Question

Are GLP-1 weight loss drugs safe for people living with HIV and what should I expect from online doctors?

24 September 2026. Related: All topics, Complications and coinfections, Living with HIV long-term, Side effects.

Hi there, I am a 46 year old woman and have been on Biktarvy for 8 years in the UK and I have undetectable viral load and a good CD4. I started treatment when diagnosed in 2018.

I want to try using Qzempic or Munjarao to lose weight that I can’t shift by exercise and I want to know if they are safe for people living with HIV. I will buy these privately but what are the advantage and disadvantages?

Answer

Answer: Simon Collins

Hi there

Thanks for your question which a lot of people are worried about.

Without more details about your personal history the following answer is mainly general information about people living with HIV using GLP-1 weight loss drugs.

These meds are either GLP-1 (like semaglutide/Ozempic) or dual GLP-1/GIP drugs (tirzepatide/Mounjaro). *

They were originally developed to treat diabetes but were later used at higher doses to help lose weight.

Are they effective and how do they work?

Firstly, they are definitely very effective at losing weight, but they do have to be used carefully. For example, in studies people lost 15%-20% of body weight over 1 – 2 years. This is similar to outcomes from bariatric surgery.

So the results for many people can be really positive and life-changing.

However, they have to be used carefully and the details about the different ways they work are also important.

For example, GLP-1 drugs slow down the time your gut takes to process and digest food. This means you can feel full for longer and not want to keep eating. They also work in a different way on the reward pathway in your brain that is linked to comfort eating. Some studies report that as well as for food, they block the pathway linked to alcohol, cigarettes and recreational drugs.

This is why some doctors refer to them as starvation drugs. You need to actively remember to plan meals and eat a healthy diet to get good nutrition. You don not want to be on a starvation diet.

Also, the weight loss comes not just from losing fat but also from losing lean muscle. This is why it is also important to follow the recommendation to exercise when using them. Exercise is needed to retain your muscles and strength.

Other controversial issues include that very little research was done on how to safely stop these drugs. They were approved as continuous treatment. In practice though, having to buy these meds privately often means people cannot afford to keep taking them long term. Or people only want to use them for a short time, to reach specific body goals and then maintain the weight loss without continuing to need the drugs.

Specific concerns if you are HIV positive

Although many HIV doctors and GPs are happy to help with private prescriptions, there is very little research in people living with HIV. Even though they will help with weight loss, there are a few additional concerns.

One early study showed that fat is lost from all parts of the body, not just from the areas that you have most fat. For example, if you already lost fat in your face or legs, then GLP-1 drugs can make this worse.

Another concern is that weight usually returns if the GLP-1 drugs are stopped, but this comes from putting on fat again and not replacing the lean muscle. This means there is a risk that after the weight returns your body could be in a worse metabolic state. Your weight can return but your body will have less muscle.

These and other proc and cons are included in a summary table below.

What to expect and tips to help

• If you are buying GLP-1 drugs online in the UK, please use a reputable site rather than any random website. For example, large companies like Boots, Superdrug and Asda have online pharmacies and have online doctors.
• These online doctors should run a detailed consultation before they approve a prescription. They go through all the other meds you are taking and your other health issues, including HIV.
• This means that the approval for a prescription should not be instant – it should take quite a while.
• The consultation should also tell you about potential side effects and cautions. This should include that weight loss can be from all over your body, that you need to be careful with maintaining a nutritious diet and that continuing to exercise is important.
• Although prescriptions are for people with a BMI of 30 or over, sometimes off-label prescription are given if just below this.
• Some site might ask to see photos – side ways and front – wearing tight-fitting clothes. This is to show that you are the weight you claim to be before you start.
• They should also ask about your personal weight loss goals so that the treatment is individual to you.
• Take the advice about making lifestyle changes seriously. The main goal is to help make healthier changes so that when stopping weight loss drugs later, you can continue with the lifestyle changes.
• Being able to stick to new lifestyle changes can really improve your quality of life which in addition to any weight loss can be a key benefit.

Cost of private prescriptions and sustaining treatment?

• Please plan the likely cost of these drugs and how easy it will be to afford them.
• In many countries, including the UK and US, most of the people starting weight loss drugs are not able to continue them. Sometimes this means stopping completely and sometimes just needing to take breaks. this is another reason to use lower doses.
• This should be part of the discussion with your HIV doctor, GP or whoever provides your prescription.
• If you can only afford a short course of treatment, the lifestyle changes will be even more important. Otherwise you risk losing lean muscle as part of treatment that will not be replaced when wight returns after stopping treatment.

What doses are best?

• As mentioned above, dosing should be individualised to you and your goals.
• It is important to start with a low dose first.
• Dosing can steadily increase over several weeks and months but please be careful when doing this. Lower doses and slow and steady weight loss is much safer for your body.
• Start with the lowest dose and try staying with this for several months. This might be all you need to reach your goals. Stopping a low dose is likely to be much easier than stopping a higher dose.

* GLP-1 stands for glucagon-like peptide-1 and GIP stands for glucose-dependent insulinotropic polypeptide receptors.