GLP-1 medicines and weight loss: understanding your options in Italy | Rodolico Health

Understanding your options and protecting your health and strength during treatment

Wegovy, Ozempic and Mounjaro have become familiar names, even to people who have never considered taking them. There is considerable interest in what these medicines can achieve, alongside understandable questions about their safety, who they are suitable for and what happens when treatment stops.

The good news is that we now have effective medicines that can make a meaningful difference to weight management and, for some people, wider health.

However, there is rather more to treatment than choosing a medicine and watching the number on the scales fall.

Nutrition, physical activity and particularly maintaining muscle strength all deserve attention from the beginning. For our international patients in Florence, there can also be questions about how treatment in Italy compares with advice or prescriptions received elsewhere.

There is an intriguing area of research looking at benefits beyond weight loss, including joint pain and inflammation, and whether these medicines might help reduce alcohol consumption. Some wider benefits are already supported by substantial clinical trials whereas others are still being explored.

What are GLP-1 medicines?

GLP-1 is a hormone naturally produced in the body that helps regulate blood sugar and appetite.

Medicines known as GLP-1 receptor agonists mimic its action. They can help people feel fuller, reduce hunger and make it easier to eat less. Semaglutide (Ozempic and Wegovy) and liraglutide (Saxenda) belong to this group.

Some people also describe a welcome reduction in “food noise” — the persistent thoughts about food, cravings or what to eat next that can take up rather a lot of mental space. Treatment can make these thoughts quieter, although the experience varies from person to person.

Tirzepatide (Mounjaro) works on two hormone receptors, GIP and GLP-1. Although technically a little different, it is usually discussed alongside GLP-1 medicines because of its related effects and uses.

These treatments were developed through research into diabetes and metabolism. Some are now also specifically approved for weight management.

Are Ozempic, Wegovy and Mounjaro the same thing?

The names can be confusing, particularly when news stories use “Ozempic” as shorthand for several different treatments.

Some products contain the same medicine but have different doses, formulations or approved uses. Others contain an entirely different active ingredient.

In Europe, the main distinctions for adults are:

Brand name	Medicine	Approved use and route
Ozempic and Rybelsus	Semaglutide	Type 2 diabetes. Ozempic is a weekly injection under the skin; Rybelsus is a daily tablet.
Wegovy	Semaglutide	Weight management in eligible patients. Weekly injection; a daily tablet is also authorised in the EU, but Italian availability is not yet confirmed.
Mounjaro	Tirzepatide	Type 2 diabetes and weight management in eligible patients. Weekly injection under the skin.
Saxenda	Liraglutide	Weight management in eligible patients. Daily injection under the skin.

This matters because the products are not automatically interchangeable.

If you are already taking a medicine prescribed in another country, it is helpful to bring the exact name, formulation and dose to your appointment. That allows us to understand what you are taking and discuss how your care can continue in Italy.

The European Medicines Agency provides information about approved medicines and their uses.

Who might benefit from treatment?

These medicines are intended for people whose weight is affecting, or placing them at increased risk of problems with, their health.

For adults, the European weight-management indications for Wegovy and Mounjaro include a body mass index, or BMI, of 30 or above, or a BMI of 27 to below 30 when there is at least one weight-related condition such as high blood pressure, type 2 diabetes or obstructive sleep apnoea.

BMI is useful as a starting point, but it cannot tell us everything about someone’s health.

Ethnic background matters too. Weight-related health risks can develop at lower BMI levels in some groups, including people of Black African, African–Caribbean or South Asian background. UK guidance recognises this through lower BMI thresholds, although the European medicine licences do not specify a separate adjustment for ethnicity. This is another reason to look at the whole person when discussing treatment.

An individual discussion should also consider medical history, other medicines, eating patterns and what the person hopes to achieve. Meeting a BMI threshold does not, on its own, tell us which treatment is the best choice.

How much weight might I lose?

The results can be substantial, although they vary between medicines and between individuals.

In a major trial of weekly semaglutide 2.4 mg, adults without diabetes lost an average of around 15% of their starting weight over 68 weeks, alongside support with diet and physical activity.

That is an average, rather than a prediction for any particular person. Some people lose more, some less, and some find that side effects limit treatment.

It is helpful to agree realistic goals at the outset and review progress over time. How you feel, what you can comfortably do and changes in your health also matter when deciding whether treatment is worthwhile.

Why does the programme around the medicine matter?

When appetite falls, eating less may become easier. Eating well still needs some thought.

If portions become much smaller, it can be harder to get enough protein and other nutrients. Persistent nausea or avoiding several foods can make this more difficult.

A balanced eating pattern, with regular sources of protein such as eggs, fish, yoghurt, beans or tofu, can help. Some people benefit from advice from a dietitian, particularly if they have other medical conditions, a restricted diet or difficulty eating enough.

There should also be room to discuss previous experiences of weight loss, sleep, activity and any concerns about food or body image.

A useful programme is one that fits your circumstances and can be adjusted as things change. Follow-up provides the opportunity to do that, including reviewing side effects and whether the medicine remains the right choice.

What about muscle loss?

This deserves more attention than it sometimes receives.

During weight loss, some lean tissue can be lost alongside body fat. This can happen when losing weight with medication, and it is one reason to think about muscle health from the beginning. Protecting muscle is an important part of healthy weight loss, particularly as we get older or if we already have reduced strength.

How can I protect my strength during treatment?

Strength training should have a regular place in the plan.

This does not have to mean joining a gym or lifting very heavy weights. Resistance bands, suitably chosen weights and adapted exercises using your own body weight can all be useful.

For most adults, a helpful goal is to work the major muscle groups on at least two days each week, starting at an appropriate level and building gradually. If you have joint problems, reduced mobility or have not exercised for some time, professional guidance can help you find a manageable starting point.

Walking, cycling and swimming remain valuable for cardiovascular fitness. Strength work has a particular role in helping maintain the muscles we depend on for daily life.

If walking is your main form of exercise, your arms, shoulders and back deserve a little attention too. A few well-chosen exercises for the upper body, alongside work for your legs and core, can help with everyday things such as carrying shopping, lifting a suitcase or reaching up to a shelf.

Adequate protein matters too, but simply adding a protein supplement is unlikely to provide the same protection without exercise. This combination of nutrition and strength training is emphasised in current multidisciplinary guidance on GLP-1 treatment.

Are there benefits beyond weight loss?

For some people, yes.

One of the strongest examples comes from the SELECT trial, which studied semaglutide in people who had overweight or obesity and established cardiovascular disease, but did not have diabetes.

Over approximately 40 months, a major cardiovascular event occurred in 6.5% of people receiving semaglutide, compared with 8.0% receiving placebo. This represented a 20% relative reduction in risk, or approximately 15 fewer events for every 1,000 people treated over that period.

That is a meaningful result. The qualification is that these participants already had cardiovascular disease; we should not assume that everyone considering treatment would receive the same benefit.

Tirzepatide has also shown benefits in obstructive sleep apnoea in people with obesity and moderate-to-severe disease.

These findings help explain why interest in these medicines extends beyond weight loss. The benefits still need to be understood in relation to the particular medicine and the people studied.

What about joint pain and inflammation?

This is another interesting area, with some encouraging findings.

In a clinical trial involving people with obesity and painful knee osteoarthritis, those receiving semaglutide had greater improvements in knee pain and physical function than those receiving placebo, alongside greater weight loss.

There are also early reports of improvements in pain, disease activity and markers of inflammation in people with rheumatoid arthritis taking GLP-1 medicines. These come from observational studies, however, which cannot establish whether the medicines themselves caused the improvement.

Losing weight can reduce the load on joints, and researchers are exploring whether these medicines also have a direct effect on inflammation. For now, we cannot confidently separate those effects or recommend GLP-1 medicines as a treatment for inflammatory arthritis. The findings are promising, but they do not replace established arthritis care.

Could these medicines help people drink less alcohol?

This is an interesting and developing area of research.

A trial published in The Lancet in 2026 studied 108 adults with alcohol use disorder and obesity over 26 weeks. Everyone received cognitive behavioural therapy, while participants were given either semaglutide or a placebo.

Those receiving semaglutide had a greater reduction in heavy-drinking days.

That adds to growing evidence suggesting that these medicines may influence alcohol consumption and cravings.

There are some qualifications, however. The trial was relatively small and involved people with both obesity and alcohol use disorder who were seeking treatment. We cannot assume that the same effect would occur in everyone taking semaglutide for weight management, or that it would persist after treatment stopped.

For now, this is promising research to follow. Reduced alcohol consumption should not be presented as an expected benefit when someone starts weight-management treatment.

What are the side effects?

Side effects are most often digestive. Nausea, constipation, diarrhoea or vomiting can happen, particularly when treatment begins or the dose increases. They are often most noticeable during these periods, so it is helpful to know what to expect.

Doses are increased gradually to give the body time to adjust. At Rodolico Health, we start low and increase step by step, following the schedule for the specific medicine and taking account of how well it is tolerated. If symptoms persist or make it difficult to eat or drink, please get in touch so we can review the plan.

Gallstones and inflammation of the gallbladder are also recognised possible complications. Losing weight, particularly quickly, can itself increase the chance of gallstones. If you have had gallstones or other gallbladder problems, mention this when discussing treatment. Persistent or severe abdominal pain — especially with fever, vomiting, or yellowing of the skin or eyes — should be assessed promptly, as it can have several causes that need medical attention.

Repeated vomiting that makes it difficult to keep fluids down is another reason to seek prompt medical advice.

Sudden loss of vision or rapidly worsening eyesight needs urgent assessment. A very rare condition affecting the optic nerve, called NAION, has been recognised as a possible side effect of semaglutide.

If you are pregnant, breastfeeding or planning a pregnancy, discuss this with your prescriber before treatment. These medicines should not be used during pregnancy, and the time to wait after stopping treatment before trying to conceive varies by medicine.

Please also tell your medical team if you are having a procedure involving anaesthesia or sedation. These medicines can slow stomach emptying, which may be relevant to the procedure. Your other prescriptions should be reviewed too, particularly insulin or medicines that can cause low blood sugar.

What happens if I stop treatment?

This is a sensible question to ask before starting.

Obesity is a chronic condition, and these medicines are usually best viewed as part of a longer-term treatment plan. How long treatment continues will depend on the benefits, side effects and your individual circumstances, with regular opportunities to review the plan together.

Weight regain is common after treatment ends. In a follow-up study of semaglutide, participants regained around two-thirds of their previous weight loss over the following year after both the medicine and the structured lifestyle support had stopped.

That can be discouraging, particularly for someone who has worked hard and felt better during treatment.

It is a reason to plan for the longer term and to make sure support continues if treatment changes. Duration, affordability, side effects and personal preferences should all be part of that discussion.

If weight returns, the response should be to review the situation and consider what support is needed, without blame.

How does treatment work in Italy?

These are prescription medicines, and access and reimbursement depend on what they are being prescribed for.

Guidance from the Agenzia Italiana del Farmaco (AIFA) states that Wegovy, Saxenda and Mounjaro prescribed for weight management are paid for by the patient rather than reimbursed by the Italian national health service. Different arrangements apply when medicines are prescribed for diabetes.

For international patients, the distinction between Italian and overseas arrangements can be useful when comparing treatment with the UK, United States or elsewhere. Local availability and costs should be checked before making a plan.

Medicines should be obtained through a legitimate prescription and pharmacy. AIFA also warns against buying these prescription products online or through social-media sellers, where illegal or falsified medicines can pose a risk.

Discussing weight management at Rodolico Health

If you are considering treatment, or already take a weight-management medicine prescribed elsewhere, we can review your circumstances and discuss appropriate next steps.

At Rodolico Health in Florence, consultations are available in English and Italian. We can help you understand the options in the context of your medical history, including the role of nutrition, physical activity and maintaining strength.

You can contact Rodolico Health or book an appointment to discuss weight management.

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