GLP-1 medications, the change in patents, access and what thoughtful care really looks like
GLP-1 medications, increasing access and why support around them matters
Introduction
You may have seen recent news around medications such as semaglutide, particularly with changes to patents in parts of the world, including India, which happens today (time of writing - 20th March 2026), with others to follow. This is likely to increase availability and over time, reduce cost and widen access. (The UK is not off-patent, they are largely intact until 2031, but will probably feel the effects as part of a global shift).
These medications can be incredibly helpful for some individuals; I have seen that in clinical practice. At the same time, wider access brings new considerations around safety, quality and the importance of appropriate support.
This is not a conversation that needs judgement. It is one that benefits from clarity, care and context.
What these medications actually are
Although often grouped under the umbrella term ‘GLP-1s’, the medications people are referring to are more accurately:
GLP-1 receptor agonists such as semaglutide (e.g., Wegovy, Ozempic)
dual GLP-1/GIP receptor agonists such as tirzepatide (e.g. Mounjaro)
These are injectable medications, most commonly used weekly, and are now prescribed in the UK for both type 2 diabetes and under specific criteria, weight management. They work by mimicking hormones involved in appetite regulation, insulin response and digestion.
In practical terms, they can:
reduce appetite
slow digestion
improve blood sugar control
support weight loss in some individuals
For people living with type 2 diabetes or those with significant metabolic challenges, these effects can be clinically meaningful. For others, particularly in the context of weight management, they can offer support where other approaches have not worked.
What is changing and why it matters
Patent changes, such as those now happening internationally with the Indian one expiring today, mean that generic versions of these medications may begin to enter the market.
This has the potential to:
improve accessibility
reduce costs
expand global use
At the same time, use has increased rapidly. In the UK, around 1.5 million people are estimated to have used these medications in the past year, with the majority accessing them privately rather than through the NHS. Some estimates suggest that up to 90-95 percent of users are outside standard NHS pathways. This does not automatically mean unsafe, but it does mean that levels of clinical oversight, support and quality assurance can vary considerably.
What to be mindful of
This is not about fear. It is about awareness.
Quality and sourcing
As access widens, particularly with global manufacturing changes, there is an increased risk of variability in quality. Products sourced outside regulated healthcare systems may not contain what they claim, or may vary in dose and purity.
Lack of clinical oversight
These medications are often accessed quickly, particularly online, without the depth of assessment, monitoring and follow up that would ideally sit around them.
Nutritional impact
Reduced appetite can be helpful, but it can also lead to inadequate intake of protein, fibre and key nutrients if not supported properly.
Over time, this may affect muscle mass, bone health, energy levels and overall resilience.
This was a key theme discussed at the recent BANT weight management conference at Oxford University I attended, where much of the focus was not on the medication itself, but on what is needed around it.
Digestive changes
The medication may also lead to symptoms such as nausea, constipation or discomfort in some individuals, plus there can be many other side effects that need careful management.
The bigger picture
Weight, metabolism and health are influenced by far more than appetite alone. Sleep, stress, hormones, gut health and lifestyle patterns all play a role.
Medication can be a tool, but it is rarely the whole answer.
What is positive about these medications
It is important to acknowledge that for some people, these medications can be genuinely helpful.
They can:
reduce constant hunger and food noise
support blood sugar stability
improve metabolic markers
create space for behaviour change
For some, this can be life-changing, particularly if they have struggled for many years. Used appropriately and within a supportive framework, they can be part of a wider strategy that improves both physical and emotional wellbeing.
What I am seeing in practice
This is no longer a niche conversation. Since the start of this year, around half of the clients I see have asked my opinion on them, discussing their desire to avoid these medications or are thinking about or currently using them and want to do so in a way that supports their health properly.
A common thread is not just about starting, but about what happens next.
How to support the body while using them.
How to maintain muscle, energy and nutritional status.
How to come off them without significant rebound and with habits in place that actually sustain progress.
The role of wraparound care
Medication alone is not care. It is one part of care.
Wraparound support may include:
ensuring adequate protein intake to preserve muscle mass
maintaining fibre intake to support gut health and microbiome diversity
monitoring micronutrient status
supporting digestion and tolerance
adapting movement and activity levels appropriately
addressing stress, sleep and hormonal factors
behaviour change work to support long term weight management
providing realistic, personalised guidance as needs change
This kind of support helps ensure that any benefits are sustainable and that health is supported as a whole, not just a number on a scale, particularly when someone chooses to stop the medication.
A balanced perspective
These medications are neither a miracle nor a problem. They are a tool.
For some people, they will be appropriate and helpful. For others, they may not be necessary or suitable.
What matters most is:
informed decision making
safe sourcing
appropriate clinical oversight
ongoing, personalised support
Long term health is rarely built through one intervention alone. It is shaped over time through a combination of factors that work together.
As these medications become more widely used, this is a conversation we are likely to be having more often.
My role is not to tell people what they should or shouldn’t do. It is to help them make sense of what is right for them, and to support their health alongside whatever choices they make.
Because in the end, it is rarely about one intervention. It is about how everything fits together.
Want to work together?
If this resonates and you feel you could use support, I offer personalised nutritional therapy designed to meet you where you are, to support change at a pace your body can trust.
Contact me for a free chat.
References
Davies, M.J., Bergenstal, R., Bode, B., Kushner, R.F., Lewin, A., Skjøth, T.V., Andreasen, A.H. and Jensen, C.B. (2015) ‘Efficacy of liraglutide for weight loss among patients with type 2 diabetes’, JAMA, 314(7), pp. 687-699.
Filippou, C.D., Tsioufis, C.P., Thomopoulos, C.G., Mihas, C.C., Dimitriadis, K.S., Sotiropoulou, L.I., Chrysochoou, C.A. and Tousoulis, D.M. (2020) ‘Dietary approaches to stop hypertension (DASH) diet and blood pressure reduction’, Advances in Nutrition, 11(5), pp. 1150-1160.
Jastreboff, A.M., Aronne, L.J., Ahmad, N.N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M.C. and Stefanski, A. (2022) ‘Tirzepatide once weekly for the treatment of obesity’, New England Journal of Medicine, 387(3), pp. 205-216.
Lean, M.E.J., Leslie, W.S., Barnes, A.C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K.G. and Sattar, N. (2018) ‘Primary care-led weight management for remission of type 2 diabetes (DiRECT)’, The Lancet, 391(10120), pp. 541-551.
McGowan, B.M., Batterham, R.L. and Cowley, M.A. (2021) ‘GLP-1 receptor agonists and obesity: a review of their efficacy and safety’, Nature Reviews Endocrinology, 17(11), pp. 671-685.
National Institute for Health and Care Excellence (NICE) (2023) Semaglutide for managing overweight and obesity. Available at: https://www.nice.org.uk (Accessed: March 2026).
Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F.L., Jensen, C., Lingvay, I., Mosenzon, O., Rosenstock, J., Rubio, M.A. and Wilding, J.P.H. (2021) ‘Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance’, JAMA, 325(14), pp. 1414-1425.
Wilding, J.P.H., Batterham, R.L., Calanna, S., Davies, M., Van Gaal, L.F., Lingvay, I., McGowan, B.M., Rosenstock, J., Tran, M.T.D., Wadden, T.A. and Wharton, S. (2021) ‘Once-weekly semaglutide in adults with overweight or obesity’, New England Journal of Medicine, 384(11), pp. 989-1002.