Overweight and obesity treatment: all options at a glance

When is treatment for overweight needed?

Medical treatment of overweight makes sense with a BMI of 30 or higher, or with a BMI from 25 combined with a large waist circumference (more than 88 cm for women, 102 cm for men) or with conditions associated with overweight, such as type 2 diabetes, high blood pressure or sleep apnoea. Doctors call these additional conditions comorbidities and weigh everything together in the weight-related health risk (gewichtsgerelateerd gezondheidsrisico, GGR): the higher that risk, the more intensive the treatment can be.

As a guide, doctors use this BMI classification:

Your BMI is a starting point, not a diagnosis. Muscle mass, fat distribution, waist circumference and your overall health all count towards the final advice.

This makes overweight clearly a medical subject and not a matter of "just eating a bit less". Obesity is recognised as a chronic disease. Your body actively defends its weight: after every diet your hunger increases and your energy expenditure falls, so the kilos often come back. Hormonal changes, for example during the menopause, can reinforce that effect even further. This explains why losing weight so often fails, even for people who do everything right.

Overweight is also very common. In 2025, 50.6% of Dutch adults were overweight and 15.7% had obesity, according to the Leefstijlmonitor (Lifestyle Monitor) by CBS (Statistics Netherlands) and RIVM (the National Institute for Public Health and the Environment). Want to know where you stand? Calculate your BMI and within a minute you will know which category you fall into.

If your BMI is above 30, or above 25 with additional health problems, it pays to take a serious look at the treatment options below.

All treatment options in one overview

There are four treatment routes for overweight, increasing in intensity. The table below sets them side by side, including coverage under basic health insurance (basisverzekering).

The routes are not mutually exclusive. Medication, for example, only works well alongside a healthy lifestyle, and supervision remains necessary even after surgery.

Not sure where you would start? These rules of thumb will help you on your way:

• BMI between 25 and 30: start with lifestyle, possibly with a dietitian. If you have a large waist circumference or additional health problems, a GLI may already be covered.
• BMI 30 or higher: the GLI is your first covered option. If you don't lose weight with it, medication under a doctor's supervision is the logical next step.
• BMI 35 or higher with comorbidity, or BMI 40 and higher: discuss stomach surgery with your GP (huisarts) as well as medication.

You always make the final choice together with a doctor, based on your complete health situation. Below you can read what to expect at each step.

Step 1: tackling lifestyle and diet

Every treatment for overweight starts with your lifestyle. A healthier diet, more daily movement, enough sleep and less stress form the foundation on which all other treatments build. Without that foundation, even the effect of medication or surgery is disappointing.

What works is different from what many people think. Not a strict crash diet, but small changes you can keep up for years:

• Regular mealtimes and normal portions, with more protein and fibre so you stay full for longer.
• Less ultra-processed food, fewer soft drinks and less alcohol.
• Daily movement as a habit: think of 8,000 steps, the stairs and a walk after meals.
• Seven to eight hours of sleep and attention to stress, because both drive your hunger hormones.

With a crash diet the opposite happens: you lose muscle mass as well as fat, your energy expenditure falls and the yo-yo effect lies in wait. So set a realistic goal: even 5 to 10% weight loss brings clear health benefits, such as lower blood pressure, better blood sugar levels and fewer joint problems.

It is also true that with a BMI above 30, lifestyle alone is often not enough for lasting weight loss. Your body then actively works against you, however well you do. Do you recognise that the scales stand still despite your efforts? Then also read why you are not losing weight, which applies to so many people who do everything right.

Step 2: combined lifestyle intervention (GLI)

The GLI is a two-year support programme for overweight, with professional help with diet, exercise and behavioural change. You work under the guidance of a lifestyle coach, dietitian or physiotherapist, individually or in a group.

A GLI programme consists of a treatment phase and a maintenance phase, with sessions on diet, eating behaviour, exercise and sticking to your new habits. Its strength lies in the duration and the behavioural component: for two years you learn not only what you need to change, but above all how to keep it up in your own daily life. According to Zorginstituut Nederland (the Dutch National Health Care Institute), the GLI is fully covered by basic health insurance, without a deductible. You do need a referral from your GP and the programme must be on the RIVM's approved list.

For many people the GLI is a good first step, but not a miracle cure: the average weight loss is modest. If you don't lose weight despite a GLI or an intensive lifestyle approach, the next step comes into view.

Step 3: medicines for overweight

Effective, registered medicines for obesity now exist. The best known belong to GLP-1 medication: semaglutide (known as Ozempic and Wegovy), tirzepatide (Mounjaro) and liraglutide (Saxenda). GLP-1 is a natural hormone that regulates your appetite; these medicines mimic it. The result: you are less hungry, feel full sooner and the constant thoughts about food quieten down.

In practice you usually use this medication as a weekly injection that you give yourself at home, with a thin needle in your abdomen or thigh; semaglutide is also available as a daily tablet (Rybelsus). You start on a low dose that is increased step by step, so your body can adjust. The medication is intended for people with obesity or with overweight plus additional health risks; a doctor assesses this per person and follows you throughout the programme.

Its effect has been well studied. In a large clinical trial, adults with obesity lost an average of 14.9% of their body weight over 68 weeks with weekly semaglutide 2.4 mg, compared with 2.4% on placebo. With tirzepatide, even greater average weight loss was measured in comparable research.

There is also a downside:

• The most common side effects are nausea, diarrhoea and constipation, especially in the first weeks. They are usually temporary and ease as your body adjusts.
• The medication works for as long as you use it. If you stop without a plan and without a changed lifestyle, the hunger returns.
• These medicines are not suitable for everyone and are available on prescription only. A doctor assesses beforehand whether it is safe for you and supervises you during use.

So never buy weight loss medication online without a prescription: you risk counterfeits and would be using a powerful medicine without medical oversight. The safe route always runs through a doctor. That is why at Qlinic, medical weight loss with injections takes place under the supervision of our own BIG-registered doctor (the BIG register is the Dutch register of healthcare professionals), with a fixed check-in every 4 weeks.

Tried everything and still not losing weight? Our BIG-registered doctor personally assesses whether medical weight loss with supervision is right for you. Take the eligibility check →

Step 4: stomach surgery (bariatric surgery)

Stomach surgery is the most drastic treatment for overweight and is intended for severe obesity. You are eligible with a BMI from 40, or from 35 combined with a serious condition such as type 2 diabetes or sleep apnoea, and if previous treatments have not helped enough. Hospitals such as Maasstad Ziekenhuis apply these criteria at intake.

The two most commonly performed operations are the gastric bypass and the gastric sleeve. Both reduce the size of your stomach, so you can eat less and your hunger decreases. The weight loss is substantial and lasts for a long time in most people.

There is a lot on the other side of the scale. Surgery is irreversible, requires an extensive preliminary process with medical and psychological screening, and afterwards you follow an adapted eating pattern with vitamin supplements and aftercare for life. Also allow for a referral process via your GP and waiting times that, depending on the hospital, can range from a few months to more than a year. Moreover, for many people with a BMI between 30 and 40, surgery is not an option at all; medication with supervision is then the more logical route.

What is covered for overweight?

Coverage varies greatly per treatment. This is the current situation for basic health insurance:

• Dietitian: 3 hours of dietary advice per calendar year are covered. This does count towards your deductible (eigen risico).
• GLI: fully covered, without a deductible, after referral by your GP.
• Medication: only covered to a limited extent. Only certain medicines qualify under strict conditions, for example in combination with a GLI. Outside those conditions you pay for the medication yourself. You can read exactly how this works in our article: is weight loss medication covered by insurance?
• Stomach surgery: fully covered if you meet the medical criteria, after referral.

If you choose a medical programme outside your insurance, you will want to know exactly where you stand beforehand. At Qlinic, a complete programme costs between €250 and €850 per month, depending on the medication the doctor prescribes, plus a one-off €400 for supervision. Not a small investment, but a complete medical programme with your own doctor, legal medication and personal supervision, without surprises afterwards.

GP or specialised clinic?

Your GP is the logical starting point for overweight. The GP determines your health risk, rules out underlying causes and refers you to a dietitian, a GLI programme or the hospital. Some GPs also prescribe weight loss medication, but by no means all: the guidelines are cautious and intensive supervision often doesn't fit into a GP consultation. You can read what is and isn't possible in our article on weight loss medication from your GP.

A specialised clinic is there for the group that falls between two stools: too heavy to leave it at "another diet", but not eligible for (or not ready for) surgery. Think, for example, of women going through the menopause who notice that their familiar approach suddenly no longer works; that is exactly when medical supervision makes the difference. Such a clinic combines medication with structured supervision by a doctor. When choosing, look out for these points:

• A BIG-registered doctor who knows you personally and follows your programme themselves, not changing practitioners or just a questionnaire.
• Fixed check-ins: at Qlinic you speak to your own doctor every 4 weeks, who adjusts your dose and progress.
• Quick access in case of side effects: you want to be able to speak to someone the same day, not wait for days.
• Legal medication through registered Dutch pharmacies, delivered discreetly to your home.
• Freedom to pause or stop: a programme should fit your life, not the other way round.

This is how it works with us, in three steps: an online eligibility check and intake consultation with the doctor, then your prescription with discreet home delivery, and after that weight loss with a check-in with the same doctor every 4 weeks. So far we have helped around 50 people this way; they rate us an average of 5.0 on Google. Most notice the first effect after about 4 weeks: the hunger decreases and with it the constant struggle with food disappears. Would you rather meet us personally first? Feel free to contact us.

Curious whether medical weight loss is right for you? Complete the online eligibility check and you will know within a few minutes, without obligation. Take the eligibility check →

Frequently asked questions about obesity treatment

What really helps against overweight?

A lasting change in lifestyle, supplemented with medical treatment where necessary. Short-term diets almost never work permanently, because your body defends itself against weight loss. With a BMI from 30, a GLI, GLP-1 medication under a doctor's supervision or, for severe obesity, stomach surgery are the proven effective options.

What is covered for overweight?

The GLI is fully covered by basic health insurance, without a deductible. A dietitian is covered for 3 hours per year, and stomach surgery is fully covered if you meet the medical criteria. Weight loss medication is only covered in specific situations; you usually pay for it yourself.

How much weight do you lose in 1 month with Ozempic?

There is no fixed figure for this. The dose is increased slowly in the first weeks, so in the first month you mainly notice that your hunger decreases; weight loss follows gradually after that. In research, people on semaglutide, the active ingredient in Ozempic that is registered at a higher dose as Wegovy, lost an average of 14.9% of their body weight over 68 weeks. Ozempic is officially a diabetes medicine and available on prescription only.

What can a GP do about overweight?

Your GP determines your weight-related health risk, investigates underlying causes and refers you to a dietitian, a GLI programme or the hospital. Some GPs also prescribe weight loss medication, but many GPs are cautious about this. A specialised clinic with its own doctors is then an alternative.

What is the difference between overweight and obesity?

Overweight means a BMI between 25 and 30; from a BMI of 30, doctors speak of obesity. Obesity has three classes: class I (BMI 30 to 35), class II (BMI 35 to 40) and class III (BMI 40 and higher). The higher the class, the greater the health risks and the more intensive the treatment can be.

Is obesity a disease?

Yes. Obesity is recognised as a chronic disease, in which hormones, genetic predisposition and environment together determine how your body handles fat and hunger. That is why "just eating less" usually doesn't work permanently and why medical treatment is often justified with a BMI from 30.

Can you simply stop taking weight loss medication?

Yes, you can always stop or pause, preferably in consultation with your doctor. Bear in mind that your hunger may then return; that is why you work on your lifestyle at the same time during a programme. If you choose a programme at a clinic, ask beforehand how pausing or stopping is arranged there.