GLP-1 treatment, built for lasting change

As an educational guide, treatment may be considered for Asian adults at BMI 27.5 or above without a related condition, or BMI 25 or above with a condition such as diabetes or fatty liver disease. For non-Asian adults, the corresponding guide is BMI 30 or above, or BMI 27 or above with a related condition. A doctor must still assess medical history, contraindications and baseline results before any prescription.

Assessment usually covers weight, waist circumference, blood pressure, previous weight-management attempts, current medicines and relevant medical history. Blood tests may include glucose or HbA1c, lipids, liver and kidney function, and thyroid markers. The doctor also screens for contraindications and discusses pregnancy plans where relevant.

In STEP 1, adults receiving semaglutide plus lifestyle intervention lost 14.9% of starting weight on average at 68 weeks, compared with 2.4% with placebo. In SURMOUNT-1, tirzepatide dose groups lost 15.0% to 20.9% on average at 72 weeks, compared with 3.1% with placebo. These are group averages from controlled studies, not a forecast for an individual.

Semaglutide acts on the GLP-1 receptor. Tirzepatide acts on both GIP and GLP-1 receptors. Both are prescription-only, once-weekly treatments used alongside nutrition and physical activity. The appropriate option depends on medical history, treatment goals, tolerability and the doctor’s assessment.

Nausea, vomiting, diarrhoea, constipation and abdominal discomfort are among the common effects. Gradual clinician-led dose progression, smaller meals and hydration can support tolerability. Severe or persistent abdominal pain, repeated vomiting or an inability to keep fluids down requires medical review.

Treatment may be unsuitable during pregnancy or breastfeeding and for people with certain endocrine cancer histories, previous pancreatitis, severe gastrointestinal disease or other relevant contraindications. This is not a complete list, so suitability must be determined by a doctor rather than a BMI result alone.

Some lean tissue loss can occur with any meaningful weight reduction. Adequate protein, regular resistance training, a sustainable rate of loss and clinician-led dose review can support lean-mass retention. Body composition, strength and food intake should be reviewed alongside scale weight.

No. Dose progression should be individualised according to response and tolerability. A higher dose is not automatically the right goal. The clinical priority is a sustainable plan that supports nutrition, activity, muscle preservation and manageable side effects.

Appetite can return and weight regain is common after treatment stops. In the STEP 1 extension, participants regained about two-thirds of their prior loss within a year of stopping semaglutide. This is why maintenance planning, nutrition, resistance training and follow-up are discussed from the beginning.

These are prescription-only medicines. Singapore’s Ministry of Health and Health Sciences Authority advise against buying them from unknown or unregulated online sellers because products may be unregistered, substandard or counterfeit. Treatment should follow a medical assessment and be supplied through regulated channels.