19 Feb Dr. Ahmed Nowier
An expert in public health and nutrition
Beyond Weight Loss: How Wegovy Is Redefining Our Relationship With Food
At a time when weight management is finally being reframed as a medical, rather than a cosmetic, issue, Novo Nordisk’s iDOL Summit in Dubai (January 27–28) brought together healthcare leaders, digital opinion makers, and regional media to rethink how obesity is understood, discussed, and treated in the Middle East. On the sidelines of the summit, Plastic & Aesthetic (PA) sat down with Dr. Ahmed Nowier, an expert in public health and nutrition, to discuss how new-generation therapies such as Wegovy are transforming not only weight-loss outcomes, but also our relationship with food, body image, and long-term health.
How does Wegovy (semaglutide) influence appetite and hunger in patients?
We often describe semaglutide as an appetite suppressant, but this is not the most important part. What this new generation of GLP-1 medications truly changes is something we now call “food noise.” Food noise is the constant mental preoccupation with food: the urge, the craving, the internal dialogue that never stops. Many people living with obesity suffer from this without even realizing it. It is not simply about being hungry; it is about the brain being constantly distracted by food.
Wegovy does not only reduce appetite. It calms that noise. And when food noise disappears, the physician finally has the space to work with the patient on behavior, habits, and lifestyle. Before, it was like talking to someone who is not really listening, because their mind is already thinking about their next meal. This is why I believe obesity treatment has now moved to a completely new level. With less food noise and fewer cravings, the patient can finally build healthy behaviors that last.
When a patient comes to you, do you start with classic dieting and calorie deficit, or do you consider medication earlier?
Let me be very clear: “eat less, move more” does not work in the way people think. Telling someone living with obesity to simply eat less is like telling someone with depression to “cheer up.” Obesity is a disease. It is a complex, chronic disease influenced by genetics, biology, environment, psychology, and social factors.
Eating less is not the treatment. Eating less is the result of successful treatment. We do not tell patients with hypertension or diabetes to try harder without medication.
Obesity should be treated with the same seriousness. The question today is no longer whether medication should be used, but when, how, and for whom.
We should stop treating numbers and start treating quality of life.
So you do not rely much on BMI or numbers on the scale?
I do not like numbers. I like people. You can have someone with a BMI of 27 who is metabolically very unhealthy, and someone else with a higher BMI who is doing much better. We are not all created equal.
With medications such as Wegovy, what improves first is not the scale, but the relationship with food.
Before, many patients had a toxic relationship with food. Now it becomes balanced. They enjoy food, they know when to stop, and they are no longer controlled by it.
This is why I consider it a quality-of-life medication more than simply a weight-loss medication.
Many patients worry about side effects such as nausea, bloating, or constipation. How do you manage this?
First, we must remember that these symptoms also happen in normal daily life. However, when someone is on medication, they become more anxious and more aware of every sensation.
I teach my patients a very simple rule: the four S’s. Slow, Small, Stop, and Stay hydrated.
They should eat slowly, eat small portions, stop at the first sign of fullness, and stay well hydrated.
Very importantly, we do not rush dose escalation. We are not chasing the highest dose. We are allowing the body to adapt. This is physiology, not toxicity. Patients should also avoid very fatty, very large, very spicy, or very sweet meals. When these rules are respected, side effects are usually mild and temporary.
Does the medication affect nutrient absorption or cause deficiencies?
No, it does not affect absorption. However, because people eat smaller portions, the total intake of nutrients can decrease. So deficiencies are possible, not because of absorption, but because of quantity. That being said, today many patients are actually over-supplementing. I often see people with extremely high vitamin levels. We need to calm down. We do not need excess. We need balance.
How important is hydration during this journey?
It is essential. When people eat less, they also tend to drink less, especially in hot climates like ours. Sometimes I even recommend electrolytes, because rapid weight loss combined with low fluid intake can create imbalance and fatigue. Many patients feel so “free” from food that they forget both eating and drinking, and this is not healthy.
What are realistic expectations for weight loss?
Again, I hate numbers. We are not in a race. People respond differently. Some are early responders, others are late responders. What matters is that the patient feels better, functions better, and lives better, without significant side effects. This is not a short-term project. This is about sustainability.
From an aesthetic point of view, some people fear skin laxity or the so-called “Ozempic face.” What is your opinion?
Anyone who loses a significant amount of weight, whether through surgery or medication, can experience changes in the face and skin. This is not unique to these treatments. If someone goes from 150 kilograms and loses 40 or 50 kilograms, of course their face will become thinner. That is not a disease.
That is weight loss. For someone who has lived with obesity for many years, the feeling is not panic. It is freedom. Freedom from stigma, from limitation, and from suffering.
What about people who only want to lose 5 or 6 kilos and use these medications, sometimes through micro-dosing?
This is dangerous. Taking these medications for 5 or 6 kilos is like taking blood pressure medication for a very small increase in pressure. The body adapts. And I can promise you that in ten years, that same person may need it for 30 or 40 kilos. There is no such thing as a perfect weight. We are not all built the same. As for micro-dosing, scientifically, it is not proven. What is happening in real life is that people are inventing their own regimens. I do not recommend this. This is a powerful and relatively new medication, and we still do not know everything about it.
Finally, what is your main message to patients living with obesity or diabetes?
First, obesity is not your fault. It is a disease. Like depression. Like cancer. Like diabetes.
Second, choose a treatment that is sustainable. Anything temporary is not treatment. It is a phase.
Today, we are looking for solutions that are livable, lovable, and enjoyable. As long as something is sustainable, it is therapy. As long as it is temporary, it is an illusion.