Clinical Insight
Graham Phillips
FRPharmS • Founder
Prediabetes is an opportunity, not an inevitability.
GLP-1 medicines can be highly effective tools for people living with obesity and prediabetes.
The medicine creates a window of opportunity.
Lasting success depends on the habits you build while appetite is reduced.
Prioritise protein, preserve muscle, stay active, improve food quality and plan ahead.
Think beyond weight loss—aim for lifelong metabolic health.
Weight-loss injections are changing lives. But lasting health isn’t created by an injection alone.
You’ve just been told your HbA1c is 44 mmol/mol. Your GP says you’ve got prediabetes. It’s a phrase that shocks and worries many people because it sounds as though diabetes is inevitable. Fortunately, it isn’t.
Prediabetes is better thought of as an early warning system. It tells you that your body is beginning to struggle with blood sugar regulation, but it also provides a valuable opportunity to intervene before type 2 diabetes develops.
At the same time, you’ve probably seen the headlines.
“Mounjaro helps people lose 25% of their body weight.”
“Wegovy transforms lives.”
“Weight-loss injections reverse prediabetes.”
Perhaps a friend or colleague has achieved remarkable results.
Naturally, the question follows:
Should I take a GLP-1 medicine if I have prediabetes?
The honest answer is: “MAYBE!” For the right person, medicines such as Mounjaro® (tirzepatide) and Wegovy® (semaglutide) can be extremely effective. They can help people lose significant amounts of weight, improve insulin resistance and reduce the likelihood of progressing to type 2 diabetes.
But here’s the key point… The injection isn’t the full treatment. It’s simply one small part of the solution. The real treatment is learning the habits that allow you to keep the weight off, maintain healthy blood sugar levels and improve your metabolic health for the rest of your life.
That’s exactly where ProLongevity Essentials comes in
Prediabetes means your blood sugar is higher than normal but not yet high enough to be diagnosed as type 2 diabetes. In the UK, this is usually identified by an HbA1c blood test between 42 and 47 mmol/mol (or between 6.0% and 6.5%)
Many people assume prediabetes simply means they’ve eaten too much sugar but the reality is more complicated. For most people, prediabetes develops because the body’s cells gradually become less responsive to insulin a condition known as insulin resistance
Initially, the pancreas simply produces more insulin to compensate for the problems with controlling blood sugar which are cause by sugar and carbs in the diet. For maybe 20 years, blood sugar levels can remain almost normal despite insulin levels becoming progressively higher. But eventually, the pancreas can no longer keep up, blood glucose starts to rise and that’s when prediabetes appears.
The good news is that this process can often be slowed, stopped or even reversed through lifestyle change, particularly when action is taken early. (The earlier the better in fact)
If you’d like to understand the science in more detail, we’ve created a truly comprehensive evidence-based guide
From Healthy Metabolism to Type 2 Diabetes
GLP-1 medicines don’t “cure” prediabetes. Instead, they help address two of the biggest drivers: insulin resistance and excess body fat, particularly around the liver and abdominal organs. Medicines such as Mounjaro® and Wegovy® work by mimicking naturally occurring gut hormones (know as incretins) that help regulate appetite.
They can:
Reduce hunger
Quieten food noise
Help you feel fuller for longer
Reduce calorie intake naturally
Support substantial weight loss
As weight falls, many people experience improvements in:
Insulin sensitivity
Liver fat
Waist circumference
Blood pressure
Blood sugar
HbA1c
For someone living with obesity and prediabetes, this can dramatically reduce the likelihood of progressing to type 2 diabetes. It’s one of the reasons GLP-1 medicines have generated so much excitement over the past few years. Remember the GLPs were originally introduced to treat type2 diabetes
But there’s something people don’t talk about enough…
The media and industry paid-for opinion formers like Oprah Winfrey and Selena Williams often present GLP-1 medicines as though they are THE answer. We see them differently. We see them as an opportunity. Think about it like this: for years you’ve been fighting constant hunger; food noise; cravings; large portions; emotional eating.
Then suddenly… Those signals become quieter. For the first time in years, changing your eating habits feels achievable. That is an extraordinary opportunity. Not simply to lose weight—but to rebuild your relationship with food.
That’s why we encourage people to view every week on a GLP-1 as valuable training for life after the injections. Because one day, for most people, the injections will stop but (crucially) the newly-acquired healthy habits need to remain.
GLP-1s Create a Window of Opportunity
In short? Yes!
Large clinical trials have consistently shown that modern GLP-1 medicines produce significant weight loss while improving blood sugar control. Many people with obesity and prediabetes return to normal glucose regulation during treatment. That’s genuinely exciting, but it’s also only part of the story.
But the key question here isn’t: “How much weight can I lose?” Its “How much of that weight will I keep off five years from now?”
Because long-term health isn’t measured by your lowest weight, it’s measured by your ability to maintain the lifestlye improvements you’ve worked so hard to achieve. In fact it’s the lifestyle changes that truly predict your future health… the weight simply comes along for the ride
That is where nutrition, movement, sleep, strength training and ongoing support become every bit as important as the medicine itself. In the next section, we’ll look at the five habits that we believe everyone should build while taking a GLP-1 medicine, not only to maximise weight loss, but to improve their chances of keeping it off for good.
Five habits to build while taking a GLP-1 medicine
GLP-1 medicines can make eating less considerably easier, but simply eating less is not the same as eating well. When your appetite falls, every meal becomes more important. You have fewer opportunities to give your body the protein, vitamins, minerals and essential fats it needs.
This means the aim should not be “How little can I eat?” but “How can I make every mouthful count?”
So here are five habits that can help you lose weight more safely, improve insulin sensitivity and prepare for life beyond the injections.
Habit 1: Prioritise protein
When people lose weight, they do not lose body fat alone. Inevitably some of the weight lost will be muscle and bone, especially when weight loss is rapid, protein intake is inadequate and there is no resistance training. That matters because muscle is not merely something that helps us look stronger. Muscle is metabolically active tissue. It helps remove glucose from the bloodstream, supports insulin sensitivity and protects strength, mobility and independence as we grow older. Preserving muscle should therefore be a central part of any weight-loss programme, especially for people with prediabetes.
Try to include a meaningful source of protein at every meal.
Good options include:
Eggs
Fish and Seafood
Chicken, Turkey and Lean meat
Greek yoghurt and cottage cheese
Tofu, Tempeh and Edamame
Beans and lentils, where these fit your carbohydrate tolerance
A high-quality protein shake when appetite is particularly low
Rather than filling up on bread, cereal, crisps or snack foods, begin each meal by asking:
Where is the protein?
A useful practical target for many people is 60 grams of protein at each main meal, adjusted for body size, age, kidney function and individual needs.
People with kidney disease or other relevant medical conditions should obtain personalised advice before substantially increasing protein intake.
A simple protein-first plate
Build your meal in this order:
1. Choose the protein
2. Add non-starchy vegetable
3. Add healthy fats where appropriate
4. Decide whether you need an additional carbohydrate
Habit 2: Reduce sugar and refined carbohydrates
Prediabetes is not caused solely by one food. Nevertheless, frequently consuming foods that rapidly raise glucose and therefore insulin make blood sugar regulation more difficult, particularly when someone is already insulin resistant.
The biggest problems are not whole, minimally processed foods. They are products that combine refined starch, sugar, industrial processing and easy overconsumption. We’re talking about Ultra Processed Foods (aka junk foods) which make up 60% of the UK diet
Common examples include:
Sweets and chocolate
Biscuits and cakes
Sugary breakfast cereals
Pastries
White bread
Large portions of pasta or rice
Crisps and similar snack foods
Fruit juice and sugary drinks
Many supposedly "healthy" cereal bars
Ultra processed convenience foods
You do not necessarily need to remove every carbohydrate, but you may benefit from reducing the carbohydrates that provide little nutrition and are easiest to overeat.
Replace them with meals based around:
Protein
non-starchy vegetables
Natural fats
Minimally processed ingredients
For a more detailed explanation of how different foods affect insulin resistance, see our comprehensive guide to prediabetes diet and reversing prediabetes naturally.
Beware of eating too little
Some people taking GLP-1 medicines become so uninterested in food that they survive on a few crackers, a small sandwich or occasional snacks. Your weight on the scales may fall rapidly, but this is not necessarily healthy progress. Very low food intake can increase the risk of:
Inadequate protein
Muscle loss
Tiredness
Dizziness
Constipation
Dehydration
Vitamin and mineral deficiencies
Hair shedding
Reduced physical strength
The aim is not to drive the body into a state of starvation assisted by high doses of medication. It is better appetite regulation combined with better nutrition.
Habit 3: Protect your muscles
Protein provides the raw material for muscle, but your body also needs a reason to retain it.
That reason is resistance training. But this doesn’t mean you need to become a bodybuilder or spend hours in a gym. Resistance exercise simply means making your muscles work against a load. That could include:
Lifting weights
Resistance bands
Body-weight squats
Wall press-ups
Step-ups
Carrying shopping
Supervised strength classes
Pilates-based resistance work
For many people, two or three short strength sessions each week are a realistic starting point. The exercises should gradually become more challenging as your strength improves, a process sometimes called progressive overload.
Walking is excellent for general health, blood sugar management and cardiovascular fitness, but walking alone may not provide enough stimulus to preserve all your muscle during substantial weight loss. The combination that matters is:
Adequate protein + resistance training + sensible weight loss
This is especially important after middle age, when we naturally become more vulnerable to losing muscle.
Do not judge success by the scales alone
Suppose two people each lose 15 kilograms. One loses mostly body fat while preserving muscle while the other loses a much larger proportion of lean tissue. The scales show the same result, but metabolically, the outcome is completely different.
Useful measures may include:
Waist circumference
Strength
Energy levels
Fitness
Blood pressure
HbA1c
Clothing fit
Body-composition measurements, where available
The aim is not simply less weight,, its better health and body composition.
Habit 4: Walk after meals
One of the simplest habits for improving post-meal glucose is also one of the most accessible:
Take a short walk after eating. When muscles contract, they can take up more glucose from the bloodstream. Even a relatively brief walk after a meal may help reduce the size and duration of the post-meal glucose rise. You do not need special clothes, equipment or a formal exercise session.
Try:
Walking around the block
Taking the dog out
Walking to the shops
Doing light household activity
Using the stairs
Taking a ten-minute walk after lunch or dinner
The most effective routine is the one you can repeat consistently. For someone who has previously been sedentary, three short walks may feel more achievable than one long workout.
Over time, you can build towards a mixture of:
Regular everyday movement
Brisk walking or other aerobic activity
Resistance training
Reduced sitting time
Movement is particularly powerful when combined with improved nutrition and weight loss.
Habit 5: Create an exit strategy before you need one
Many people begin a GLP-1 medicine with a detailed plan for losing weight but no plan for maintaining it. That is a mistake. When the treatment stops, appetite and food noise returns. If the environment, routines and coping strategies are unchanged, weight regain becomes much more likely. This is not a personal failure or lack of willpower, It reflects the fact that the medicine was helping regulate biological signals involved in appetite and weight.
Your exit strategy should therefore begin while the medicine is still working.
Use this time to establish:
Regular protein-rich meals
Reliable shopping routines
Healthier food choices at home
Strategies for eating out
Resistance training
Post-meal walking
Better sleep
Ways of managing stress without food
A plan for hunger returning
Regular weight and waist monitoring
Continuing professional or peer support
Some people remain on treatment longer term under appropriate medical supervision while others reduce, micro-dose or stop completely. This is where the ProLongevity Essential program can be invaluable. That decision should be made with the clinician responsible for prescribing the medicine not by abruptly changing the dose without advice. But whatever the duration of treatment, the underlying principle remains:
Do not wait until the injections end to begin building the life that follows them.
Food quality matters most. Of course its possible to lose weight while eating small quantities of poor-quality (junk) food. But weight loss alone does not guarantee good nutrition or optimal metabolic health. A person could eat fewer calories while still relying heavily on:
Ready meals
Processed snacks
Sugary drinks
Refined carbohydrates
Alcohol
Foods low in protein and micronutrients
GLP-1 treatment should create the head- space for a better dietary pattern: not simply a smaller version of the old one.
At ProLongevity Essentials, we encourage people to base most meals around real, recognisable food:
Fish
Eggs
Meat and poultry
Vegetables
Full-fat unsweetened dairy where suitable
Nuts and seeds
Olive oil
Avocado
Herbs and spices
Minimally processed plant foods
This does not require perfection.
It means gradually making nutrient-dense food the default rather than the exception.
Do not overlook hydration and digestion
GLP-1 medicines slow gastric emptying and commonly affect the digestive system.
Some people experience:
Nausea
Constipation
Diarrhoea
Bloating
Reflux
Reduced thirst
Difficulty eating normal-sized meals
Eating slowly and stopping when comfortably satisfied can help. Smaller meals may be better tolerated than forcing down a large plate. Rich, greasy meals and excessive alcohol may make symptoms worse for some people. Adequate fluid intake and added electrolytes is also important, particularly during hot weather, illness, exercise or episodes of vomiting or diarrhoea. However, persistent vomiting, severe abdominal pain, an inability to keep fluids down or signs of significant dehydration require prompt medical advice.
Do not assume that every symptom is simply a normal part of taking the medication.
Sleep is part of the treatment
Sleep is often treated as optional. Metabolically, it is not. Poor sleep makes appetite much harder to regulate, reduces motivation to exercise and increase the appeal of highly processed food. It makes healthy decision-making considerably more difficult.
Aim for a consistent routine:
Go to bed and wake at broadly similar times
Obtain natural light early in the day
Reduce bright light and stimulating content late at night
Avoid large meals immediately before bed
Keep the bedroom cool, dark and quiet
Address persistent snoring or suspected sleep apnoea
Obstructive sleep apnoea is particularly common in people living with obesity and can contribute to daytime tiredness, high blood pressure and impaired metabolic health. Weight loss may improve sleep apnoea, but suspected cases still deserve proper assessment.
A continuous glucose monitor CGM) measures glucose throughout the day and night.
For some people with prediabetes, it can reveal patterns that an occasional blood test cannot show. You may discover that:
A breakfast cereal marketed as healthy causes a large glucose rise
A short walk after dinner improves your response
Poor sleep affects glucose the following day
The same carbohydrate affects two people very differently
Meal order changes the result
Portion size matters
Stress can influence glucose even without eating
CGM should not be used to create anxiety about every small rise, mild glucose fluctuations are perfectly healthy. The value lies in identifying repeated patterns and using them to make better-informed choices.
At ProLongevity, we use CGM as part of a broader approach to personalised metabolic health rather than treating it as a simple pass-or-fail food test.
Rapid weight loss may seem desirable, but faster is not better. Losing weight too quickly implies over-suppression of appetite. In turn that makes it hard or impossible to consume sufficient protein and micronutrients and may increase the amount of muscle lost. In other words if you over-suppress appetite, malnutrition results. Speak to your prescriber or healthcare team if:
You are struggling to eat
You are losing weight much faster than expected
You feel weak or persistently exhausted
You are frequently dizzy
You cannot maintain hydration
You have ongoing vomiting or diarrhoea
Your symptoms interfere with normal life
The answer is certainly not to push the dose ever higher. The optimum dose is the one that delivers meaningful benefit with acceptable side effects while still allowing you to nourish your body properly. (And of course a lower dose costs less)
The ProLongevity Essentials approach
We do not believe GLP-1 medicines should be treated as a stand-alone solution. We see them as a way to support a wider metabolic-health strategy.
That means helping people:
Understand insulin resistance
Improve food quality
Eat sufficient protein
Preserve muscle
Become more active
Manage food noise
Improve sleep
Prepare for long-term maintenance
Reduce dependence on medication where Clinically appropriate
Used appropriately (emphasis on appropriately) GLPs may make change easier and can be genuinely life-changing. But it is the habits practised repeatedly, particularly when nobody is watching, that determine what happens next.
Medicines can help you lose weight. Habits help you keep it off.
Now lets consider who might benefit from a GLP-1 medicine, who may need a different approach, the questions to ask before starting treatment, and how to access appropriate support across the ProLongevity healthcare network.
Although medicines such as Mounjaro® and Wegovy® have transformed obesity treatment, they are not the right choice for everyone. For many people, lifestyle change alone may be sufficient (and of course it’s a much cheaper option) Others may benefit from medication alongside structured support. Some people may not be suitable for treatment because of their medical history or because the potential risks outweigh the expected benefits.
That is why these medicines should always be prescribed following an appropriate clinical assessment rather than simply purchased online without meaningful follow-up. The best outcomes occur when medication is combined with education, coaching and long-term lifestyle change. This, it goes without saying, is our preferred approach.
Rather than asking: “Can this medicine help me lose weight?” consider asking about the root cause of the problem:
These questions are more important than deciding which injection to use, or indeed tablet forms of GLPs.
The ProLongevity philosophy
At ProLongevity, we see obesity and prediabetes differently. They are not caused by a lack of willpower, they reflect a complex interaction between:
Modern food environments
Insulin resistance
Poor sleep
Stress
Inactivity
Muscle loss
Genetics
Hormones
Food noise
Medication can help address part of that picture but genuine metabolic health requires a broader approach. Our aim is not simply to help people lose weight. It is to help them become healthier, stronger and more metabolically resilient.
Whatever stage you are at, there is support available across our healthcare network.
Want to understand prediabetes better?
Read our comprehensive guide:
Prediabetes Diet: What Should You Eat to Reverse Prediabetes Naturally?
Considering a GLP-1 medicine?
Our pharmacist-led teams can discuss whether treatment may be appropriate and how to maximise your chances of long-term success.
Already taking Mounjaro® or Wegovy®?
Our ProLongevity Essentials programme focuses on:
Building healthier eating habits
Preserving muscle
Reducing food noise
Understanding protein
Improving metabolic health
Planning for life after GLP-1 treatment
Looking for local support?
You can also access pharmacist-led weight management services through:
Whether you need clinical assessment, ongoing prescribing or lifestyle support, our goal is the same:
Helping you achieve better health that lasts.
Final thoughts
GLP-1 medicines have changed the conversation around obesity and prediabetes. For many people they provide the first realistic opportunity to lose significant weight after years of frustration. That is something worth celebrating, but the real success story is not reaching your target weight and then regaining it all. It is still being healthy five years later. The injection may help you start the journey but your daily habits determine where it ends.
Continue your metabolic health journey
New to prediabetes?
→ Read our in-depth guide to Prediabetes Diet: What Should You Eat to Reverse Prediabetes Naturally?
Want to understand insulin resistance?
→ Explore our evidence-based articles on insulin resistance and metabolic health.
Already taking a GLP-1?
Read our guides on:
Ready for personalised support?
Join ProLongevity Essentials and learn how to make your results last long after the injections have stopped.
Graham Phillips is a registered pharmacist (FRPharmS) with over 35 years of experience. Frustrated by “pill for every ill” medicine, he founded ProLongevity to help people reverse chronic disease and lose weight through precision lifestyle medicine.