By Dr Zamiel Hussain, Founder and Lead GP at AccessGP
As a GP, I see the same pattern every year. Autumn turns to winter, the days get shorter, routines slip, celebrations multiply and weight can creep up almost without noticing. Many people feel frustrated, especially if they have tried multiple diets or are hearing about new “weight loss injections” in the news and are not sure what is safe, realistic or right for them.
The truth is that weight management is now a fast moving area of medicine. We have better evidence, more powerful medications and stronger data on long term health risks and benefits than ever before. At the same time, there is a lot of hype, oversimplification and confusion.
In this article I will outline what the latest evidence shows, the role of lifestyle versus medication, and how a GP led approach can help you lose weight safely this winter and beyond.
What do we mean by a “healthy weight”?
Health is about more than a number on the scales. In the UK, we still use body mass index (BMI) as a starting point, while also thinking about waist measurement, metabolic markers and individual risk.
- A BMI between 18.5 and 24.9 is usually considered the “healthy” range
- 25 to 29.9 is described as overweight
- 30 and above falls into the obesity range, with higher classes above this
NICE now takes a more nuanced approach, considering central adiposity (abdominal fat), ethnicity and other conditions when assessing risk and treatment options.
For many people, even a 5 to 10 percent weight reduction can improve blood pressure, blood sugar and cholesterol, and can reduce the risk of heart disease and type 2 diabetes.
Why winter makes weight loss harder
Several seasonal factors make weight management more challenging at this time of year:
- Less daylight and energy
Shorter days affect mood, motivation and activity. Many people find themselves walking less, exercising less and relying more on convenience food. - Comfort eating and celebrations
Festive meals, social events, buffets at work and drinks with friends often mean extra calories, sugar and alcohol several times a week. - Stress and tiredness
End of year deadlines, financial pressure and family commitments can all increase stress. When we are tired and stressed, we are more likely to snack, skip cooking and move less. - Colder weather
People naturally choose indoor activities, which often involve more sitting and less movement.
None of this means winter has to derail progress, but it helps to recognise that the season is working against you and plan around it.
What actually works for weight loss in 2025?
The evidence consistently shows that there are several pillars of effective weight management.
1) Nutrition and calorie balance
Almost all weight loss methods that work over time involve some degree of calorie reduction. The most sustainable approaches focus on:
- Higher fibre, higher protein meals
- Plenty of vegetables, fruit and whole grains
- Limiting ultra processed foods and sugary drinks
- Being aware of portion size and eating speed
- Matching intake more closely to activity
There is no single “perfect” diet for everyone. Mediterranean style patterns, lower carbohydrate approaches and plant based diets can all be effective if they are balanced, sustainable and tailored to the individual.
2) Physical activity
Exercise alone is usually not enough to cause large weight loss, but it is vital for health, metabolic control and maintaining weight loss. Guidelines generally recommend at least:
- 150 minutes of moderate physical activity per week
- strength or resistance exercise on 2 days per week
Even a modest increase in daily steps, especially if you currently sit for long periods, makes a difference.
3) Sleep, stress and routines
There is growing evidence that poor sleep and chronic stress can affect appetite hormones, cravings and weight regulation. Practical steps include:
- aiming for 7 to 9 hours of sleep most nights
- having a regular bedtime routine
- limiting screens and caffeine late in the day
- using simple stress management strategies such as short walks, breathing exercises or talking therapy
These foundations still matter, even if medications are considered later.
“New weight loss injections can be powerful tools, but they are not magic. Without changes to habits, routines and support, the benefits often fade when treatment stops.”
Where do newer weight loss medications fit in?
Medications are not a shortcut or a cosmetic tool. They are one option within a wider, structured weight management plan, and they are not right for everyone.
GLP-1 and related medicines
In the last few years, medicines that act on the GLP 1 pathway, and more recently dual GIP and GLP 1 agonists, have transformed the evidence base for medical weight loss.
Clinical trials of semaglutide in people living with obesity have shown average weight loss of around 15 percent of body weight when combined with lifestyle support.
Trials of tirzepatide have reported even larger average reductions, approaching 20 percent in some groups.
In England, NICE now recommends specific medicines for weight management in carefully defined situations, alongside a reduced calorie diet and increased physical activity.
Important limitations
There are important points that often do not appear in headlines:
- These medicines are usually reserved for people with a higher BMI and weight related health risks, they are not licensed for minor cosmetic loss.
- They can cause gastrointestinal side effects, such as nausea, diarrhoea or constipation, especially when doses are increased too quickly.
- They have specific cautions, for example in people with certain endocrine conditions or a history of pancreatitis.
- Long term data is still emerging, and not all questions about rare risks are fully answered.
- Stopping the medication often leads to partial weight regain, especially if lifestyle and behavioural supports are not in place. Studies of semaglutide have shown that people can regain around two thirds of the weight lost after treatment is stopped.
Recent analysis from UK policy organisations has also raised questions about equity, capacity and cost when rolling these medicines out at scale on the NHS.
For these reasons, medical treatment for weight management should only be used with careful assessment, informed consent and close follow up, usually after a structured trial of lifestyle support.
“Weight loss is not a moral success or failure. It is a complex interaction between biology, environment, medications and daily life. Good care starts with understanding that.“
Why a GP led approach matters
There is a difference between a quick online questionnaire and a full, GP led review of weight, health and medication options.
A careful assessment should include:
- weight history and previous attempts to lose weight
- medical conditions such as diabetes, cardiovascular disease, liver disease, sleep apnoea or osteoarthritis
- mental health, including any history of eating disorders or body image distress
- current medications that may affect weight
- blood tests where appropriate, such as lipids, HbA1c, thyroid function and liver function
- a discussion of your goals, expectations and timeframe
As a GP, my priority is to support safe, evidence based choices. For some people, that means focusing on structured lifestyle changes. For others, it may mean exploring medical options if they meet strict criteria and fully understand the benefits and risks. For many, the answer is somewhere in between, with lifestyle change always at the core.
What GP led weight loss support might look like
Every service is different, but a GP led weight management plan might include:
- An in depth initial consultation to understand your health, lifestyle and goals
- Blood tests to assess cardiovascular risk, metabolic health and any secondary causes
- A tailored nutrition and activity plan that fits your routine and preferences
- Support with sleep, stress and mental health where needed
- Regular follow up appointments to review progress and adjust the plan
- Consideration of medications only where appropriate, based on current NICE guidance and your individual risk profile
- Coordination with NHS services or specialist clinics if more intensive support is required
The aim is not rapid, unsustainable loss, but a steady, realistic change that improves long term health.
How to approach weight loss safely this winter
If you are considering making a change this winter, some practical steps are:
- Start with a health review
Check your blood pressure, weight and, where appropriate, blood tests. Knowing your baseline helps guide the right plan. - Avoid extreme or unproven diets
Rapid, unsupervised diets, unregulated injections or supplements can be harmful. - Be cautious about medication offers online
Only consider prescription treatments through regulated services that follow UK guidance, use legitimate pharmacies and offer proper follow up. - Focus on small changes you can sustain
For example, adding a daily brisk walk, adjusting portions, or reducing sugary drinks. - Ask for help
If you feel stuck, a structured review with a GP can help you understand your options more clearly.
How AccessGP can support you
At AccessGP our weight loss support is:
- GP led, with UK trained clinicians
- centred on safety and long term health
- focused on realistic goals and evidence based methods
- integrated with blood tests, cardiovascular risk assessment and lifestyle advice
We can also work alongside your NHS care, and with your consent we can share information where it is helpful.
If you would like to explore weight management in more detail, booking a consultation is a good place to start.
Key sources: NICE NG246 – Overweight and obesity management; NICE TA1026 – Tirzepatide for managing overweight and obesity; NEJM – Once weekly semaglutide in adults with overweight or obesity; NEJM – Tirzepatide once weekly for the treatment of obesity; Nature Medicine – Long term weight loss and cardiovascular outcomes with semaglutide; Diabetes Obesity and Metabolism – Weight regain after stopping semaglutide; NHS England – Medicines for obesity; The King’s Fund – GLP 1 drugs on the NHS; ZAVA – GP led online weight loss treatment overview.