Opinion: Obesity medication: Fast results – but at the expense of long-term health

While injection pens and weight-loss pills are gaining ground across the Western world, the debate focuses one-sidedly on the kilos – not on the body’s health and the long-term consequences.

By Gustav H. Gram, CEO of Pila Pharma, a biotech company developing a new pill for obesity and diabetes.

Demand for GLP-1 medication for weight loss is rising rapidly in Europe – especially in the United Kingdom, Germany and France. In the United Kingdom, researchers have estimated that around 1.6 million adults in 2024–2025 have used weight-loss medication such as Wegovy and Mounjaro, showing significant demand. In France, from June 2026, the country will be the first in Europe to begin covering the costs of weight-loss medication through the public healthcare system, which is expected to make the medicine more accessible to citizens.

Globally, the market is expected to more than double to 190 billion dollars in 2035, driven by increased adoption in the United States, Europe and other regions. This is according to Healthcare Dive, a U.S. news platform that covers the healthcare sector, including pharmaceutical trends, policy and innovation.

The development shows that obesity medication is becoming a global phenomenon, and that discussion about long-term health is relevant across the global community.

Although medicine can lead to impressive weight loss in the short term, the long-term health consequences are often overlooked. So far, the global debate has primarily been about the percentage of body weight lost, rather than what the body loses – muscle mass versus fat – and how patients are affected after treatment ends.

Focus on health rather than weight

Studies reported in The Lancet Diabetes & Endocrinology, among others,show that nearly half of the weight lost using obesity medication consists of muscle mass. At the same time, both research and clinical experience show that the weight many people regain after ending treatment often consists primarily of fat. This means that the patient may end up with a worse body composition than before the treatment began – and that is not reasonable.

This raises an ethical question: Are we treating symptoms or causes? The current development in obesity medication is characterized by a narrow focus on market shares and volume, while the health perspective is increasingly being pushed into the background.

Long-term rather than short-term

I understand the hype around the injection pens and now also the pills. Obesity medication is the first real attempt for people who are overweight to achieve weight loss, and it sounds almost fairy-tale-like that one can lose 10–20 percent of body weight with the help of medicine.

But the end does not justify the means when the medicine ends up as a quick fix that can produce weight loss in the short term, but with the risk of rebound, where the patient regains weight – this time primarily as fat – and thus ends up in a worse physical condition than before the treatment.

The golden key

The global pharmaceutical industry is not working to develop a drug that preserves muscle mass and functional health while reducing fat. From a health perspective, it is unwise to have such a narrow focus.

Instead, we should articulate healthy, long-term weight loss – supported by medicine, but with a time horizon of two to three years, rather than as quickly as possible, except for those with the most severe obesity and a critical need. Research indicates that this is the best path to lasting weight loss and improved health for most people.

Long-term, healthy weight loss from a global perspective

For us as a global community, the ambition should be to offer safe and accessible alternatives that support long-term and healthy weight loss. It is important that everyone in need has access to solutions that promote controlled weight loss over time and support genuine health rather than merely cosmetic results.

This is the way forward to strengthen health and quality of life – both for individuals and for society as a whole.