Weight management medication

Doctor-led support providing guidance, prescribed weight-loss medication and health monitoring to ensure safe prescribing of medication to achieve sustainable, long term weight loss.

What is the aim?

This treatment aims to enable you to achieve a healthy weight together with making changes to your lifestyle (diet/exercises) so you can maintain your healthy weight and lifestyle changes after medication has been discontinued.  

What is involved?

• A detailed initial assessment to provide guidance and support about diet and exercise to guide you in developing a healthy lifestyle that you can sustain. This includes discussion about other support services that you may like to consider alongside any medical advice and medication.

• Prescribed weight-loss medication (injections) which are approved for use in weight management.

• Ongoing clinical reviews with your doctor

• Close monitoring with regular blood tests and clinical reviews

How does the medication work?

The medications increase the level of hormones in the body which make you feel full, slowing digestion, reducing hunger and cravings. This can lead to decreased intake of food making it easier to lose weight. In addition, the medication helps our bodies use insulin more effectively to control blood sugar levels. In time, the medication aims to allow you to achieve a healthy weight and establish healthier diet and exercise habits so your healthy weight and lifestyle can be maintained after the medication has been discontinued.

Are the medications safe for everyone?

Studies have evaluated the medications in patients with a BMI over 30 and those with a BMI over 27 and one weight-related comorbidity (hight blood pressure, prediabetes or diabetes, high cholesterol, heart issues). The medication is safe for most people, but if you have specific digestive issues, liver disease, thyroid issues or a family history of thyroid cancer or are taking other medication this needs to be evaluated.

Weight loss medication is not suitable if you are planning to get pregnant or are currently pregnant nor if you are breast feeding.

All patients must complete an assessment with the doctor who will decide if they are suitable to have the treatment. The doctor will review your medical history and with the support of the clinic nurse take measurements of your weight, height, waist circumference and blood pressure, and arrange for a blood test to check for any underlying health conditions.

Only once it has been determined there are no contraindications for treatment and that it is safe for the medication to be taken, will the doctor prescribe the medication.

​How do I take the medication?

The medication is a weekly injection that you inject yourself into your abdomen or thigh. The doctor will show you how to do this.

If you would prefer the doctor undertook the injection for you, there is a £50 charge to attend the clinic for an injection each week.

When do I take the medication?

You can take the medication at any time of the day, it does not need to be taken with meals.

What do I do if I miss a dose?

If you miss a dose, try and administer as soon as possible, you can take your injection up to 4 day after you usual injection time to ensure at least 3 days between doses. If you are due to inject within 3 days when you realise you have missed the dose, omit the missed dose and restart on your normal dosing day, resuming once weekly injections. You can change you day of administration provided you allow at least 3 days between doses.

How long can I use the medication for?

There is no time limit for using this medication but by 6 months of use, at least 5% of your initial body weight should have been lost. If this has not occurred a decision with your health care professional will be required to decide whether you can continue.

Are there any side effects?

Common side effects include reduced appetite, nausea, vomiting, diarrhoea, headaches and low blood sugar. These often settle in time but drinking plenty of water and ensuring you minimise alcohol, caffeine and follow a healthy diet can also help. Side effects are more pronounced in the first 2-3 weeks after starting or increasing the dose.

Reduced appetite, indigestion, low blood sugar and dizziness can also occur. Some patients experience redness/soreness at the site of injection, this can be improved by changing to a different similar medication.

Uncommon issues include acute pancreatitis and diabetic eye changes. Pancreatitis is severe inflammation in the pancreas, symptoms include severe abdominal pain, usually in the upper abdomen but it can spread to the back or chest and may be worse after eating or drinking, nausea, vomiting, fever, swelling/tenderness in the abdomen, jaundice and diarrhoea. If these symptoms occur stop your injection immediately and seek urgent medical help (999/111 if needed). If you have previously experienced pancreatitis these medications should not be prescribed.

There are limited studies/data evaluating these medications in pregnant or breast-feeding women so the current advice is not to prescribe in these circumstances.

What do I do when I reach my target weight?

Studies show patients do regain some weight on discontinuing weight-loss medications, it is therefore vital that changes you have made in your lifestyle (diet/exercise) continue after the medication is stopped. There are no specific recommendations for tapering once-weekly injections but this should be discussed with your doctor and decisions about reducing/continuing at a lower dose would be made on an individual patient basis.

Treatment plan

Initial assessment

• Clinical assessment with doctor and nurse

• 30-minute appointment to review medical history, assess body measurements and arrange for blood tests to assess for any underlying health issues

• Blood tests include U+Es, LFTs, TFTs, lipids, HBA1c

• Medication will only be prescribed if the clinician has determined the treatment is appropriate and safe to prescribe

• Medication is prescribed for 4 weeks and self-injection taught

• If a patient wishes the doctor to inject the medication a fee of £50 is charged to attend the clinic for this to be undertaken

First review (4 weeks)

• Clinical review with doctor

• Blood pressure, height and weight measurement

• Medication prescribed for 4 weeks

Second review (8 weeks)

• Clinical review with doctor

• Blood pressure, height and weight measurement

• Medication prescribed for 4 weeks

Third review (12 weeks)

• Clinical review with doctor

• Blood pressure, height, weight and waist circumference measurement

• Blood tests – LFTs, U+Es, TFTs, HBA1c, lipids

• Medication prescribed for 4 weeks

Thereafter reviews are undertaken every 4 weeks with blood tests undertaken every 12 weeks.

Costs

Initial assessment – assessment, bloods and prescription included £280

Review (no blood tests) – clinical review and prescription £150

Reviews with blood monitoring – clinical review, bloods and prescription £245

6-month inclusive package – includes initial consult, bloods, prescription, 5 further reviews with bloods at 3rd and 6th review £1,100

Medication costs are paid directly to the pharmacy – medication starts at £138/month