whilst weight loss can be hard, you can still be healthy at any size.

GLP-1s in a nutshell

GLP-1 receptor agonists were discovered accidentally while developing treatments for type 2 diabetes. They work by lowering insulin, reducing blood sugar dips and sugar cravings, and limiting fat storage. This typically results in reduced appetite and weight loss.

We have GLP-1 receptors throughout the body, so research now shows that these drugs may reduce risk of diseases like dementia, depression, colon cancer, and heart disease. It's too early to say how much of a game-changer they’ll be in managing chronic illness, but many more GLP-1-based drugs are on the way.

Side effects are common, including nausea, vomiting, diarrhoea, constipation, and “eggy burps.” More serious risks include pancreatitis, gallstones, thyroid cancer, bowel blockages, and the risk of weight loss addiction.

The most common issue is rebound weight gain. In the 2021 STEP trial, a year after stopping Wegovy, participants regained 60% of the weight they had lost. This often includes more fat than muscle, worsening overall body composition.

Nutritional considerations if you’re taking GLP-1s

If you're considering or using GLP-1 weight loss medication, you need a clear nutrition strategy to support long-term success and minimise weight regain.

Even if your appetite is low, it’s vital to prioritise nutrient density:

• Fibre to support the gut microbiome and reduce constipation

• Phytonutrients for immune support

• Adequate protein to protect muscle mass and maintain body composition

This can help improve your results both during and after medication use.

Use this window to establish healthy lifestyle habits, become more in tune with your hunger and fullness cues, reduce processed food cravings, and embrace more plant-based meals.

Healthy at any size

Some people find weight loss difficult, others find it hard to gain weight. The new GLP-1 medications may be helpful in both cases, and potentially in treating chronic diseases - but they are not without risk.

Whatever route you take, prioritising whole-food nutrition, movement, and mental wellbeing can support you in being healthy at any size.

- Written by Sara Jubb, Wellbeing Director, Change Coach & Nutritional Therapist