The treatments we use most
This page explains what these treatments do, what the evidence shows, and what we monitor while you're on them. It is information, not a shop — nothing here is for sale, and no medicine is recommended until a consultant has assessed you.
UK law prevents prescription-only medicines being advertised to the public. Nothing on this page is promotional. Our consultation fees are on the fees page; the medicine pages list partner-pharmacy prices for information only.
How a consultant decides
Four things, weighed in a conversation rather than scored by a form.
A BMI of 30 or above, or 27 with a weight-related condition. Those conditions include raised blood pressure, prediabetes or type 2 diabetes, high cholesterol, sleep apnoea, reflux, joint pain and weight-related low mood.
Lower thresholds apply for some groups. People of Asian, Black African, African-Caribbean and Arab family origin develop type 2 diabetes and cardiovascular complications at lower BMIs, and we assess on that basis rather than on the number alone.
Some histories make treatment higher risk, or contraindicated. Pancreatitis, gallbladder disease, certain thyroid conditions, active eating disorders, pregnancy or planning a pregnancy. This is exactly the kind of judgement a questionnaire handles badly. Treatment can be safe for many patients with type 1 diabetes, but only under medical supervision.
Your goals, and how you feel about medication. Some people leave a consultation with a plan that contains no medicine at all. That is a legitimate outcome, and we'd rather reach it in a conversation than sell you something.
These work on the hormones that control appetite
Neither is a diet drug in the old sense. They mimic gut hormones your body already makes, which is why a specialist in those hormones is a reasonable person to ask about them.
Semaglutide
GLP-1 receptor agonist · marketed as Wegovy
GLP-1 is one of several hormones that regulate appetite. It acts on the part of the brain that governs hunger and slows how quickly the stomach empties, so you feel full sooner and for longer. Semaglutide mimics it. Most people find they eat smaller portions and snack less without consciously trying to.
It is a weekly injection you give yourself, starting at a low dose and increasing slowly — the slow increase is what keeps side effects tolerable. A higher 7.2mg dose was approved in 2026. An oral form is also available; both are discussed at your consultation.
The main thing we track, alongside digestive side effects, gallbladder symptoms, hydration, protein intake, exercise and global wellbeing.
Tirzepatide
Dual GIP and GLP-1 receptor agonist · marketed as Mounjaro
Tirzepatide mimics two hormones rather than one — GLP-1 and GIP. At the top doses, trial results are similar to Wegovy’s; in our experience the side-effect pattern differs slightly. Greater effect on appetite also means a greater risk of losing weight too quickly, which is one of the things we watch for.
A UK survey has suggested that lower doses can produce strong results with fewer side effects, so the highest dose is not automatically the goal. Where you settle is a clinical decision, made with you.
Rate of loss, digestive side effects, gallbladder symptoms, hydration, protein intake, exercise and global wellbeing — with particular attention to the rate of loss in the first three months.
Oral semaglutide
GLP-1 receptor agonist as a daily tablet · marketed as Wegovy tablets
The same active medicine as the Wegovy injection, carried by an absorption enhancer so it survives the stomach. It is taken first thing on an empty stomach with a small sip of water, then a 30-minute wait before anything else — including coffee. That morning routine is the biggest practical difference.
Semaglutide tablets have been used in type 2 diabetes for over five years — the higher dose and the weight loss licence are what is new. Up to 80% of trial participants reported side effects, mostly digestive.
Rate of loss, digestive side effects, hydration, exercise and global wellbeing — the same checks as the injections.
A medicine is one part of this. It is not the plan.
Which is why the plan comes with more than a prescription. Every patient gets the AmaraHealth app, which tracks the daily detail those conversations depend on — protein and calories, weight trend, activity, sleep, water and alcohol, in one place at no extra cost. Beyond that, a specialist dietitian and an exercise therapist are available to book whenever they'd be useful.
Protein, fibre and hydration while your appetite is suppressed — the practical difference between losing fat and losing muscle.
For the part of eating that was never about hunger. Available whether or not you take medication.
Resistance work to protect muscle and bone density, built from wherever you are now — not from where a programme assumes you are.
What can go wrong, and what we do about it
Written by our consultants.
The common side effects+
Mostly digestive: nausea, heartburn, bloating, constipation, diarrhoea, sometimes vomiting. They happen because the medicine slows the stomach and gut, which is part of how it works. Headache is also common in the first few days, and some people notice hair loss while weight is falling quickly — it usually recovers as the rate settles.
Side effects are usually worst in the days after starting or moving up a dose, and improve with time. When the dose is increased slowly, more than 95% of people find them manageable. We tell you how to reduce them before you start, and may adjust the pace of dose increases during your consultations.
The serious ones you need to recognise+
Gallstones affected roughly one to three people in a hundred in trials, and gallbladder inflammation up to one in a hundred. Pain on the right side under the ribs needs medical attention. Severe abdominal pain, with or without persistent vomiting, may indicate pancreatitis and needs help immediately. Difficulty breathing or swelling of the face, lips or tongue is an allergic reaction and needs emergency care. NAION — non-arteritic ischaemic optic neuropathy — is a rare eye condition reported with these medicines; any sudden change in your vision needs same-day assessment.
Rapid weight loss itself carries risk — gallstones, dehydration, hair thinning, loss of bone density. This is a large part of why supervision matters, and why we would rather slow you down than let a number fall quickly.
Muscle, water and how fast is too fast+
Half a kilogram to one kilogram a week is safe and sustainable. Slightly faster in the first few weeks is normal and largely water, as glycogen stores empty. Consistently faster than that after two months is too quick, and we would usually reduce the dose.
Across studies, muscle accounts for about a quarter of weight lost, whether the loss comes from dieting or from these medicines. Protein, fluids and resistance exercise reduce it — which is what the dietitian and exercise therapist are for.
Contraception and other interactions+
If you take an oral contraceptive, use a barrier method as well — or switch to a non-oral method — for four weeks after starting and for four weeks after each dose increase, as absorption can be affected. Alcohol is best avoided: it makes nausea worse, is high in calories, and causes dehydration — and many people find they lose interest in it anyway.
Tell us about anything you experience, including things not listed in the patient information leaflet. You can also report directly to the MHRA through the Yellow Card scheme. Please read the patient information leaflet before starting any treatment.
MHRA Yellow Card scheme →Talk it through with someone who has prescribed these for fifteen years
Thirty minutes with a consultant, and no obligation to start anything. Check your BMI first if you'd like to know where you stand.
What we have been writing about
3 April 2026
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