Who is medical weight loss with medication suitable for?

Medical weight loss with injections, such as Saxenda® or Mounjaro®, is intended for overweight or obese people who struggle to lose weight with diet and exercise alone. This approach combines medication with lifestyle counseling and is typically used for individuals with a BMI of 27 or higher.

In this article, we discuss who is eligible for medical weight loss medication, what health problems are associated with it, and when this treatment is not suitable.

When are you eligible for medical weight loss?

1. Your BMI and weight class

The Body Mass Index (BMI) is a commonly used metric to determine eligibility for medical weight loss medication. BMI is calculated by dividing weight (kg) by height squared (m²).

According to international guidelines, overweight is defined as a BMI of 25 or higher, and obesity is defined as a BMI of 30 or higher [1]. Based on this, the following criteria apply for medical weight management [2]:

• BMI 27 – 30 (highly overweight): Medication may be considered if there are weight-related health problems (comorbidities).

• BMI ≥ 30 (obesity): Medical weight-loss guidance is usually possible, even without additional conditions.

If you have a BMI higher than 40, it is wise to consult a GP about specialized care, because other factors such as hormones, medication use or genetic causes can also play a role [3].

2. Weight-related health problems (comorbidities)

Being overweight can be more than just a few extra pounds. It can lead to various health problems. Therefore, medical support for weight loss can be a good option, especially if you have certain comorbidities. Weight loss can improve or even eliminate many of these conditions. Therefore, it's important not only to lose weight, but also to do so in a healthy and sustainable way.

These are some common health problems associated with being overweight [2]:

• High blood pressure (hypertension): Extra weight puts a strain on the cardiovascular system, causing blood pressure to rise.

• Type 2 Diabetes: Being overweight reduces insulin sensitivity, which can lead to elevated blood sugar levels.

• High cholesterol (dyslipidemia): Being overweight often increases bad cholesterol, which increases the risk of cardiovascular disease.

• Joint complaints (arthrosis): Extra body weight puts more strain on the joints, which can cause pain and wear and tear.

• Obstructive sleep apnea: Fat buildup around the airways can cause breathing problems during sleep.

• Stomach and intestinal complaints: Think of heartburn and fatty liver disease, which are more common in overweight people.

• Hormonal disruptions: Being overweight can disrupt the hormonal balance, which can cause menstrual problems or fertility problems, for example.

In consultation with one of our doctors, it can be determined whether medical support for weight loss is suitable for you.

When is medical weight loss with injections not suitable?

While medical weight loss medication can be effective, it's not suitable for everyone. Use is not recommended or further consultation with a doctor is necessary in the following cases [4]:

1. Age restrictions

• Children under 18 years of age – Treatment will only be considered in specialist centres or research settings.

• People over 75 years of age – There is insufficient evidence of effectiveness and safety in this age group.

2. Pregnancy and breastfeeding

This medication should not be used during pregnancy and breastfeeding, as the possible effects on the unborn child or baby have not been sufficiently studied.

3. Certain medical conditions

• Type 1 Diabetes – This medication does not replace insulin and is therefore not suitable.

• Type 2 Diabetes – Weight loss can be beneficial, but due to the impact on blood sugar levels, use should always be done in consultation with a GP or specialist.

• Kidney or liver disease – If you have reduced kidney or liver function, additional medical monitoring is necessary when using weight-loss medication, and consultation with a specialist is recommended.

• Severe heart failure (NYHA class IV) – The safety of this medication has not been sufficiently studied in severe heart failure, therefore use is not recommended.

• Pancreatitis – People with a history of pancreatitis are advised not to use this medication due to a possible increased risk of new inflammation.

• Familial risk of pancreatic cancer – Although the evidence is not conclusive, caution is advised if there is an increased risk in the family.

4. Thyroid disorders

Thyroid cancer – Animal studies suggest a possible link between GLP-1 medications and thyroid tumors. Although this has not been proven in humans, the medication is not prescribed as a precaution to people with a history of thyroid cancer.

5. Eye problems

Diabetic retinopathy – Rapid drops in blood sugar can worsen this condition. Additional medical monitoring is necessary when using weight-loss medication, and consultation with a specialist is recommended.

6. Eating disorders

Binge Eating Disorder (BED), bulimia or anorexia – People with an eating disorder require specialized care, as weight loss medication does not address the underlying psychological problems.

Conclusion

Medical weight loss is suitable for adults with moderate to severe overweight (BMI 27-40), especially when traditional methods are not effective enough and there are health risks.

Want to know if this method is right for you? Contact us for a free consultation with one of our doctors.

References

1. Volksgezondheidsinformatie.nl (VZinfo). Overweight - definitions and accountability. RIVM. Available at: https://www.vzinfo.nl/overgewicht/verantwoording/definities . Accessed on [08-03-2025].

2. Guidelines database. Overweight and obesity in adults and children – Medication effectiveness. Federation of Medical Specialists. Available at: https://richtlijnendatabase.nl/richtlijn/overgewicht_en_obesitas_bij_volwassenen_en_kinderen/volwassenen/effectiviteit_medicatie.html . Accessed on [08-03-2025].

3. Treating Obesity. (n.d.). Possible causes and actions to be taken. Retrieved on [08-03-2025], from https://www.behandelovergewicht.nl/mogelijke-oorzaken-en-de-te-nemen-acties/

4. Medicijngebruik.nl. New medications for obesity:

5. Tirzepatide (Mounjaro). Dutch Medicines Bulletin Foundation. Available at: https://www.medicijngebruik.nl/nieuwe-geneesmiddelen/obesitas/medicijn/5616/tirzepatide-(mounjaro) .

6. Liraglutide (Saxenda). Dutch Medicines Bulletin Foundation. Available at: https://www.medicijngebruik.nl/nieuwe-geneesmiddelen/obesitas/medicijn/4338/liraglutide-(saxenda) . Accessed on [date of consultation].