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How can medication help?

 

Let's be honest - medication to aid weight loss has a certain stigma attached to it. Have you heard the phrase "just eat less and move more"? For some, it is not that easy. Previous medications to aid weight loss have been amphetamine based or provided claims that could not be substantiated, resulting in the industry receiving a bad name for itself.

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Then along came a new breed of medications, backed by clinical research, clinical trials and big pharma. These medications act as a synthetic hormone, mimicking the natural hormone that satiates our hunger. This synthetic version is called Glucagon-Like-Peptide-1, acting as a receptor agonist. It helps regulate our blood sugars to keep them stable throughout the day to avoid the high and the lows (when we feel the urges to snack to refuel). It also acts on the receptors in the appetite-control section of the brain, reducing your appetite. It slows down gastric emptying, keeping you fuller for longer which further reduces your appetite.

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When you diet, your appetite does not automatically shrink to match the dietary requirements. Portion control has a major impact on the ability of a person to effectively lose weight. With a suppressed appetite, you will naturally start eating smaller portions. Your stomach will begin to get used to these reduced portions, making it easier to stick with them when you finish the treatment.

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It is important to ensure you are eating a healthy amount of calories per day - enough to sustain your activities of daily living and to continue at a healthy weight, but less than before to enable a steady and long-lasting weight loss. With the right guidance, support and aftercare, medication can be used as an adjunct to health eating and exercise to manage your weight and help you to introduce healthier habits.

 

What exactly are these medications?

 

These medications are, essentially, a synthetic hormone. It is not like any previous medication for weight loss (no gimmicks, false claims, no amphetamines and no fat absorbing pills!). The medications work by mimicking the natural hormone that satiates our hunger. This synthetic version acts as a Glucagon-Like-Peptide-1, a receptor agonist that helps regulate our blood sugar throughout the day to avoid sugar crashes (these lead to us reaching for snacks to refuel and give us that sugar high). As mentioned above, it also slows down gastric emptying, keeping you fuller for longer which further reduces your appetite.

 

GLP-1 Receptor Agonists have been available since 2009 but originally for treating diabetes. 

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How do these medications work?

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The medications mimic a natural hormone already found in your body (GLP-1). They work in three key ways to reduce your appetite.

 

1. It blocks a key hunger hormone telling your brain that you are hungry, whilst also helping to reduce leptin resistance (a hormone which can help off-set weight gain by increasing satiety aka fullness, and speed up your metabolism to help regulate the levels of fatty tissue in your body). This also helps stop the weight from coming straight back on when you stop the jab.

2. It slows down the gastric emptying process, meaning that your body takes longer to process food and it is fuller for longer. This means your body does not need as much intake as normal as it works off the food it has.

3. The medication helps to speed up your metabolism and increase fat burning by reducing glucogon & reducing insulin resistance. This promotes normal blood glucose levels, the liver metabolism of glucose and helps adipose tissue burn fat in a safe and controlled method without causing a sugar-crash. This avoids the urges for quick-fix sugary foods.

 

This all helps to reduce the risk of the so-called "starvation mode" and other side effects like ketoacidosis, as you will be burning off a mixture of stored carbs & fats.

 

Unlike fad diets which tend to starve the body when it's shouting out for food, the medication reduces your body's desire to get more food, which makes it easier to make healthier choices and to reduce calories. It also stops leptin levels from lowering due to "starvation". Low leptin levels can cause increased hunger & a slower metabolism!

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The medications that can be used to aid weight management are Saxenda, Wegovy, and Mounjaro.

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How does Mounjaro work differently?

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Mounjaro works in two different ways. The active ingredient in Mounjaro is called tirzepatide. Tirzepatide works on two different hormonal receptors: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). You may have heard of GLP-1 from other weight loss injections.

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GLP-1 helps to regulate blood sugar levels, which in turn talks to the brain to make you feel less hungry and prevent cravings. It also slows down the emptying of the stomach to keep you feeling fuller for longer.

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GIP regulates energy balance in brain and fat cells, enhancing the GLP-1 effect of suppressing your appetite and improving sugar control.

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By mimicking the effects of both these naturally occurring hormones, Mounjaro has been shown to have greater weight loss potential than medicines that work on GLP-1 alone.

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How much weight could a person potentially lose using medication as an adjunct to dieting and exercise?

 

The average weight loss per person is always different. Clinical trials for the medications have shown a range of weight loss between 8lbs and 19lbs.

 

In the latest Semaglutide (the weekly injection) study released in February 2021, 75% of participants lost 10% of their body weight. For more detailed results of Semaglutide, please click here.

 

During clinical trials for Liraglutide (Saxenda - the daily injection), patients saw better results in losing weight when compared to using a placebo injection over the course of 56 weeks.

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In summary;

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63% lost at least 5% of body weight

33% lost at least 10% body weight

15% lost at least 15% of body weight

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80% of those who used Saxenda kept the weight for over a year.

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The full results for Liraglutide can be found here.

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For the newer Mounjaro (Tirzepatide), clinical trials found participants without diabetes lost on average 52lbs after 16 months - or 22.5 per cent of their weight - compared to those who took the placebo. The highest-dose of the weekly injection, known as tirzepatide (brand name Mounjaro), saw obese adults drop more than a fifth of their bodyweight in little over a year.

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The latest study involved 2,539 adults, although none had diabetes

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Volunteers given the highest dosage of tirzepatide lost 52lbs after 16 months - or 22.5 per cent of their weight - while those given weaker shots dropped between 35 and 49lbs.

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The key is not to compare yourself to others losing weight - focus on yourself, your goals and your progress. Every person is different.

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How do I commence treatment?

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Any medication approved and used to aid weight management must be prescribed to you by a qualified & UK registered prescriber. It must also be dispensed by a UK regulated & registered pharmacy. There is a process to go through to ascertain suitability and to receive treatment:

 

1. Screening: you complete our online health form (or we receive your health form from a referrer)

2. Payment: if both sides are happy with all the information provided and you wish to go ahead, payment is made.

3. Dispatch - the medication is prescribed, dispensed and dispatched to you.

 

Once payment has been processed and your health form has been approved, we will send the medication to you on one of your selected delivery days.​

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Who can use medications to aid weight management?

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The medication can be used for those with BMI over 25. We take into account a range of factors such as:

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• BMI

• Medical History

• Current Medication

• Body measurements

• Eating habits

• Past diets

• Current exercise levels

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The medications ARE NOT suitable for:

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• Under 18's

• Ladies who are breastfeeding, pregnant or actively trying to get pregnant.

• Type 1 diabetics

• Anyone with a history of pancreatitis or thyroid tumours

• Anyone with direct family members who have had thyroid cancer

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How do you send the medication?

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If you have been approved and prescribed a medication for weight loss, this will be sent via next day Special Delivery with Tracking. You will be sent the tracking details the day before delivery once your item is confirmed with the courier for collection.

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Certain couriers will email you the day of delivery with a time frame of when to expect your package (e.g. APC, DPD) whilst Royal Mail always aim to deliver before 1pm. If there are any issues with your delivery, please contact us immediately via email so everything is in writing for us to liaise with the relevant courier.

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​Are there any side effects?

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Like any medication, there are the risks of side effects. The most common side effects are transient - this means that they only last for a couple of days whilst your body adjusts to the medication.  40-60% of clients experience no side effects, whilst others experience one or two mild side effects e.g. a dry mouth or a mild headache. The aftercare literature (booklet & online aftercare) offers advice on how to deal with the most common side side effects. You also receive a Patient Information Leaflet detailing the ins & outs of the medication, including all side effects. We are also available for you to contact should you need any advice or support.

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Everyone is different. You may not experience any side effects, you may experience one side effect or several side effects.

 

Common Side Effects:

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• Nausea

• Headaches

• Dry Mouth

• Constipation

• Loose Stool

• Tiredness

• Stomach Cramps

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Please do not hesitate to contact us if you need any support on dealing with side effects. We are more than happy to advise you.

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Adverse Effects:

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Adverse effects are rare but they are something you should be aware of.

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Adverse effects may include:

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• Palpitations / Fast Heart Rate

• Pancreatitis

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If you experience or feel that you may be experiencing these adverse effects, please stop using the medication & contact 111. When you are safe to do so, please contact us.

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Anaphylaxis:

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There have been no documented cases of an anaphylactic reaction to Liraglutide, Dulaglutide or Semaglutide but as this is a new medication being introduced to your body, we want to make you aware of the possible signs of anaphylaxis.

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If you experience swelling of the lips/tongue/throat, difficulty breathing, tightness in the chest, a severe rash or severe itching, discontinue use immediately and call 999.

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What is included with our programme?

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Our programme will include:

 

• Your health screening & consultation (or referral from another clinic)

• For the injectables, we include all your needles

• Aftercare literature, including side effects, how to deal with them, how to take measurements etc

• Free special delivery with tracking information from a UK regulated pharmacy

• Dietary & nutritional advice from our in-house qualified nutritionists

• Our 4 week meal plan, plus our 4 week Metabolism Reset meal plan

• Exercise Crib Sheet for basic home exercises

• Access to our Facebook Support Group

• Regular email check-ins from our team to ensure you are getting the best possible results

• You can request unlimited check-ins with our team if you need any advice or guidance

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Our Members Area will be coming soon, which will aim to include:

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• Progress tracking - keep an eye on your weight, waist measurements & BMI

• Track your daily calories - you can input & see your daily calorie intake from food & fluids

• Access to recipes, healthy food swaps & healthy food tips from our Personal Trainer

• Access to the medication information, demo videos & aftercare literature

• Online Exercise Programmes - home workouts with no need for expensive equipment

• Request a review of your progress

• Order repeat products if you wish to continue the programme

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Will I get support when using these medications?

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Absolutely! Being overweight is a very common problem. More than 2/3 adults in the UK are either overweight or obese. Excess weight is linked to several serious health problems such as heart disease, diabetes and stroke.

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We send every new starter a Starter Pack, which has everything you need to get going. We’ll get in touch regularly to see how you're getting on and we are always available if you need any advice or support, or if you need any help with making the lifestyle changes you need to manage your weight over the long-term.

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After you start any treatment with us, we’ll check in with you to see how you’re getting on. If it’s going well, we can look at arranging repeat courses for you. If you need any advice or support in the meantime, our team are available 7 days a week via telephone or email.

 

We know what it is like trying to lose weight - it can be scary, it can be hard, it can sometimes seem impossible - so we welcome our clients to contact us even for the slightest concern. We are here to ensure your journey with us is as smooth as possible.

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Do I need to see my doctor before starting treatment?

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Whilst you do not need to see your doctor or inform them that you are taking this medication, we do strongly advise that it would be sensible to keep your GP informed of any medications you use privately so that they have a full picture of your medical history. We can write to your GP on your behalf should you like us to.

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What if I am travelling? Can I take my medication with me?

 

In short, yes you can take the medication with you if you are travelling abroad. We can provide a Flight or Travel Letter at a cost of £10 (to cover admin time & expenses). This letter will allow you to safely travel with your medication through customs and security.

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What about alcohol and these medications?

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Although alcohol does not directly interact with the medication, it is advisable people to avoid alcohol if possible. Research has shown that alcohol mixed with the medication may put extra strain on your liver and it may affect your blood sugar levels.

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Is weight loss guaranteed?

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Unfortunately, a desired result from a medication can never be 100% guaranteed. Although the clinical evidence and clinical studies showed weight loss for the majority of people, everyone is different and we do not like to give false promises.

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Is medicated weight loss right for me?

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That is ultimately a decision for you to make once you have received all the relevant information and have been screened for suitability to use these medications. We recommend everyone to try all conventional methods first before turning to medication for aesthetic weight loss. The NHS offer a Free 12 Week programme, whilst other companies offer diet & exercise focused programmes. If you have weighed up all the information and feel this is the correct route for you, and you are deemed safe & suitable to commence onto treatment, you are able to make an informed decision and consent to starting treatment.

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Receiving & storing the medication:

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All items (except Saxenda) should arrive in the original manufacturer's packaging - completely sealed and unopened. Saxenda may arrive in a pharmacy's own box/packaging if they have to 'break up' a box of 5 pens to accommodate 5 individual patients. Each item must contain the manufacturer's Patient Information Leaflet, and clearly display the product code, batch number and expiry date.

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If you have ordered an injection, please ensure you store the product in the fridge before first use. After first use, you can store it at room temperature up to 30 degrees or keep it in the fridge - please ensure you use Saxenda within 30 days and Ozempic/Wegovy/Trulicity within 6 weeks. If your item breaks the cold chain (e.g. is left out of the fridge for too long), please do not be alarmed - this will start the same countdown timer as when you use the pen for the first time. You no longer need to store it in the fridge (though you can do so if you wish) and must use the pen within the above time frames.

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Is my personal information safe?

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We are registered with the Information Commissioners Office, which means we are on a UK governed register for being GDPR and Data Protection compliant. Your details are only ever seen by the pharmacies we work with and our internal team who will be supporting your weight loss journey. Whilst we do ask for a form of ID, this is only for the pharmacy to verify your identity and your age for their prescribing purposes.

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Is this medication genuine?

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The medication is is governed and authorised for use under UK regulations by the MHRA. Some of the medications are also approved for use in the NHS by NICE. The medication is prescribed by a UK regulated prescriber. The medication is sourced via UK based pharmacies who use official UK wholesalers to ensure you receive a genuine product from the manufacturer. Any other route of providing the medication is illegal. Please see this notice from Novo Nordisk on how to spot a fake medication: Novo Nordisk Fake Ozempic Warning.

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Are you a pharmacy?

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No. We are not a registered pharmacy. We act as a third party platform offering a service to you. Most pharmacies do not offer a service other than prescribing, dispensing or selling medications - we offer a service centred around regular aftercare and check ins which not all online pharmacies are able to offer due to the nature of their business model. However, we use a registered prescriber and we source the medication from UK registered pharmacies that are licensed and regulated by the General Pharmaceutical Council. We only share your personal details with the prescriber and the pharmacy that will oversee your medication.

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What is the difference between Off-Label & Off-License prescribing?

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To get a medicine license, a medication goes through rigorous testing & clinical trials. It is then granted a license for a specific purpose by the Medicines and Healthcare Regulatory Authority (MHRA) for the UK. The license will include information on what the medicine is for, who the medicine is for and the parameters in which it can be used.

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Prescribing Off-Licence means prescribing the medication outside of the licence's parameters.

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Prescribing Off-Label means prescribing a drug for a different purpose than what it is licensed for.

 

Sometimes, medications show a secondary effect or benefit during clinical trials, which are then investigated further with new clinical trials to ascertain if the medication can be used for that secondary effect / benefit.

 

For example, a medication that is licensed for diabetes can be prescribed for weight loss if clinical trials have shown that weight loss was a secondary effect of the medication and that medication has undergone new clinical trials to show the medication is effective for weight loss.

 

To prescribe in this manner, it must be shown that a person is deemed safe & suitable, it is clinically justifiable & reasonable, and you are made fully aware of the pros & cons alongside the fact that it is unlicensed for weight loss. This usage of the medication still falls under the remit of the MHRA and is strictly regulated to ensure the medication is used correctly.

 

Please contact us if you would like more information regarding the above.

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