They're being handed out like churros just to lose five or six kilos
Weight-loss drugs can cause nausea, fatigue, and dehydration during treatment and are being misused for minor weight loss despite not being designed for that purpose. The body develops more fat-storing cells during weight gain, making it harder to maintain weight loss afterward—a biological mechanism creating the rebound effect.
- Weight-loss drugs can cause nausea, fatigue, and dehydration during treatment
- The body develops additional fat cells during sustained weight gain, which remain even after weight loss
- Very few people who lose weight manage to keep it off long-term
- New weight-loss pills have been approved in the United States and are expected to reach other markets
Nutritionist Pablo Ojeda warns that weight-loss medications cause significant rebound effects and health complications, with most users regaining weight after treatment ends due to increased fat-storing cells.
Pablo Ojeda, a nutritionist, appeared on the television program La Roca this past weekend to discuss a problem he sees accelerating across Spain and beyond: people who lose weight on medications are gaining it all back, often within months of stopping treatment. The phenomenon is well-documented now in clinical studies, and Ojeda wanted the public to understand why it happens—and why the drugs themselves may be doing more harm than most people realize.
The medications in question are being prescribed with increasing frequency, marketed as solutions for weight loss. But Ojeda was blunt about the reality. These drugs can cause nausea, fatigue, and dehydration while someone is taking them. More troubling to him is the casual way they're being dispensed. "They're being handed out like churros just to lose five or six kilos," he said, "and they weren't designed for that." He compared the trend to how antidepressants are sometimes misused—powerful medications being repurposed for problems they were never meant to treat.
The core of his concern lies in how the human body actually works. Everyone has fat cells, specialized structures whose job is to store energy. When someone carries excess weight for an extended period, those cells gradually fill up and expand. But there's a threshold. Once existing fat cells reach capacity, the body doesn't simply stop storing fat—it creates new cells. This multiplication is the body's adaptation to sustained weight gain. A person who has been overweight for years may have double or triple the number of fat cells compared to someone who has always been lean.
This is where the rebound effect becomes almost inevitable. When someone loses weight through medication or extreme dieting, they're shrinking those cells, but the cells themselves remain. The body hasn't forgotten how to make them, and it hasn't reduced their number. What it has done is create a biological landscape primed for rapid weight regain. "Your body's capacity to recover that weight afterward is much greater than it was before," Ojeda explained. The person isn't developing a new tendency to gain weight—they've engineered one through the cycle of loss and restriction.
Ojeda was candid about the long-term outlook. The percentage of people who lose weight and actually keep it off is very small. "Unfortunately, there's no going backward," he said. Once those extra fat cells exist, they exist. The body will work to fill them again, especially during the inevitable fluctuations of daily life—stress, changes in routine, aging. The rebound isn't a failure of willpower; it's biology reasserting itself.
What worries Ojeda most is what's coming. The United States has already approved a new class of weight-loss pills, and he expects a wave of similar medications to flood the market globally. More drugs means more people taking them casually, more people experiencing the side effects during treatment, and more people facing the rebound afterward. "We're going to be amazed," he said, with a tone suggesting amazement wouldn't be the positive kind. The infrastructure for widespread use is being built, and the conversation about whether these drugs should be used this way—and what happens when millions of people stop taking them—is only beginning.
Notable Quotes
They're being handed out like churros just to lose five or six kilos, and they weren't designed for that.— Pablo Ojeda, nutritionist
Unfortunately, there's no going backward. The percentage of people who lose weight and keep it off is very, very low.— Pablo Ojeda, nutritionist
The Hearth Conversation Another angle on the story
Why does the body create more fat cells in the first place? Isn't that wasteful?
It's actually a survival mechanism. When the body is consistently storing more energy than it's using, it adapts by expanding capacity. More cells mean more storage potential. The problem is that adaptation is permanent—the cells don't disappear when you lose weight.
So if someone loses weight and keeps it off for years, those extra cells just sit there empty?
Exactly. They're dormant but present. And the body "remembers" them. During stress, dietary changes, or just normal life fluctuations, the body preferentially refills those cells because they're already there.
What makes these weight-loss drugs different from, say, a strict diet?
The drugs suppress appetite or increase metabolism artificially. A diet requires behavioral change. But both approaches leave you with the same problem: the extra fat cells remain. When the drug stops or the diet ends, the body hasn't learned anything new—it just returns to its expanded baseline.
Is there any way to actually reduce the number of fat cells?
Not really, not in any practical sense. That's what Ojeda meant by "no going backward." The cells can shrink, but they don't disappear. Surgery can remove some, but that's extreme and not a solution for most people.
Then why are these drugs being prescribed so casually?
Because they work in the short term. People see results quickly. But nobody's talking about what happens six months after someone stops taking them. The pharmaceutical incentive is to sell the drug, not to manage the long-term biology.
What should someone actually do if they need to lose weight?
That's the harder question Ojeda was implying. There's no magic solution. Sustainable change requires addressing why the weight accumulated in the first place—lifestyle, habits, stress management. But that takes time and doesn't sell pills.