Why Medications Alone Aren't Enough: Building a Weight Loss Plan That Actually Lasts

Anti-obesity medications like Ozempic, Wegovy, and Mounjaro are becoming increasingly common tools in the fight against obesity. They can be incredibly effective. But while these medications offer powerful support, they're not a magic bullet—and they're not the full solution.

Tedi Nikova, a Registered Dietitian who focuses her practice in sustainable weight loss and women's health, urges a balanced perspective. "These medications are great tools in your toolbox, but that's all they are," she says. "If you don't address your eating patterns and lifestyle, the old habits will eventually creep back in."

What Medications Can—and Can't—Do

How They Help:

Anti-obesity medications, specifically GLP-1 medications work by mimicking the effects of a natural hormone called glucagon-like peptide-1 (GLP-1), which plays a key role in regulating appetite, insulin secretion, and digestion. These drugs are widely used to treat type 2 diabetes and obesity.

Where They Fall Short:

"Think of it like treating depression," Tedi explains. "You might take an antidepressant, but you're also likely going to therapy and working on lifestyle changes. The same goes for weight loss medications—they support the process, but they don't replace the work."

Without also using the rest of your toolbox, you might run into these issues:

Muscle Loss Risk: "If your nutrition isn't on point, you'll lose a lot of muscle because these medications suppress your appetite so much. People end up undereating, becoming malnourished, and facing issues like iron deficiency, low energy, and muscle loss. This can be especially detrimental for women's health as they age," Tedi warns.

Rebound Weight Gain: She also points out that the effects of these medications aren't static. "Although these medications continue to work, hunger and cravings can creep back in. If you haven't worked on your eating patterns or your relationship with food by then, it's easy to fall back into old habits."

By addressing nutrition, lifestyle, and emotional eating alongside medications, Tedi helps her clients build a strong foundation for sustainable weight loss. "We can't skip the nutrition piece," she says. "I wish we could, but medication is definitely not a shortcut."

So what are the other tools you need?

The Rest of the Toolbox

Address Hormonal Concerns

"Most women come to me focused on weight loss, but the first place to start is really with the hormonal issues driving their weight gain. If we don't address conditions like PCOS, insulin resistance, or hypothyroidism first, sustainable weight loss becomes nearly impossible," Tedi explains. "Nutrition, sleep, and lifestyle changes are the foundation for bringing hormones back into balance."

Prioritize Lifestyle Changes

Sleep, stress management, and daily movement are often overlooked in weight loss journeys, but they are just as critical as nutrition. Tedi stresses that these factors form the foundation for sustainable weight loss and overall health. "If your sleep is off, your stress is unmanaged, and you're not moving throughout the day, you're constantly going to be struggling," she explains. These lifestyle basics directly impact key hormones that regulate hunger, cravings, and metabolism.

For example, poor sleep can disrupt hunger hormones like ghrelin, leading to increased cravings and overeating. Chronic stress raises cortisol levels, which can contribute to weight gain. And without regular movement, your body's energy expenditure decreases, making it harder to achieve a calorie balance.

If Tedi hears clients say they don't have time to focus on these areas, she challenges that mindset. "If you're someone who says, 'I don't have time for sleep, stress management, or movement,' that's exactly why you need it the most," she says. "When you don't fill your own cup first, you burn out, and you're not able to show up fully for others—or for yourself."

She encourages clients to treat these lifestyle changes like non-negotiable appointments with themselves. "Why do we prioritize emails or work tasks over taking a walk or getting enough sleep? Those tasks can wait. Your health cannot," Tedi reminds us all.

Simple changes, like aiming for 7-8 hours of sleep per night, practicing mindfulness or meditation to manage stress, and incorporating daily movement like walking, can have a profound impact. "It's not about doing everything perfectly; it's about consistently making small, manageable changes," she explains.

By prioritizing these lifestyle factors, you create a strong foundation for your health and make weight loss feel less like an uphill battle. As Tedi puts it, "When you take care of the basics, everything else becomes easier—your cravings reduce, your energy improves, and your body works with you, not against you."

Understand Your Emotional Eating Patterns

Unaddressed emotional eating is a common obstacle in weight loss. Food often becomes a coping mechanism for stress, sadness, or even boredom. Recognizing and addressing these patterns is crucial.

"We're all emotional eaters," Tedi shares. "The key is to figure out what emotions are your triggers and what high-risk times or circumstances lead to overeating."

Identify Triggers: Be curious, and build your awareness of what feelings and circumstances are related to food habits that are not aligned with your health goals.
Replace Coping Mechanisms: Find healthier ways to manage emotions, such as journaling, meditating, or taking a walk.
Practice Self-Compassion: Emotional eating is normal. The goal isn't perfection but progress in building healthier habits.

Avoid Extreme Restrictions

Eliminating whole food groups or drastically reducing intake can lead to nutrient deficiencies. For example, cutting out dairy without medical reasons can lead to deficiencies in calcium, iron, or protein.

As Tedi puts it, "Any extremes are going to cause nutrient deficiencies. For example, you might get iron deficiency or your thyroid might stop functioning optimally if you go too low carb. It's about balance, not extremes."

Focus on Protein

Protein is a cornerstone of sustainable weight loss and overall health, yet many women are unknowingly under-consuming it. Tedi emphasizes its importance, explaining, "Protein keeps us full, supports metabolism, and helps prevent muscle loss during weight loss. It's one of the most impactful changes you can make."

A good starting point is aiming for 30 grams of complete protein at each meal. "Complete proteins provide all the essential amino acids your body needs and are crucial for satiety and maintaining muscle mass," she notes. Excellent sources of complete protein include animal-based options like Greek yogurt, eggs, cottage cheese, chicken, tofu, tempeh, and edamame beans.

Consistently hitting your protein goals can make a significant difference. "If you're not sure whether you're getting enough, try tracking your meals for a few days," Tedi suggests. "You might be surprised how much more full and energized you feel when you prioritize protein."

By focusing on protein, you not only support your weight loss journey but also lay the foundation for better energy, stronger muscles, and sustainable, long-term health.

Food is Medicine, Too

As Tedi reminds us, "We hold so much power through our lifestyle. Whatever genetics or circumstances we've been given, we can shift so much by improving our nutrition and habits."

"Food is fuel. Food is data. Food is medicine," says Tedi. "When we focus on how food makes us feel and how it impacts our health, everything else—like weight loss—comes more naturally."

Tedi Nikova RD MPH practices in the areas of weight management, PCOS, menopause and women's health. She is dedicated to empowering her clients to reach their healthiest self while living their most fulfilling life. Want more from Tedi? Book an appointment with her, or connect on Instagram.