Fat loss is often presented as a choice between "doing it naturally" and using medication. In reality, these approaches can overlap: prescription medicines are generally intended to support—not replace—changes to eating and physical activity. The right option depends on a person's health, circumstances and goals.
Here's a clear look at three broad approaches: a sustainable calorie deficit with exercise, GLP-1 medicines such as semaglutide, and dual-agonist medicines such as tirzepatide.
1. A small calorie deficit and regular exercise
A calorie deficit means consuming less energy than your body uses over time. It doesn't need to mean severe restriction, strict food rules or cutting out entire food groups. A modest, manageable change—alongside regular activity—may be easier to stick with than a short, intense diet.
Advantages
- Builds habits that can support weight management over the long term.
- Doesn't require prescription medication.
- Exercise can improve fitness, strength and physical function, even when scale weight changes slowly.
- Resistance training can help preserve muscle during weight loss.
Challenges
- Progress may be gradual, and weight can fluctuate or plateau.
- Meal planning and regular activity take time and consistency.
- A plan that is too restrictive may be difficult to maintain.
Why include muscle-building training?
When people lose weight through diet alone, they can lose some lean tissue as well as fat. Resistance training—using weights, resistance bands or body-weight exercises—gives the body a reason to retain and build muscle. That can make a weight-loss phase more beneficial even if the scale doesn't move faster.
A 2025 systematic review and meta-analysis looked at resistance exercise during dietary weight loss in adults with overweight or obesity. Compared with diet-only approaches, adding resistance exercise helped protect fat-free mass, increased fat loss and improved muscle strength. It didn't produce a greater change in total body weight, which is a useful reminder that the scale doesn't tell the whole story. (pubmed.ncbi.nlm.nih.gov)
Building strength can also help with everyday tasks—such as carrying shopping, climbing stairs and getting up from a chair. Research in older adults has found that progressive resistance training can improve strength and may benefit hip bone mineral density. (pubmed.ncbi.nlm.nih.gov)
A routine could include exercises such as squats or sit-to-stands, rows, presses, hip hinges and step-ups, adjusted to a person's ability. Walking, cycling, swimming, dancing or a sport can add cardiovascular exercise and make the plan more enjoyable. The best routine is one someone can repeat consistently and progress gradually.
2. GLP-1 medicines, such as semaglutide
GLP-1 medicines mimic a hormone involved in appetite and fullness. They can help some people feel fuller and eat less. Semaglutide is the active ingredient in several medicines, but the brand and its approved use matter: in the UK, Wegovy is licensed for weight management (available as both injections and, since June 2026, tablets), while Ozempic is licensed for type 2 diabetes, not weight management. Rybelsus, another oral semaglutide product, is also licensed for type 2 diabetes only. (gov.uk)
Potential advantages
- May reduce appetite and make it easier for eligible people to follow a reduced-calorie eating plan.
- Can support clinically meaningful weight loss when prescribed and used as directed.
- May be one option within a wider, clinician-supported treatment plan.
- Now available in tablet form (Wegovy), offering an alternative to injections for some people.
In the STEP 1 clinical trial, adults with overweight or obesity received semaglutide alongside lifestyle support or a placebo alongside lifestyle support. At 68 weeks, the semaglutide group had a greater average reduction in body weight. The result describes a group in a clinical trial, not a guaranteed outcome for any individual. (pubmed.ncbi.nlm.nih.gov)
Potential disadvantages
- These are prescription medicines, and they aren't suitable for everyone.
- Common side effects include nausea, vomiting and diarrhoea; some side effects can become serious and need medical attention.
- Treatment requires medical guidance and follow-up.
- Eligibility and access can vary, and buying from unregulated sellers carries serious risks. (gov.uk)
Medication can support weight loss, but it doesn't replace the value of nutritious eating, strength and fitness, or habits that can be maintained. In the UK, GLP-1 medicines should only be obtained with a prescription from a healthcare professional. (gov.uk)
3. Dual-agonist medicines, such as tirzepatide
Tirzepatide, sold as Mounjaro, acts on two hormone receptors: GIP and GLP-1. Like GLP-1 medicines, it can affect appetite and fullness. In the UK it is licensed for weight management in eligible people (since November 2023), as well as for type 2 diabetes. (gov.uk)
Potential advantages
- Provides another prescription option for eligible people.
- May help reduce appetite as part of a wider weight-management plan.
- Can be used alongside reduced-calorie eating and physical activity under healthcare guidance. (gov.uk)
Potential disadvantages
- It requires a prescription and isn't suitable for everyone.
- It can cause side effects, including gastrointestinal symptoms; a prescriber should explain the risks and monitor treatment.
- It doesn't remove the need to consider food, activity and long-term support. (gov.uk)
So, which approach is best?
There isn't one answer for everyone. Medicines can be important tools for people who meet the relevant criteria, and a clinician can help assess whether they're appropriate. For others, or as part of a broader plan, sustainable eating changes and regular activity may be the right starting point.
It's also worth looking beyond scale weight. Strength, fitness, how clothes fit, waist measurements and the ability to keep up everyday activities can all help show progress. Resistance training is particularly useful because it supports strength and can help preserve lean mass while losing fat. (pubmed.ncbi.nlm.nih.gov)
Our recommendation: make it sustainable
Our recommendation is to start with a small calorie deficit and regular sport or exercise as a lifestyle change. Build a routine that includes muscle-strengthening work as well as activities you enjoy. Aim for steady progress, not a quick fix: a plan only works long term if it can fit into real life.
For anyone considering weight-loss medication, the next step is a conversation with a qualified healthcare professional. Medication may be appropriate for some people, but it should be prescribed and monitored—and it works best as part of a thoughtful, ongoing approach to health.