Everything you need to know about getting an Ozempic-style fat jab

Every January, millions of people start the new year vowing that they will lose weight.

But in 2025, many of those hoping to shed the kilos will be turning not to slimming clubs or traditional diet plans, but instead to Ozempic, Mounjaro and other so-called ‘skinny jabs’.

In anticipation of this New Year demand and potential shortages, some eager dieters are getting in early to place their orders before the rush.

If you’re tempted to try these injections then planning ahead is essential.

Read on as dietitian and weightloss expert Nichola Ludlam-Raine reveals everything you need to know before you join the jabbers...

BIN THE PRE-DIET BINGE

Anyone tempted to have a final blowout meal the night before they begin injections should think again.

Weight-loss drugs such as Ozempic, Wegovy, Saxenda and Mounjaro are known as ‘GLP-1 agonists’.

They work by mimicking glucagon-like peptide 1, the naturally occurring hormone that helps us feel satiated after eating.

Users will typically feel fuller for far longer, have decreased appetite and may even find themselves thinking about food less as well.

However, one way they work is to delay what’s called “gastric emptying” (the time it takes for food to empty out of your stomach) and it’s this lag that makes a pre-jab binge a bad idea.

If you eat a large amount of fatty, carb-heavy food the night before you start injecting, it could end up sitting in your stomach longer than usual.

This may result in you feeling bloated and sluggish – you could even start off your weight-loss jab experience with a nasty dose of stomach cramps, nausea or sickness and diarrhoea.

If you really need to have a blowout meal then do it the week – not the day – before.

PREP AND PLAN

It’s normal to shop and prepare for any diet, and weight loss injections should be no different.

Before you begin, set up your home so that healthy food is the easiest option to hand.

Although you’re going to be eating less and taking in fewer calories, you want that food to be healthy and nutritious.

The injections can work wonders but if you don’t feel better from the inside out then it’s going to be a waste of between $460-$260 a month.

I tell my patients to always have a filled fruit bowl on a counter top to grab from when they want to snack.

Pre-prepare crudites (cucumber, carrot, celery) and have them stored in your fridge along with your favourite healthy dips such as hummus or home-made salsa.

Arrange your cereals so the high fibre ones are at the front and the sugary ones at the back, give away any leftover Christmas chocolates and cake and keep the biscuit tin in a top cupboard rather than next to the kettle, to discourage mindless eating.

Over time you’ll discover what foods you enjoy more or less of when on the injections.

But to avoid making unhealthy choices, meal plan your first week using the guidance below.

JAB IN THE MORNING – IN YOUR FATTEST AREA

For most people, morning injecting is going to be the best option.

You’re more likely to forget to take the injection in the evening if you have a busy and stressful day, work late or have a night out.

If your choice of drug is one that is injected daily (such as Saxenda) then taking it in the morning will mean you get the full potency of the drugs throughout the day when you are eating rather than at night when you’re sleeping.

The recommended sites for injecting are the abdomen, thigh or upper arm. The best location for you will be the area where you carry your weight and can pinch a bit of fat – meaning that the extra padding will make the injection more comfortable.

Don’t be tempted to start the injections by launching straight in at a higher dose in the belief that you will lose weight faster.

If you do this then you are far more likely to experience unwanted side-effects.

The drugs are designed to be ‘titrated’ (introduced in slowly increasing doses) so that the body can adapt.

SO WHEN DOES IT ACTUALLY START WORKING?

Most people notice the effects of the drugs kicking in within a few days.

I’ve spoken to patients who have claimed to feel it working instantly, but that is far more likely to be a powerful placebo effect.

But even if it is just a placebo effect, who cares?

You are still reaping the benefits of portion sizes being reduced because you’re feeling fuller.

Don’t be put off if you reach the end of the first week and feel no different at all, it could just be that your body takes a little longer to adapt.

Some patients report that the drugs don’t kick in for them until they have built up to a higher dose (usually after one month.)

There are a very small number of dieters for whom Ozempic and similar drugs just won’t work.

This is simply because all our hormonal systems are different and in some cases the body seems to be able to override the effects of the drug.

As long as you are happy to remain on the drug and are not feeling unwell then I would encourage everyone to try them for at least four to six weeks before quitting.

KEEP YOUR CALORIES UP

The most important thing to remember is that even if the injections kill your appetite completely, you must eat and fuel your body.

Women should be aiming for a minimum of around 1200 calories and ideally closer to 1500 if they’re exercising regularly.

Most women will lose weight on around 1500 calories per day.

If you take in too few calories, you’ll risk slipping into something called “metabolic adaptation”, when your body adapts to its lack of fuel by burning fewer calories.

So, even though you may be eating very little, the weight won’t be shifting.

If you struggle to eat more than 1000 calories a day in the first week it’s not the end of the world and won’t cause you any harm, but it’s not suitable for the long term.

On a very low-calorie diet, you’re not going to be hitting targets for protein, fibre and healthy fat intake.

Surviving on a couple of bars of chocolate just because you can is going to result in a severe lack of energy.

Your skin will be dull from lack of nutrients, and you may experience hair loss and brittle nails.

Remember you are taking these drugs to be slimmer and healthier, so do be sensible.

To get the right balance, aim for a plate of half vegetables and a quarter each of carbohydrate and protein.

Be sure to eat at least one portion of wholegrains per day – this could be in the form of oats, wholemeal sourdough or wholegrain basmati rice.

If you’re struggling to eat, then prioritise the vegetables (fibre) and protein over the carbohydrates.

If you are eating a daily portion of oily fish then you won’t need to take in extra fat.

Otherwise, avocado, nut butters, nuts and seeds, and drizzles of olive oil on vegetables and salads are all good sources.

LIQUID DIET BOOST

In the first few days if you don’t feel like eating or you’re experiencing indigestion, nausea or stomach cramps (all possible side-effects) then going liquid-only is a good solution.

The above-mentioned side-effects are a result of the delayed gastric emptying.

However, liquids pass through the system more quickly than solids and your stomach doesn’t have to work as hard to digest them.

You could try meal-replacement drinks, protein drinks or smoothies and soups – but only for three days maximum.

PACK IN THE PROTEIN – AND BUY DUMBBELLS

When we lose weight, we need to do all we can to lose more fat than lean muscle.

Contrary to what many believe, people in larger bodies will have a decent amount of muscle because it’s needed to carry their body and you want to make sure you don’t lose too much of it as you shrink in size.

This is where resistance exercise and protein intake are vital as both protect and build muscle – and muscles burn more calories than fat.

A good rule of thumb for protein intake is to aim for 1.6g for every kilogram of ideal body weight (ie. not your starting weight but your target weight).

For most people that’s going to be a minimum of 60-80g per day.

Meat and fish are the best sources of protein along with eggs, dairy or soya.

Lentils, beans and hummus are also great sources.

Eat a source of protein at least three times a day.

High-protein yogurts (20g of protein) are a good way to get your fix on days where you don’t have much appetite.

When it comes to strength-based exercises, simple bicep curls, squats and lunges are a good place to start.

I’d also suggest buying a cheap set of dumbbells. Start with 3-5kg initially and use them at least twice a week to help preserve muscle mass.

GET YOUR ‘FFM’ FIX

That stands for ‘Fibre, Fluid, Movement’ and all three will be vital in order to support digestion and help you feel as well as possible when using weight-loss injections.

The recommended guidelines are to eat 30g of fibre a day and 30 different plant-based food a week.

Fruit, veg, wholegrains, legumes, chickpeas, kidney beans and hummus are all excellent sources.

Where possible eat the flesh and the skin of fruits and veg for an extra fibre boost.

Constipation can be a side- effect of drugs like Ozempic.

Flax seed (either milled or whole) is a good solution.

Start with a teaspoon a day and build up to two tablespoons if needed, by adding to yogurt or porridge.

Two kiwi fruits per day – try to eat the skin too if you can – will also help with fibre and ease constipation.

Keep hydrated throughout the day and aim for eight glasses of liquid, drunk either side of meals rather than with them.

Your pee should be a pale straw colour. If it’s darker, up your water intake.

Finally, movement is going to work your digestive muscles and help to avoid constipation, so get walking straight away!

DON’T RELY ON THOSE READY MEALS

Aim for three smaller meals a day.

Some people may be tempted to have just one larger meal, but this is going to increase the risk of nausea and indigestion.

You’re not going to be able to get five a day and all your fibre requirements in one meal, plus research shows protein is better absorbed when spaced throughout the day, rather than being consumed in one sitting.

Avoid an over-reliance on calorie-counted ready meals and be wary of ultra processed foods particularly if they are HFSS (high in fat, salt and sugar).

Don’t ban the foods you love – instead aim for the 80/20 rule, where you eat healthily 80 per cent of the time and allow yourself treats the other 20 per cent.

Psychologically, if you tell yourself you aren’t allowed to eat something, you will start to crave it.

It’s important to adopt healthy habits so that when you stop the injections those habits will sustain the weight loss.

DRY-ZEMPIC

Many people taking weight-loss injections find they curb alcohol cravings to the extent some users become teetotal.

Alcoholic drinks are essentially “empty calories” meaning they provide little to no nutritional value, so if you don’t feel like drinking, make the most of it!

Even if you do fancy a tipple, I’d recommend not drinking in your first month, until your body has got used to the drugs – dry January should make this easier as so many other people will be swearing off booze.

After that, try to avoid carbonated drinks that may cause indigestion (or if you’re drinking something like prosecco wait a while for the bubbles to die down before sipping).

A gin with a slimline mixer is a good low-calorie option, or you could choose a small glass of red or white wine for the polyphenols.

SPEED OF WEIGHT LOSS

Many people on Ozempic will find – and this is typical of most diets – that the weight comes off quickly at first, then slows down.

Hormonal changes such as monthly periods and menopause can affect weight-loss rates as well as other factors such as salt, carbohydrate intake and water retention.

That initial big weight loss won’t be fat, it will be water and glycogen.

Fat takes a little longer, which is why it’s important not to be deterred by an initial big drop on the scales followed by some much lower ones.

STEER CLEAR OF…

Processed, fatty and heavily spicy foods that could make indigestion worse, as will excessive amounts of caffeine, alcohol and carbonated drinks.

Drinking through a straw – you’ll only be taking in extra air and increasing your chances of bloating.

This goes for fancy water bottles with a built-in straw, too.

“Resistant starches” are also best swerved.

These are the starches found in carbohydrates when they’re cooked and then cooled; examples would be cold pasta salad, cold potato salad or partly baked bread such as shop-bought garlic bread or frozen pizza.

The name is due to them being resistant to the action of digestion – instead they ferment in the stomach and give off gases that cause bloating.

HEAL YOUR HEART HUNGER ISSUES

Make a note of what you eat and how you feel afterwards.

This will help build a picture of what foods you do and don’t enjoy while using the injections and those that leave you feeling bloated and uncomfortable.

Also, note your mood at the time of eating to help identify if you are an emotional eater.

There are three types of hunger.

“Head hunger” food cravings are triggered by seeing, hearing or smelling food.

“Stomach hunger” is true hunger, and “heart hunger” is when emotions (such as stress, anger, loneliness) are the drivers.

Ozempic-type drugs will help quieten down both head and stomach hunger but, even though you may be consuming less, emotional eaters will still experience some “heart hunger”.

With a decreased appetite, now is a good time to devise a nonfood linked strategy to help soothe these emotions.

It could be phoning a friend, going for a walk or taking up a hobby.

Finding coping strategies now will help keep the weight off after you stop using the injections.

— As told to Claudia Connell