Why weight loss medications should focus on health gain, not just numbers

A shift in perspective on obesity treatment

At the European Congress on Obesity (ECO) in Málaga, the SURMOUNT-5 trial drew major attention. Tirzepatide (Mounjaro) achieved approximately 20% average weight loss versus 14% for semaglutide.

Obesity is a chronic, relapsing disease. It needs sustained management, not constant medication switching for marginal weight-loss gains. As I often tell my patients: if someone is already doing well on semaglutide, tolerates it, and has easy access — why switch just for more weight loss?

Why ‘health gain’ is the real goal

At Beyondbmi we reframe the conversation. The metric isn’t kilograms. It’s functionality and quality of life.

Health gain includes:

• Walking without discomfort
• Climbing stairs without breathlessness
• Returning to work or social engagement
• Improved emotional wellbeing and connection

Feeling better in your body and being able to do what matters — these are the wins that matter most.— Dr Harriet Treacy

Safe, effective… but misunderstood

Anti-obesity medications carry rare serious side effects. Common mild effects — nausea, constipation — are typically manageable with proper support. That support is the missing piece in many headlines.

A multidisciplinary team plays a real role:

• Dietitians for nutritional guidance
• Psychologists for reshaping food relationships
• Pharmacists for medication safety
• Doctors for monitoring progress and adverse effects

The hidden cost of weight bias

Obesity stigma persists in healthcare settings. Patients report dismissal and delayed specialist referrals. Yet obesity is a recognised disease — and avoiding treatment carries significant risks: cardiovascular disease, diabetes, stroke, cancer.

Beyond the scale: real-world benefits

Patient experiences emphasise lifestyle improvements: I can go on city breaks with my family again; I can play with my kids without feeling breathless. These are the outcomes the scale doesn’t capture.

A call for compassionate, ongoing care

Treatment success requires:

• Proper clinical oversight
• Side-effect education
• Support addressing food, behaviour, and emotional dimensions
• Access to regulated, trustworthy providers

Many patients discontinue treatment within one year without adequate support. Medications work best when people are supported in managing obesity as the complex, chronic disease it is.

Final thoughts

We need to move beyond numbers, beyond stigma, and beyond BMI. The right measure of treatment success is the health that’s gained.