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Guide 3 of 9 · Stage: Decide

What are my options for losing weight? Where GLP-1 medicines fit

Food and activity, older pills, GLP-1 injections, balloons and surgery, side by side, with UAE prices and insurance rules.

GLP Guidebook teamUpdated 12 Oct 202612 min read43 sourcesWritten from published sources
The short answer

There are five main routes:

  1. Lifestyle changesFood, activity and sleep. The base for all the others.
  2. Older weight-loss pillsMainly orlistat. It helps a little.
  3. GLP-1 medicinesSuch as semaglutide and tirzepatide
  4. Endoscopic proceduresDone through the mouth, without cutting the skin
  5. Weight-loss surgeryThe largest, longest-lasting loss, but a major operation

They differ a lot in weight lost, risk and cost. Medicines, procedures and surgery are added to lifestyle changes, not used instead of them. Procedures and surgery are only for much higher BMIs. See which are for you

Key facts

Lifestyle programmes
About 9% of body weight lost after 1 year in a large trial, 6% after 10 years1
Older pills
Orlistat is the main one. It adds a few kilos of loss.2,3
GLP-1 medicines
About 15–21% lost in trials of people without diabetes. Weight returns after stopping.4,5,6
Surgery
The largest and longest-lasting loss: about 25% of body weight 10 years after a gastric bypass, with operation risks7,8
WHO's view (Dec 2025)
GLP-1 medicines may be used long term, with diet and activity support alongside9
On this page
  1. Which options are for you?
  2. How do the options compare?
  3. Can food and activity changes alone help?
  4. What about pills, and other medicines that lower weight a little?
  5. Where do GLP-1 medicines fit?
  6. Who is weight-loss surgery for in the UAE?
  7. What are gastric balloons and endoscopic sleeves?
  8. How do doctors choose between them?
  9. Questions people ask

Which options are for you?

It depends mostly on your BMI. Lifestyle changes are for everyone. Medicines come in at a lower BMI. Procedures and surgery are for much higher weights.

Lifestyle changesEveryone, at any weight
Adding a medicineDubai: BMI 30 or more, or 27 with a weight-related condition. Abu Dhabi is stricter.10,3
Endoscopic proceduresStudied in people with a BMI of about 30–4011,12
Weight-loss surgeryDubai: BMI 40 or more, or 35 with a serious weight-related condition10
BMI along the bottom. Lighter shading means "only with another condition". The kilograms are for someone 170 cm (5 ft 7 in) tall. Check your own BMI

So if your BMI is in the high 20s, the choice is usually between lifestyle changes alone and lifestyle changes plus a medicine. At 170 cm, a BMI of 27 is about 78 kg (172 lb). In Dubai's guideline, surgery starts at a BMI of 35 to 40, about 101 to 116 kg (223 to 256 lb) at the same height.10

Abu Dhabi sets a higher bar for medicines: a BMI of 30 or more with at least one weight-related condition, or over 40. A BMI of 27 to 29.9 doesn't qualify there.3 If your family is of Asian origin, health risks start at a lower BMI, but UAE rules still use these lines.3 Guide 1 explains.

These are points where you and a doctor can start a conversation, not rules that you must or must not have something. Guidelines also look at your health, not just your weight.10,8

How do the options compare?

In trials, surgery led to the most weight loss. GLP-1 medicines came next, but only while people kept taking them. Lifestyle programmes and pills led to less.

The numbers below come from different trials, with different people. So treat them as rough guides. They are not a direct comparison. "Weight lost" is the average share of starting body weight.

At a glance: average weight lost by someone starting at 90 kg (198 lb). Lighter shading shows a range.
  1. Dummy injection (for comparison)2–3 kg4,5
  2. Orlistat (pill)~3 kg more than a dummy pill2
  3. Lifestyle programme~8 kg1
  4. Gastric balloon~9 kg11
  5. Endoscopic sleeve (ESG)~12 kg12
  6. GLP-1 medicine~13–19 kg4,5
  7. Gastric bypass surgery~23–29 kg7

Rough guide only: different trials, different people and different lengths of time. Details for each option are below.

Each option in detail. Weight lost is the average share of starting weight.

Lifestyle programme

Ongoing

A structured plan: a calorie target, regular activity, and regular sessions with a dietitian or coach. More ↓

About 9%about 8 kg of 90 kg

At 1 year, falling to about 6% at 10 years1

This is an average, not a limit. In the same trial, about 1 in 4 people had kept off 10% or more 8 years later. The people who kept it off were the ones who kept up the habits.13

Time to work
Most loss in the first year1
Main downsides
Hard to keep up; some weight creeps back1
Cost in the UAE
Varies: food, plus any dietitian or coach fees

Orlistat (pill)

Ongoing

A pill taken with meals that stops some of the fat you eat from being absorbed. More ↓

About 3 kgmore than a dummy pill

Over 4 years2

Time to work
Months14
Main downsides
Oily, loose stools; urgent toilet trips14
Cost in the UAE
We found no official price15

GLP-1 medicine

Ongoing

A weekly injection or daily tablet that makes you less hungry. Explained in Guide 2. More ↓

About 15–21%about 13–19 kg of 90 kg

Semaglutide to tirzepatide at its top dose, after 68–72 weeks.4,5 Less with type 2 diabetes: about 10%16

Time to work
Doses rise over 16–20 weeks4,5
Main downsides
Stomach side effects, rare serious risks; weight returns on stopping17,6
Cost in the UAE
About AED 744 to AED 1,734 a month at the official price, depending on medicine and dose18,19Dubai's basic insurance plan excludes weight-loss medicines20

Gastric balloon

One-off, temporary

A soft balloon is put into your stomach through the mouth, so there's less room for food. It's taken out after about 6 months. More ↓

About 10%about 9 kg of 90 kg

At 6 months, about 8% at 1 year11

Time to work
6 months, then removed11
Main downsides
Nausea and vomiting are very common11
Cost in the UAE
Set by each clinic; we don't list clinic pricesNot covered by Dubai's basic insurance plan20

Endoscopic sleeve (ESG)

One-off

Stitches are put inside your stomach through the mouth to make it smaller. No cuts in the skin. More ↓

About 14%about 12 kg of 90 kg

At 1 year12

Time to work
Within a year12
Main downsides
Serious problems in about 2 in 10012
Cost in the UAE
Set by each clinic; we don't list clinic pricesNot covered by Dubai's basic insurance plan20

Weight-loss (bariatric) surgery

One-off, lifelong follow-up

An operation that makes your stomach much smaller. Some types, like gastric bypass, also reroute the gut so food skips part of it. More ↓

About 25–32%about 23–29 kg of 90 kg

Gastric bypass: 32% at its peak (1–2 years), 25% at 10 years7

Time to work
Peak at 1–2 years7
Main downsides
Operation risks, repeat operations, lifelong vitamins and check-ups8,21
Cost in the UAE
Set by each hospital; we don't list hospital pricesDubai's basic insurance plan excludes surgery for obesity; enhanced plans vary20

Medicine prices in the UAE are fixed nationally, so the same pack costs the same at every pharmacy; we show those official prices only. We don't list or compare clinic or hospital prices. GLP-1 costs repeat every month.

In the medicine trials, the dummy-injection groups lost 2.4% and 3.1%, or about 2–3 kg.4,5 These are averages, and results vary from person to person. In those trials, about 14 in 100 people on semaglutide and 9 in 100 on tirzepatide lost less than 5% of their weight.4,5

Can food and activity changes alone help?

Yes, for many people. Structured programmes helped people lose around 6–9% of their weight, and cut their risk of diabetes.

Start here. Lifestyle change is the first step and the base for every other option. It's the only one with no medicine or procedure risks. The trial figures below are averages: some people lose far more, and how much you lose depends a lot on how well you can keep up the changes.13

One large trial, Look AHEAD, followed 5,145 adults with type 2 diabetes.1 The programme set a calorie target and about 3 hours of activity a week, with frequent group and one-to-one sessions.1 People lost 8.6% of their weight in the first year, against 0.7% with usual care.1 After about 10 years, they were still 6.0% lighter, against 3.5%.1

In the US Diabetes Prevention Program, 3,234 people with high blood sugar (prediabetes) took part.22 The lifestyle group lost 5.6 kg on average over about 3 years, against 0.1 kg on a dummy pill.22 Their rate of new diabetes was 58% lower: 4.8 cases per 100 people a year, against 11.0.22

For South Asian readers. The Indian Diabetes Prevention Programme tested lifestyle advice in 531 Asian Indians with high blood sugar.23 They were younger and leaner than in Western trials, with an average BMI of about 26.23 Over 3 years, 39% in the lifestyle group got diabetes, against 55% with no advice.23

Food: how much to cut

US guidelines give a figure: eat about 500–750 calories a day less than your body uses.24 That's a cut from what you need, not a daily total. Someone whose body uses 2,200 calories a day would eat about 1,450–1,700.

The WHO advises keeping free sugars (added sugar, plus the sugar in honey, syrups and juices) under 10% of your daily energy, and ideally under 5%.25

On a GLP-1 medicine, the risk is eating too little. People on these medicines eat 16–39% fewer calories without trying. Below about 1,200 calories a day for women or 1,800 for men, vitamins and minerals can fall short. So the focus shifts from cutting more to eating well: enough protein, vegetables, fruit, whole grains and pulses.26

Protein: the part most people miss

When you lose weight, some of it is muscle. Too little protein makes that worse, and a smaller appetite on a GLP-1 medicine makes protein harder to get.26

A simple daily target80–120 gof protein a day, suggested by four US obesity and nutrition societies in a 2025 advisory on GLP-1 medicines26
  • 0.8 g per kg of body weight is the usual minimum for adults.
  • 1.2–1.6 g per kg has been proposed while you're losing weight.
  • Don't go below 0.4–0.5 g per kg, which leads to muscle loss, or stay at 2 g per kg or more for long.26

The same advisory says to pair protein with strength exercise at least 3 times a week, plus at least 150 minutes of moderate activity like brisk walking.26 If you have kidney disease, ask your doctor before raising your protein.

What to put on the plate

The 2025 advisory on GLP-1 medicines suggests building meals around whole, minimally processed foods.26 In practice:

Plant foods
  • Vegetables and salad at every meal, and fruit in place of sweets26
  • Lentils, chickpeas and beans for protein and fibre26
  • Whole grains in place of white bread and white rice26
  • Water in place of sweet drinks and juice25
Fish, meat, eggs, dairy
  • Fish, eggs, chicken or lean meat as a protein at each meal26
  • Plain yoghurt and other low-fat dairy as protein-rich snacks26
  • Fewer processed meats and fried foods26
  • Keep the vegetables and whole grains on the plate too26

Ramadan, Eid and Iftar gatherings change how and when people eat. Guide 8 covers fasting on a GLP-1 medicine.

Activity, sleep and support

Activity. The WHO advises adults to do 150–300 minutes of moderate activity a week, like brisk walking, or 75–150 minutes of vigorous activity, plus strength exercise on at least 2 days.27 For people on a GLP-1 medicine, the US advisory above suggests strength exercise at least 3 times a week.26 In summer heat, an indoor walk or an early-morning or evening session can make this easier.

Abu Dhabi's Thiqa obesity programme builds activity into its rules: members track 150 minutes of moderate exercise a week, 75 minutes of vigorous exercise, or 10,000 steps a day.28

Support. WHO says diet and activity programmes may be offered alongside GLP-1 medicines.9 Dubai's guideline describes a "comprehensive lifestyle intervention" as the first step, with medicines added if it isn't enough.10

What about pills, and other medicines that lower weight a little?

The main older weight-loss pill is orlistat. It helps a little. Some diabetes medicines also lower weight a little.

Orlistat blocks an enzyme that digests fat (a lipase), so some fat passes out unabsorbed.29 In a 4-year trial, people on orlistat lost 5.8 kg, against 3.0 kg on a dummy pill.2 In a small Indian trial over 24 weeks, it was 4.65 kg against 2.5 kg.14 Loose, oily stools, oily spotting and urgent toilet trips were common.14 It can also lower the absorption of some vitamins and other medicines.29 Abu Dhabi's standard says to stop it if you haven't lost 5% of your weight after 3 months.3

Metformin is a diabetes medicine, not an approved weight-loss one.30 In the Diabetes Prevention Program it led to 2.1 kg of loss on average.22 In the Indian trial, 41 in 100 people on metformin got diabetes over 3 years, against 55 in 100 with no treatment. That is about 26% fewer.23 An international PCOS guideline says doctors should consider it for women with PCOS and a BMI of 25 or more.31

SGLT2 inhibitors, such as dapagliflozin, lead to modest weight loss. Across 116 trials, people lost about 1.8 kg more than on a dummy pill.32

Phentermine–topiramate is a combination pill approved for weight in the US. Abu Dhabi's standard has rules for it: a BMI of 35 or more with a weight-related condition, and stopping if less than 5% is lost after 3 months.3 We could not confirm which brands are sold in the UAE.

Be careful with "fat burners" and slimming products. The US drug regulator warns that many weight-loss products sold as supplements or "all-natural" contain hidden drug ingredients.33 It says they can cause serious harm and hospital stays.33 In July 2026, the UAE's drug regulator acted against 71 sources selling unapproved weight-loss products, and referred 14 social media influencers to the authorities.34

Where do GLP-1 medicines fit?

They lead to more weight loss than pills or lifestyle alone. But they are a long-term treatment, and most of the weight returns if you stop.

Semaglutide acts like the gut hormone GLP-1.16 Tirzepatide acts on GLP-1 and a second gut hormone, GIP.5 Guide 2 explains how they work. In every trial below, people also followed a diet and activity plan.4,5

Average weight lost in each trial. Kilograms are for someone who starts at 90 kg.

STEP 1Semaglutide 2.4 mg, weekly

Adults without diabetes, 68 weeks.4

Semaglutide14.9%about 13 kg
Dummy injection2.4%about 2 kg
SURMOUNT-1Tirzepatide 15 mg, weekly

Adults without diabetes, 72 weeks.5

Tirzepatide20.9%about 19 kg
Dummy injection3.1%about 3 kg
STEP 2Semaglutide 2.4 mg, weekly

Adults with type 2 diabetes, 68 weeks.16

Semaglutide9.6%about 9 kg
Dummy injection3.4%about 3 kg
SURMOUNT-5Tirzepatide vs semaglutide, head to head

The only trial that compared them directly, 72 weeks. Paid for by the maker of tirzepatide.35

Tirzepatide20.2%about 18 kg
Semaglutide13.7%about 12 kg

Only the last trial compared the two medicines directly; the others each tested one medicine against a dummy injection, so don't compare across them.

Tablets. The UAE was among the first countries to approve two daily weight-loss tablets: Foundayo (orforglipron) in April 2026 and the Wegovy pill (oral semaglutide) in June 2026.36,37 Rybelsus, a lower-dose semaglutide tablet, is for type 2 diabetes.38 The trial results on this page are for weekly injections.4,5

What happens when you stop. A year after stopping semaglutide, trial participants had regained about two-thirds of the weight they lost.6 In a tirzepatide trial, everyone first took the medicine for 36 weeks and lost about 21% of their weight.39 Then some were switched to dummy injections. Over the next year, their weight went up by 14% of what they weighed at the switch.39 For someone who weighed 85 kg by then, that is about 12 kg (85 × 0.14 = 11.9). Those who stayed on tirzepatide lost a further 5.5% over the same year.39 Guide 9 covers stopping.

Cost. On Abu Dhabi's official drug list from 2 October 2026, a Mounjaro KwikPen (4 weekly doses) costs AED 1,734 at every strength, from 2.5 mg to 15 mg. A Wegovy pen costs from AED 743.50 at the starting doses to AED 1,712 at 2.4 mg. These are official prices to the public, checked 12 Oct 2026.18,19 Guide 6 lists the official price of each medicine. GLP-1s for weight are mostly paid out of pocket: Dubai's basic insurance plan excludes weight-loss medicines, and in Abu Dhabi they are covered for obesity only through the Thiqa obesity programme for UAE nationals.20,38,19

Who it's for. Dubai's guideline says medicine can be considered at a BMI over 30, or 27 to 29.9 with a weight-related condition, if a lifestyle programme hasn't brought at least 5% weight loss in 3 to 6 months.10 Abu Dhabi's standard needs a BMI of 30 or more with a weight-related condition, or over 40.3 That is a point where you and a doctor can start talking about it. It does not mean you should take one. Guide 4 covers who should and shouldn't take them.

Who is weight-loss surgery for in the UAE?

Surgery is for people with a much higher BMI, or with diabetes that other treatment hasn't controlled. It gives the largest, longest-lasting loss, but it is a major operation.

The main operations are sleeve gastrectomy, which removes most of the stomach, and gastric bypass, which also reroutes the gut.21

UAE and international thresholds

  • Dubai's guideline: a BMI of 40 or more, or 35 to 39.9 with a serious weight-related condition.10
  • US and international surgeons (2022): surgery is recommended from a BMI of 35, and can be considered from 30 with metabolic disease such as type 2 diabetes. For Asian people, they suggest offering it from a BMI of 27.5.8

So the two sets of guidance differ, and your surgical team will say which it follows.

Results

A Swedish study followed over 4,000 people. Gastric bypass led to 32% loss at its peak, and 25% after 10 years.7 Gastric banding, which puts a band around the stomach, led to less: 20% and 14%.7 People who had surgery were less likely to die during the study than similar people who didn't.7

Diabetes. In a US trial, 5 years after surgery, 29% (bypass) and 23% (sleeve) had near-normal blood sugar.40 With medicines alone, it was 5%.40 In a Finnish trial, about 1 in 4 to 1 in 3 had diabetes in remission at 10 years.21

Risks

  • Death around the time of the operation is rare: between 3 in 10,000 and 2 in 1,000.8
  • Over 10 years, 16–19% needed another operation.21
  • Acid damage to the food pipe was found in 31% after a sleeve, against 7% after a bypass.21
  • You need lifelong check-ups, and help with vitamin and mineral shortfalls.8

Cost. Hospitals set their own prices, and we don't list them. Dubai's basic insurance plan (the Essential Benefits Plan) excludes "surgical and non-surgical treatment for obesity".20 Enhanced plans differ, so check your own policy before you plan anything.

What are gastric balloons and endoscopic sleeves?

Both are done through the mouth with a camera tube (an endoscope), without cutting the skin.11,12 Neither removes any part of the stomach.11,12

Gastric balloon. A balloon is placed in the stomach using the endoscope. In a US trial, it was removed after 6 months.11 People lost 10.2% of their weight by then, against 3.3% with lifestyle alone.11 By 12 months, loss had eased to 7.6%.11 Nausea (87%) and vomiting (76%) were common, and 19% had it taken out early.11 The trial included adults with a BMI of 30 to 40.11

Endoscopic sleeve gastroplasty (ESG) reshapes the stomach from the inside.12 In a trial at nine US centres, adults with a BMI of about 30 to 40 (class 1 or 2 obesity) took part.12 They lost 13.6% at 1 year, against 0.8% with lifestyle alone.12 Serious problems happened in 2% of people.12

How do doctors choose between them?

There is no single fixed order. Options can be combined, and diet and activity stay part of every plan.9,10

Guidelines describe treatment as building up from a base, rather than a fixed order.10,8 Here is a simple picture of that idea:

  1. 1
    Food, activity, sleep and supportThe base for everyone, at every step above9,10
  2. 2
    Adding a medicineOrlistat, or a GLP-1 medicine, when lifestyle alone isn't enough. In Dubai, considered from a BMI of 30, or 27 with a weight-related condition; in Abu Dhabi, from 30 with a condition10,3
  3. 3
    Endoscopic proceduresGastric balloon or ESG, done through the mouth. Studied in people with a BMI of about 30–4011,12
  4. 4
    Bariatric surgeryIn Dubai's guideline, a BMI of 40 or more, or 35 with a serious weight-related condition10
This is not a ladder you must climb in order. People can skip steps, combine them or step down. A doctor matches the step to you.

For example, in the only head-to-head trial, tirzepatide led to more loss than semaglutide, so a doctor may weigh that against side effects, price and what's available.35 For people with type 2 diabetes and a BMI of 30 or more, surgeons may suggest surgery sooner.8

Questions people ask

Can I just diet instead?

Yes. Changing what you eat and how much you move can work on its own, with no medicine, no procedure and none of their side effects. For many people it's enough, and it's the base of every other plan. The evidence for it is strong:

  • It prevents diabetes. In large trials, structured programmes led to 6–9% weight loss on average and far fewer new cases of diabetes: 58% fewer in the US trial.1,22 In an Indian trial, 39 in 100 people on lifestyle advice got diabetes over 3 years, against 55 in 100 with none.23
  • Big results are possible. In a UK trial called DiRECT, people with type 2 diabetes stopped their diabetes medicines and followed a diet plan: a few months of low-calorie meal-replacement shakes, then a slow return to normal food, with support. After a year, 1 in 4 had lost 15 kg or more, and almost half no longer had diabetes. Among those who lost 15 kg or more, 86 in 100 were free of it.41
  • People do keep it off. About 1 in 5 people with overweight manage to lose 10% of their weight and keep it off for at least a year. A US registry of people who succeeded has members who lost an average of 33 kg and kept it off for more than 5 years.42

What the people who keep it off have in common: about an hour of activity a day, a lower-calorie diet, eating breakfast, weighing themselves regularly, and eating the same way on weekdays and weekends.42

Not everyone gets these best results: trial averages are smaller, and some weight often creeps back over the years.1 If diet and activity alone don't get you far enough, medicines are added on top, not used instead.10

Is surgery safer than lifelong injections?

They're usually for different people. In Dubai's guideline, surgery is for a BMI of 40 or more, or 35 with a serious weight-related condition. Medicines can be considered from a BMI of 30, or 27 with a weight-related condition.10 So at a BMI in the high 20s, surgery usually isn't on the table. Where both are options, they carry different risks. Surgery has a small risk of death at the time, and some people need a second operation.8,21 GLP-1 medicines have ongoing side effects, and most of the weight returns if you stop.17,6 Surgery is a one-off cost. Medicines cost every month, for as long as you take them: a Mounjaro pen is AED 1,734 a month at any dose.18

Do herbal or "natural" slimming products work?

Abu Dhabi's obesity standard doesn't list any herbal product among the medicines doctors can use.3 In the US, many slimming products sold as supplements or "all-natural" have been found to contain hidden drugs.33 In the UAE, the Media Council has taken legal action against a social media account promoting a product with unverified medical claims.43

Can I take metformin to lose weight?

Metformin isn't a weight-loss medicine. In a large trial, it led to about 2 kg of loss.22 Doctors use it for type 2 diabetes and prediabetes, and for some women with PCOS.23,31

If I take a GLP-1, do I still need to change what I eat?

Yes. Dubai's guideline adds medicines to a lifestyle programme, not in place of one.10 WHO also says diet and activity support should go alongside them.9

Before you move on

  • Lifestyle changes are the base of every option, including medicines and surgery.
  • Orlistat is the main older weight-loss pill, and it helps a little.
  • GLP-1 medicines lead to more loss, but cost money every month and weight returns on stopping.
  • Surgery gives the most lasting loss, but it's a major operation with lifelong follow-up.
  • There's no fixed order. A doctor matches the option to you.
What GLP-1 medicines doSide effects and risksStoppingConsidering it for weight
Was this guide easy to understand?

Sources

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Last checked 12 Oct 2026 · Next review due Jan 2027 · Report an error

How this guide was made. Written by the GLP Guidebook team from the sources above: guidance from the UAE's health authorities, international guidelines, published trials, insurance documents and official medicine prices. It's general information, not medical advice. Talk to a qualified doctor before starting, stopping or changing any treatment. In a medical emergency in the UAE, call 998 for an ambulance, or 999. How we write