Medical Weight Loss with GLP-1

What is medical weight loss with GLP-1?

Medical weight loss with GLP-1 is a treatment under the supervision of a BIG-registered doctor in which GLP-1 receptor agonists are used to make weight loss possible for people who are overweight or living with obesity. It is not a diet pill or a fitness supplement: these are medicines that were originally developed for type 2 diabetes and have been shown to be highly effective for obesity as well.

GLP-1 stands for glucagon-like peptide 1, a hormone that is naturally produced in the gut after eating. Synthetic GLP-1 receptor agonists mimic this hormone, but remain active for much longer. By giving an injection once a week (or daily with Saxenda), the active ingredient stays at a constant level, which leads to a steady reduction in hunger and a natural drop in calorie intake.

At Go Leaner, medical weight loss is always a combination of three elements: (1) prescribed GLP-1 medication, (2) personal lifestyle coaching according to a four-phase anti-yo-yo protocol, and (3) unlimited access to your doctor for questions, adjustments and check-ups. This integrated approach is what sets medical weight loss apart from self-medication or online pharmacies.

How does GLP-1 work for weight loss?

Three mechanisms that together result in less hunger

GLP-1 receptor agonists work in three ways at once. First, they bind to GLP-1 receptors in the area of the brain that regulates appetite (the hypothalamus). This lowers the hunger signal and increases the feeling of fullness, so you automatically eat smaller portions and have fewer cravings between meals.

Second, GLP-1 agonists slow gastric emptying. Food stays in the stomach longer, which means you keep feeling full for longer after a meal. This reduces the risk of snacking and helps people who are used to large portions to eat less more easily without constantly feeling hungry.

Third, GLP-1 improves blood sugar regulation. The pancreas only produces insulin when blood sugar levels are elevated, and glucagon production, which raises blood sugar, is suppressed. As a result, the peaks and troughs that cause hunger attacks in many people who are overweight disappear.

The combined result of these three mechanisms is that the average patient loses 15 to 20 percent of their body weight over 12 to 18 months of treatment without extreme dieting. This is considerably more than with lifestyle advice alone, where 3 to 5 percent is already a good result.

Who is GLP-1 medication suitable for?

BMI thresholds and medical indications

GLP-1 medication for weight loss is registered for adults with a Body Mass Index (BMI) of 30 or higher, or a BMI of 27 or higher combined with a weight-related condition. These thresholds were set by the European Medicines Agency (EMA) and the American FDA on the basis of large-scale research.

Weight-related conditions that qualify as a comorbidity include type 2 diabetes, prediabetes, high blood pressure, high cholesterol, sleep apnoea, osteoarthritis due to excess weight, non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS). In case of doubt, a doctor assesses on the basis of blood tests and medical history whether you qualify medically.

GLP-1 medication is not suitable for people with a personal or family history of medullary thyroid carcinoma, Multiple Endocrine Neoplasia type 2, previous pancreatitis, severe gastrointestinal problems, or during pregnancy and breastfeeding. GLP-1 is also not indicated with a BMI below 27 without comorbidity: the risk-benefit balance is then unfavourable.

Which GLP-1 medicines exist in the Netherlands?

Ozempic, Wegovy, Mounjaro, Saxenda and Rybelsus

Ozempic (semaglutide) was originally registered for type 2 diabetes but is also prescribed off-label for weight loss. Doses range from 0.25 mg to 2 mg per week. Weekly subcutaneous injection.

Wegovy (semaglutide) contains the same active ingredient as Ozempic, but is specifically registered for chronic weight management in obesity. Higher maintenance dose (up to 2.4 mg per week), greater effectiveness for weight loss.

Mounjaro (tirzepatide) is a dual agonist: it acts on both the GLP-1 receptor and the GIP receptor. In studies, this dual mechanism leads to even more weight loss than semaglutide alone, with up to 22 percent reduction at the highest dose. Weekly injection.

Saxenda (liraglutide) is an older GLP-1 agonist that is injected daily. Less effective than semaglutide or tirzepatide, but an option for those who respond poorly to weekly medicines or want finer titration.

Rybelsus is oral semaglutide: a tablet taken daily before breakfast. Effective for type 2 diabetes, but for weight loss the injectable form is usually more powerful.

What does a medical weight loss programme at Go Leaner look like?

From questionnaire to maintenance phase

Step 1 is the online questionnaire. Here you fill in your medical history, current weight and height, medication use and goals. On that basis, the doctor determines whether you qualify for an intake consultation.

Step 2 is the blood test. Before every GLP-1 treatment we have blood drawn as standard to check your kidney and liver function, thyroid, cholesterol and HbA1c (long-term blood sugar). This takes place at a blood collection point near you.

Step 3 is the video consultation with your doctor. Together we discuss the results, your medical history and which medicine suits you best. The doctor writes the prescription and we have your medication delivered discreetly to your home.

Step 4 is the build-up phase. During the first 16 to 20 weeks you titrate the dose upwards step by step under the guidance of your coach and doctor. Side effects are most pronounced in this phase and often temporary.

Step 5 is the maintenance phase. Once you are on your effective dose, we see each other monthly for a check-up. We look at weight, side effects, blood values and lifestyle. The goal is sustainable weight loss without a yo-yo effect.

Side effects and safety of GLP-1

The most common side effects are gastrointestinal: nausea, diarrhoea, constipation, stomach pain and reduced appetite. These symptoms are usually mild, occur mainly in the build-up phase, and largely disappear within 4 to 8 weeks once the body has adjusted.

Less common side effects are tiredness, headache, dizziness and an altered sense of taste. Some patients also report the so-called Ozempic Face: a sagging of the facial skin due to rapid weight loss. This is not a direct effect of the medicine itself but of the weight loss.

Rare but serious side effects are pancreatitis (inflammation of the pancreas), gallstones and impaired kidney function. That is why prior blood tests and regular monitoring are essential. With severe abdominal pain that does not go away, you should always contact your doctor immediately.

What does GLP-1 medication cost in the Netherlands?

At Go Leaner the Basic Programme costs 199 euros per month. This includes doctor consultations, coach contact and regular check-ups. Medication costs come on top of that separately; exactly how much depends on the chosen medicine (semaglutide, tirzepatide or liraglutide) and the dose you need.

Coverage by health insurers is limited. Since 2024, Wegovy has been covered under strict conditions for patients with a BMI above 35 combined with a weight-related condition, provided they have first completed a GLI programme (Gecombineerde Leefstijl Interventie, combined lifestyle intervention). Ozempic is only covered for type 2 diabetes. Mounjaro and Saxenda are in most cases not covered for weight loss.

A detailed explanation of the rates and coverage options per medicine can be found in our separate cost guide.

Why choose a specialised GLP-1 clinic?

Self-medication or online pharmacies without a doctor on board carry risks: wrong dosing, no monitoring of kidney and liver function, no support with side effects and often no check for contraindications. A specialised clinic such as Go Leaner does provide that structure.

At Go Leaner, only BIG-registered doctors and certified lifestyle coaches work with you. We have physical locations in Amstelveen and Aalsmeer, an online platform for consultations and daily contact with your coach. Our medication comes from regulated Dutch pharmacies, not from obscure online channels.

In addition, we work according to a four-phase anti-yo-yo protocol, based on what we know works for sustainable weight loss: build up, stabilise, taper off and maintain. This is what distinguishes medical weight loss at a clinic from a simple e-prescription.