If there’s still some doubt in your mind about whether you can lose more weight with a simple diet and exercise program than you can with the highly popular new weight-loss medicines, then you should pay some attention to the following quote that puts this issue to rest once and for all. According to Dr. Yoni Freedhoff’s article in the Medscape Diabetes and Endocrinology web journal with the title Diet and Exercise Are Not Better Than Drugs for Obesity:
“there’s never been a reproducible diet and exercise intervention that has led to anywhere near the average weight lost by those taking obesity medications. Furthermore, when it comes to the durability of weight lost, the gulf between outcomes with diet and exercise vs obesity medications is even more dramatic.”
Obesity has often been seen as a result of lifestyle choices instead of being a medical condition that needs professional treatment. New medications like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) have now changed how some people think about weight loss. However, some still ask whether these medications are more effective than diet and exercise. And if so, is there still a place for healthy habits and lifestyle changes in this new era of weight-loss medications?
Losing weight has never been easy, or everyone would already be doing it. Telling someone to diet and exercise might seem like good advice, but it’s often not helpful. Most people already want healthier habits, but desiring something and achieving it are two very different things. When it comes to weight loss, there are so many reasons why people struggle to lose weight that figuring out which behavior changes actually work can be hard. Many diets help people lose weight at first, but real solutions need lasting results, and this is where dietary interventions fall short. It’s not just about losing weight; it’s about keeping it off, too.
Are diet and exercise more effective than weight loss drugs?
In an ideal world, diet and exercise would be the best way to achieve sustainable weight loss, but from widespread experience, it is obvious that they can’t compete with the newer treatments. Studies have yet to discover a diet and exercise plan that results in sustainable weight loss similar to what people achieve with obesity medications. In particular, the long-term results achieved by obesity medications are much better than anything that can be achieved by diet and exercise alone.
A weight-loss plan must result in a loss of at least 5% of body weight to be considered effective. The usual goal is to keep off at least 10% of starting weight for long-term health benefits. Diet and exercise alone often fail to yield even these minimal benefits, although some people do lose more. 
One commonly referenced study on how lifestyle changes affect weight over time is the Look AHEAD trial. Before obesity medications became widely available, many experts used this study as an example. The Look AHEAD study found that participants in the intensive lifestyle program lost an average of 4.7% of their body weight after four years, and this stayed the same after eight years. For comparison, the STEP 1 trial on semaglutide showed that after 68 weeks, participants lost an average of 15% of their body weight, more than five times the amount of loss in the placebo cohort. In another study, SURMOUNT-4, which focused on tirzepatide, participants lost an average of 25.3% of their body weight after 88 weeks, which is similar to the results seen with bariatric surgery, with no signs of weight regain.
A shift in perspective
Many people struggle to accept the evidence that obesity medications work better than diet and exercise for managing weight. This may be because of a preconceived bias, which pushes the idea that people who don’t lose weight just aren’t trying hard enough, or the fact that for such a long time, diet and exercise were the only ways to achieve healthy, long-term weight loss without surgery. But this perspective needs to shift.
With many other chronic diseases, we already understand that medications are often more effective than lifestyle changes, and most people are comfortable with that. Obesity is a chronic condition and needs to be thought of as such. Obesity medications are now considered the best option for treatment. They lead to much greater and longer-lasting weight loss compared to diet and exercise alone. The medications also greatly lower the risk of many health problems like heart attacks, strokes, type 2 diabetes, high blood pressure, sleep apnea, and fatty liver disease.
Of course, making improvements to diet and exercise can be beneficial because they enhance the effectiveness of weight loss drugs and possibly mitigate side effects. A balanced diet with plenty of fruits and vegetables, along with regular physical activity, is necessary for fueling the body and keeping things running properly, but if someone is struggling to lose weight effectively, then weight loss medications are clearly the preferred option. 
FAQs
How much weight do obese people lose on Ozempic?
According to the STEP (Semaglutide Treatment Effect in People with Obesity) clinical trials, obese individuals taking Ozempic (semaglutide) lost an average of 15-20% of their body weight over 68 weeks.
Specific results from clinical trials include:
- STEP 1 trial: Participants lost an average of 14.9% of their body weight.
- STEP 2 trial: Participants lost an average of 16% of their body weight.
- STEP 3 trial: Participants lost an average of 15.2% of their body weight.
Do you gain weight back after stopping Ozempic?
It is recommended to slowly wean patients off weight-loss medications, and for them to continue with diet and exercise. Unless this is done, there can be weight gain after stopping Ozempic. In all of the studies, it was found that participants who didn’t taper off their doses, and who returned to their previous eating and activity habits did regain some of the weight loss, but most did not return to their previous weight..
How long can you stay on Ozempic?
There isn’t a specific time limit for using Ozempic. For individuals with diabetes, it is usually a long-term treatment with no defined end date. The medication has only been in general use for around eight years, and there are no reasons yet to indicate that long-term use can have negative effects.
How to speed up weight loss on Ozempic?
Try to reduce or eliminate foods high in salt, sugar, fat, red meat, and processed options. Focus on adding more vegetables, fruits, nuts, and whole grains to your meals. Even small adjustments, like opting for healthier snacks or cutting back on a specific food or alcohol, can support weight loss.
