The New Mindset for Medication-Assisted Weight Loss

In 2024, GLP-1 agonists (Ozempic, Wegovy, Zepbound) seemed to officially take over the U.S. health care system. Consider some of the rapid changes we’ve witnessed this year.

1. The British Medical Journal (BMJ) reported in 2024 that prescription rates for these medicines increased by over 700% in the past four years.¹
2. Despite the high costs and lack of widespread insurance coverage, more than 1 in 8 adult Americans reported having already used a GLP-1 medicine (mostly for weight loss)². And up to half of U.S. adults reported interest in using one of these medicines in 2024.
3. 2024 research shows that GLP-1 medicines are so effective and popular that rates of bariatric surgery have declined by over 25% in the past few years.³
4. Even powerful food companies this year, such as Nestlé, are developing entirely new product lines in response to rapid shifts among the growing number of consumers using GLP-1 agonist medicines.

As we enter 2025, rates of weight and weight-related health conditions are at record levels in the U.S. among both adults and children⁴. That’s the bad news. But the good news is that if you are a person stepping into 2025 with an interest in improving your health, the treatment options are more promising than ever.

After decades of futile dieting and personal responsibility campaigns for health and weight loss, we are finally entering an era where we can focus on improving the biology inside a person and fixing the environment outside of them instead of putting the blame on them.

The game has changed, but mindset still matters

Whether your goal is weight loss, diabetes management, or treating sleep apnea or kidney disease, GLP-1 agonist medicines can do a lot on their own to help by improving your metabolic function (GLP-1 agonists alter specific hormones that affect how your brain, stomach, and other lower body organs function to promote positive health changes).

However, if you want the best results from these new treatments, you will also want to combine them with a new mindset. The Tables below (1-2) summarize some of the mindset features we’ve taught during the recent decades of the “diet era” versus the mindset features that psychologists, nutritionists, and physicians are encouraging today. They could hardly be more different.

Table 1: Diet-era mindset

• Eat less (count calories).
• Exercise to burn calories.
• Being overweight is about personal responsibility and motivation.
• “Food noise” is loud and constant. Weight loss feels like a second job.
• Relies on “top-down,” deliberate changes in lifestyle.

Table 2: Medication-era mindset

• Eat better (e.g., more protein and fiber).
• Exercise to optimize bone and muscle health and improve quality of life.
• Being overweight is a medical condition that benefits from specific treatments that improve metabolic function.
• “Food noise” is quiet and infrequent. Weight loss feels like a hobby.
• Relies on “bottom-up,” biology-driven changes in satiety and lifestyle.

Summary

Don’t enter the new GLP-1 medicine health and weight-loss paradigm with an old mindset.

Psychological factors—in the form of our attitudes, beliefs, and behaviors—are as important as ever to achieving healthy weight loss in the modern era of medication-assisted therapy. However, just like we are upgrading our physical programs from traditional diet and exercise-based treatments to GLP-1 agonists, we also need to upgrade our mental program to obtain the best results.