Personalised Weight Loss Solutions from our UK based expert specialist Doctors

I emphasise the importance of combining weight loss medication with sustainable diet and exercise change, emphasising and agreeing safe individual targets with patients and outlining some of the risks associated with too rapid weight loss.

It is very difficult to disentangle some of the health benefits of weight loss medication from those of appearance. Most of my patients are motivated by the wish to improve their health generally but get positive reinforcement when they feel happier with their appearance.

1. This a real concern for some people. This is caused by subcutaneous fat loss from around the face. Most people though are motivated by the general health improvements seen with weight loss.
2. With any weight loss there is loss of both subcutaneous fat alongside visceral fat (that is “belly fat” that is stored deep in the abdominal cavity and surrounding/within the abdominal organs).
3. Staying hydrated and ensuring adequate protein intake to maintain muscle mass can help reduce this. Some individuals take collagen tablets. While these may reduce wrinkles they are not treating the underlying cause.

Firstly I would emphasise the importance of safe and sustainable weight loss. I recommend combining weight loss medication with sustainable diet and exercise change, emphasising and agreeing individual targets with patients in line with above and outlining some of the risks associated with too rapid weight loss. If weight loss was too rapid I would usually advice dose reduction of any weight loss mediation and diet/lifestyle advice above.

Most companies supplying Wegovy and Mounjaro online are pharmacy businesses. We at the Weight loss medics are different.

We are Consultant Endocrinologists with over 15 years Consultant experience of using medications like Wegovy and Mounjaro.

We believe a medical consultation with a member of our specialist team helps people know if these medications are for them or not and we provide on-going clinical support to help people reach their weight loss goals.
We believe this provides people with an unrivalled level of assistance that’s delivered by real experts.

While these are legitimate concerns it is equally important to balance this with the well-established health benefits of weight loss using medical weight loss therapy in people who meet  the MHRA guidelines ie BMI >30kg/m2 or BMI 27 kg/m2 plus a weight related medical condition. If health and aesthetic benefits align all to the good.

0.5 – 1.0 kg weight loss per week is safe and sustainable weight loss. In people who have just started weight loss a slightly faster loss of weight in the first few weeks is acceptable. The initial greater weight loss may be partly to do with loss of glycogen from the liver and muscles together with water.

Weight loss that consistently exceeds this amount after the first 2 months is generally considered too rapid. An individual approach looking at total energy expenditure, calorie deficit, micro and macronutrient diet composition can better inform any therapeutic decisions and prevent too rapid weight loss and the risks associated.

With GLP-1 agonists (and combined GLP-1 GIP agonists) there may higher risk of losing weight too fast.

The potential consequences of too rapid weight loss are

1. Increased risk of gallstones and biliary problems. This may be particularly an issue for people taking GLP-1 agonists where the risk of biliary problems and gallstones is doubled.
2. Possible increased risk of pancreatitis. It is uncertain if this risk may be exacerbated by GLP-1 or if it is just the rapid weight loss per se. It should be borne in mind though that biliary problems and gallstones are a risk factor for pancreatitis.
3. In people who lose weight very rapidly on severe calorie restriction there is evidence of accelerated bone mineral density loss. There is no evidence that this is particularly a risk of GLP-1 agonists. Exercise is very important in preserving and improving bone mineral density so combining safe weight loss with an exercise program that includes weight bearing exercise is likely to limit any adverse effects bone mineral density.
4. Risk of hair loss is increased if weight loss is too rapid. This is called “telogen effluvium” and in this situation the body shuts down non-essential functions. Hence the hair loss and to a certain extent the accelerated bone mineral density loss described above.
5. Dehydration is a major problem in people who lose weight too rapidly. Much of what we drink is associated with food and in extreme calorie restriction dehydration and acute kidney injury can occur. There is evidence that GLP-1 agonists if used safely can actually provide protection against the progression of kidney disease, particularly in those at higher cardiovascular risk and with type 2 diabetes.
6. Fatigue and weakness may be a signal that weight loss is too rapid and should be monitored by the physician supervising therapy with appropriate dietary and therapeutic adjustments made.
7. Micronutrient deficiencies may be an issue with too rapid weight loss. I usually recommend a multivitamin and vitamin D supplement just to be on the safe side but avoid too rapid weight loss.

1. In most studies muscle loss represents about 25% of weight loss whether this with diets or with GLP-1 agonists.
2. In the early weeks of weight loss (either by diet or GLP-1/GIP agonists) water represents a higher proportion of the weight lost. This is likely related to depletion of glycogen stores
3. By focussing on hydration and a protein rich diet with plenty of fresh fruit and veg combined with exercise, the risks of muscle loss can be attenuated. This is the same with any successful weight loss strategy but the risks may be higher with GLP-1 agonists simply because they are more effective at switching off appetite.

While I have seen the side effects described above in people on GLP-1 agonists on an individual patient basis it is very difficult to say to what extent the problems were caused by rapid weight loss per se or the GLP-1 agonist.

Wegovy (semaglutide) and Mounjaro (tirzepatide) are approved for use in adults with a BMI of 30 or higher, although there are certain medical conditions that would make treatment inadvisable.

This BMI cut-off is lowered to 27 for those who also have at least one weight-related condition. Some examples include high blood pressure, type 2 diabetes, high cholesterol, sleep apnoea, gastro-oesophageal reflux, weight-related depression, or joint pain.

People of certain ethnic origins (Asian, Black Afro-Caribbean, Arabs) are more prone to developing type 2 diabetes and cardiovascular complications of obesity at lower BMIs than Caucasians.

Complete our free, online medical questionnaire to determine whether you are suitable.

Initial 30 minute one-one appointment with a GMC registered Specialist Medical Consultant £75. First months medication (indicative price from pharmacy partner) ; Mounjaro £156 Wegovy £110

For 6 one-one appointments with  your GMC registered Specialist Medical Consultant and 6 e-mail reviews over 12 months the cost is less than £50 per month. See our fees page for more details.

Mounjaro and Wegovy slow the emptying of the stomach and suppress the appetite. Both are recommended to be combined with a healthy diet and exercise. We are going to focus on dietary advice here and there is a separate FAQ on exercise guidelines on our website.

There isn’t a specific diet recommended when taking Mounjaro or Wegovy but focussing on healthy eating is advised. Everyone is different and will find some things easier and more effective in supporting healthy weight loss. As a broad principle focus on eating vegetables, whole grains, lean protein and fresh fruits. Try to avoid foods that are high in sugar, saturated fat and salt.

Fruit and vegetables tend to be high in fibre and may help you feel fuller longer, enhancing the effect of Mounjaro and Wegovy.

Whole grains similarly tend to be high in fibre and may help you feel fuller longer, enhancing the effect of Mounjaro and Wegovy.

Proteins such as fish, chicken, lean meats and vegetarian protein sources eg pulses, eggs and soy should form an important part of everyone’s diet. These sources of protein can help increase satiety and reduce food cravings. They may also slow the emptying of the stomach and help you feel fuller longer.

Many authorities advise avoiding alcohol when on Wegovy or Mpopunjaro. This is for a number of reasons; alcohol can exacerbate gallstone problems and in excess increase risk of pancreatitis, alcohol may also interact with Mounjaro or Wegovy and cause sickness or vomiting. Many people find they don’t want to drink alcohol when taking Mounjaro or Wegovy and this can certainly enhance weight loss as alcohol contins high amounts of “empty calories”

In general focussing on nutritionally rich foods that help with satiety and avoiding unhealthy foods will aid you in your weight loss journey. If you feel you need further advice to support you in making dietary changes please e-mail us at info @theweightlossmedics.co.uk or ask us during your video consultation and we can put you in touch with a specialist dietitian.

While exercise on its own is often not successful in achieving significant weight loss it is a very valuable part of a weight loss programme and general health. It is recommended to do 150 minutes per week of moderate intensity exercise or 75 minutes of vigorous intensity exercise a week. Moderate intensity exercise includes brisk walking, cycling, doubles tennis, mowing the lawn etc. Vigorous exercise includes team sport, swimming and running.

Resistance exercise is also beneficial and it is recommended to do strengthening activities that work all the major muscle groups (legs, hips, back, abdomen, chest, shoulders and arms) on at least 2 days a week.

The NHS live well website provides valuable information and is useful to look at.

We understand that there may be barriers to starting exercise and will be happy to arrange a consultation with an exercise expert to design a bespoke programme for you. As a rule of thumb when starting out with exercise start with a low level that you are comfortable with and increase activity by 10% per week. This might seem quite slow but it all builds up.

We are all short of time and lead busy lives. Active commuting could meet all your exercise needs, save you money, improve your mental health and help save the planet! The NHS has recognised this in its strategy document about the route to net zero. Most employers now offer cycle to work schemes that save money on buying a bicycle (traditional or electric). Using e-bikes can provide many of the same benefits as standard cycling. Sustrans provide a wealth of information and can help you plan your commute.

• NHS live well website
• NHS England policy including information on benefits of active commuting
• Sustrans (information on cycling)

Like all medications, Wegovy and Mounjaro may cause side effects.

The most common side effects are gastrointestinal. These include nausea, heartburn, bloating, constipation (occasionally accompanied by abdominal cramps), diarrhoea and vomiting . This is because one of the ways Wegovy and Mounjaro help is by slowing down how fast the stomach and intestine empty, which contributes to a sense of early and prolonged fullness after meals. During our clinical consultations we will provide you with advice of how to reduce the risk of the common gastrointestinal side effects and how to manage them if they occur.

Another common side effect includes headache but usually settles within a few days. To help with headaches drink plenty of clear fluids, eat small amounts, get enough sleep and rest and take a simple pain medication such as paracetamol to help control the pain as your body gets used to Wegovy or Mounjaro.

Side effects are typically worse when first starting the treatment and for the first few days after moving up to a higher dose pen.

Usually if the medication dose is increased slowly, most people (>95%) find side effects fairly easy to tolerate, particularly as they tend to improve over time.

During our follow up clinical consultations we will assess your response to the medication and any side effects and we will advise when to increase the medication dose to reduce the side effects.

Other side effects seen with these medications include:

Gallstones: In clinical trials, around 1-3 in 100 people using Wegovy or Mounjaro developed gallstones. This may be due to rapid weight loss.

Cholecystitis: is an inflamed gallbladder and up to 1 in 100 people taking Wegovy and Mounjaro get this. If you develop abdominal pain, especially on the right side under your ribs you must seek medical attention.

Pancreatitis: this is a condition where the pancreas becomes inflamed. If you develop severe abdominal pain with or without persistent vomiting this may be a sign of pancreatitis and you need to get medical help immediately.
Gastroparesis: this is unusually slow emptying of the stomach that can be associated with excess vomiting. It has been noted in a very small number of patients taking Wegovy and Mounjaro.

Anaphylaxis: this is a severe allergic reaction. If you experience symptoms like difficulty in breathing, swelling of the face, lips or tongue or difficulty swallowing you may be having a severe allergic reaction (anaphylaxis) and you need to seek immediate medical help.

If you get any side effects please let us know. This includes any possible side effects not listed in the Patient Information leaflet.
You can also report side effects directly via the Yellow Card Scheme  or search for MHRA Yellow Card.

Please make sure to read the Patient Information Leaflet carefully before starting any treatment

In clinical trials of Wegovy individuals lost up to 15% in weight.

In clinical trials of Mounjaro individuals lost up to 20% in weight.

People in both trials had clinical support alongside the medications to help them achieve their weight loss. We at The Weight Loss Medics believe that the clinical support and expertise we provide will help people achieve their weight loss goals when prescribed Wegovy or Mounjaro.

The medications work by suppressing your appetite and making you feel full sooner than normal. They do not alter your taste for food. This means you will still enjoy your food but you will eat less of it and snack less.

GLP-1 is one of several hormones that regulate food intake and appetite – the body’s way of stopping us from putting on too much weight.

It does this by targeting a specific region in the brain responsible for appetite control, reducing feelings of hunger. It also slows stomach emptying, which makes you feel full for longer.

Wegovy (semaglutide) and Mounjaro (tirzepatide) both mimic GLP-1. In addition Mounjaro also mimics the effect of glucose-dependent insulinotropic polypeptide (GIP). People taking both of these medications find it much easier to decrease their calorie intake by reducing portion size and eating less often and so they lose weight.

Obese or overweight female patients using oral contraceptives should consider also using a barrier method of contraception (e.g., a condom) or switching to a non-oral contraceptive method for 4 weeks after starting Wegovy or Mounjaro and for 4 weeks after each increase in dose as these medications and dose changes may affect how well the contraceptive pill works.