Your editorial (15 March) is right to highlight the growing evidence that GLP-1 medicines influence the brain’s reward systems and may have potential in treating addiction. These drugs represent an important therapeutic advance, and the moralising that has historically surrounded obesity treatment is both unhelpful and scientifically outdated. However, in clinical practice it is also clear that medication alone is rarely the whole answer.
Obesity, like addiction, involves powerful biological drivers such as appetite signalling, reward pathways and metabolic adaptation, but it also unfolds within behavioural and environmental contexts. Patients who achieve the most durable outcomes are typically those who combine pharmacological treatment with meaningful changes in diet quality, physical activity, sleep and muscle preservation.
