Injectables & Pills

There are several non-injectable weight loss medications that are approved by the MHRA (Medicines and Healthcare products Regulatory Agency) for use in the UK. These medications are only available with a prescription and should be used under the guidance of a healthcare professional as part of a comprehensive weight management program that includes lifestyle changes such as a healthy diet and exercise. Here are some examples of non-injectable weight loss medications that are approved by the MHRA:

1. Wegovy Pill: Wegovy is available as a once-daily tablet containing semaglutide, a GLP-1 receptor agonist that reduces appetite and food cravings. It is approved for adults with a BMI of 30 or above, or 27–30 with a weight-related health condition. Common side effects include nausea, diarrhoea, constipation and vomiting.
2. Orlistat: Orlistat is a medication that works by blocking the absorption of some of the fat in the food you eat. It is available as a capsule and should be taken with meals. Orlistat can cause gastrointestinal side effects such as oily stools, flatulence, and abdominal pain.
3. Mysimba: Mysimba is a medication that contains two active ingredients (bupropion and naltrexone) that work together to reduce appetite and cravings. It is available as a tablet and should be taken twice a day. Mysimba can cause side effects such as nausea, headache, and dry mouth.

It is important to note that these medications are not suitable for everyone, and potential side effects and contraindications should be discussed with a healthcare professional before starting treatment. In addition, these medications are not a magic bullet for weight loss and should be used in conjunction with lifestyle changes such as a healthy diet and exercise.

The MHRA (Medicines and Healthcare products Regulatory Agency) is the regulatory body responsible for ensuring that medicines and medical devices are safe and effective for use in the UK. It is an executive agency of the UK government's Department of Health and Social Care.

The FDA (Food and Drug Administration) is the regulatory body responsible for ensuring that medicines and medical devices are safe and effective for use in the United States. It is a federal agency of the US Department of Health and Human Services.

Both the MHRA and FDA play important roles in ensuring that medications and medical devices are safe and effective for use by patients. However, there are some differences between the two agencies. For example:

1. Jurisdiction: The MHRA regulates medicines and medical devices in the UK, while the FDA regulates medicines and medical devices in the United States.
2. Approval process: The MHRA and FDA have similar processes for approving new medicines and medical devices, but there may be differences in the specific requirements and timelines for approval.
3. Post-marketing surveillance: Both the MHRA and FDA monitor the safety of medicines and medical devices after they are approved, but there may be differences in the specific methods used for monitoring and the frequency of safety reviews.
4. Labelling and packaging: The MHRA and FDA have different requirements for labeling and packaging of medicines and medical devices, which can lead to differences in the information provided to patients and healthcare professionals.

Despite these differences, both the MHRA and FDA have the same overall goal of protecting public health and ensuring that patients have access to safe and effective medicines and medical devices.

There are several weight loss treatments available in the UK, and the most effective option will depend on individual factors such as starting weight, medical history, and lifestyle. Research consistently shows that the best outcomes come from combining behavioural changes, such as a healthier diet and increased physical activity with medical or surgical intervention where appropriate.

Dietary programmes

Structured low-calorie diets (typically 800–900 kcal/day) have strong evidence behind them. The NHS DiRECT trial, published in The Lancet in 2018, found that a structured dietary programme led to remission of type 2 diabetes in nearly half of participants after one year, alongside significant weight loss.

Weight loss medication

Several medications are approved in the UK for weight management. Semaglutide (Wegovy) currently has the strongest evidence, with the STEP 1 trial published in the New England Journal of Medicine in 2021 showing an average weight loss of around 15% of body weight over 68 weeks. Liraglutide (Saxenda) is also licensed for weight loss and supported by the SCALE Obesity and Prediabetes trial, though it generally produces more modest results than semaglutide.

GLP-1 (glucagon-like peptide-1) injections are used to treat type 2 diabetes and obesity. They help regulate blood sugar and reduce appetite, leading to weight loss. GLP-1 is a natural hormone released by your gut when you eat.

It:

1. Stimulates insulin release from the pancreas
2. Reduces sugar release from the liver
3. Sends signals to the brain that you are full

However, natural GLP-1 breaks down very quickly. GLP-1 medications are designed to last much longer (from 1 day up to 1 week), which strengthens and prolongs these effects.

Because GLP-1 medications slow digestion, some people may experience:

1. Nausea (common)
2. Diarrhoea
3. Bloating or a feeling of fullness
4. Indigestion or reflux

These side effects are usually mild and improve over time as the body adjusts to treatment.

How to Reduce Symptoms

1. Eat smaller, more frequent meals
2. Eat slowly and chew food well
3. Avoid high-sulphur foods (e.g. eggs, red meat, beans, broccoli, cabbage, cauliflower) if symptoms are bothersome
4. Avoid fizzy drinks
5. Stay well hydrated
6. Peppermint tea may help some people
7. Probiotics may be helpful for gut balance (evidence varies)

If symptoms are severe or persistent, a clinician may consider adjusting the dose or assessing for other gastrointestinal causes.

GLP-1 injections are prescribed following an assessment by a qualified clinician through an online consultation platform.

Our clinicians review your medical history, BMI, waist circumference, previous use of weight management treatments, and any relevant medical conditions to determine whether treatment is appropriate and safe for you.

To ensure a thorough assessment, please complete the consultation form in full and upload all required supporting documents. Our clinical team may contact you for further information if needed to ensure safe prescribing.

TREATMENT

In the UK, GLP-1 receptor agonist injections are approved for the treatment of type 2 diabetes and, in some cases, weight management (obesity).

Common GLP-1 medications include:

· Liraglutide (Saxenda for weight loss / Victoza for diabetes)

· Semaglutide (Ozempic for diabetes / Wegovy for weight loss)

· Dulaglutide (Trulicity – diabetes only)

· Exenatide (Byetta/Bydureon – diabetes only)

· Tirzepatide (Mounjaro – diabetes and weight management in the UK)

Only GLP-1 / related injections approved specifically for weight loss in the UK:

· Semaglutide (Wegovy)

· Liraglutide (Saxenda)

· Tirzepatide (Mounjaro

ALTERNATIVES

Alternative treatments to GLP-1 injections may include other evidence-based options such as orlistat or oral GLP-1 receptor agonists (where appropriate and available).

Non-pharmacological approaches are also an important part of weight management and may include:

· Structured weight loss programmes

· Nutritional and dietary counselling

· Increased physical activity and exercise therapy

It is important to note that the most suitable option will depend on individual medical history, BMI, and clinical needs. You should always consult a healthcare professional before starting or switching any treatment for diabetes or obesity.

Obesity is a chronic, multifactorial condition managed primarily through dietary change, behaviour modification, and increased physical activity. Anti-obesity medications and bariatric surgery may be used in selected patients.

Weight loss is only possible when there is a sustained negative energy balance, meaning energy intake is lower than energy expenditure. Without this, no dietary approach can produce meaningful fat loss.

Energy balance vs macronutrients

Although earlier theories suggested that specific macronutrient ratios (fat, carbohydrate, protein) could independently drive superior weight loss through effects on satiety, fat oxidation, or lean mass preservation, evidence shows these effects are mainly short-term. Long-term trials consistently demonstrate that total calorie deficit is the dominant driver of weight loss, while macronutrient composition has limited independent impact when calories are matched. Inter-individual differences, adherence, and behaviour are more important determinants of success than diet composition alone.

What is a conventional hypocaloric (calorie-reduced) diet?

A conventional hypocaloric diet involves reducing daily intake by 500–750 kcal, typically to 1,200–1,500 kcal/day for women and 1,500–1,800 kcal/day for men. It emphasises fruit, vegetables, fibre-rich foods, and reduced saturated fat, and typically produces around 0.5 kg weight loss per week initially, slowing over time due to metabolic adaptation.

Are low-fat diets effective for weight loss?

Low-fat diets reduce overall calorie density, but meta-analyses show no consistent superiority over other diets when total calorie intake is matched. Outcomes depend primarily on adherence and diet quality, with typical results of around 3–7 kg over 6–12 months.

Do low-carbohydrate or ketogenic diets work better?

Low-carbohydrate diets may produce faster results short term (5–10 kg over 3–6 months in some individuals), but show no consistent advantage over 12 months. Long-term adherence is often poor, and some individuals may see an increase in LDL cholesterol.

What is a high-protein diet and does it help with weight loss?

High-protein diets (20–30% of total energy from protein) increase satiety, preserve muscle mass, and raise the thermic effect of food. Some trials show an additional 3–4 kg loss over 6 months, though long-term evidence is inconsistent and high animal protein intake may carry risks for those with renal or cardiovascular concerns.

What is a very low-calorie diet (VLCD) and when is it used?

A VLCD involves under 800 kcal/day via meal replacements and can produce 10–20 kg weight loss in 8–12 weeks. It is a short-term intervention (maximum 12 weeks) requiring medical supervision, typically used for severe obesity, pre-bariatric surgery preparation, or obesity-related conditions such as type 2 diabetes.

What are the benefits of the Mediterranean diet for weight loss?

The Mediterranean diet produces around 4.4 kg weight loss at 2 years and approximately 3.1 kg maintained at 6 years — with better long-term maintenance than low-fat diets. Beyond weight, it is associated with reduced cardiovascular risk, improved lipid profile, and reduced mortality, making it one of the most sustainable and broadly beneficial dietary patterns available.

Does intermittent fasting work for weight loss?

Intermittent energy restriction (such as the 5:2 diet or alternate-day fasting) produces around 3–8% body weight loss over 3–6 months — broadly similar to continuous calorie restriction, with no consistent advantage over standard approaches. Long-term safety data remains limited.

Do I need to count calories to lose weight?

Not necessarily. The DIETFITS trial (609 participants, 12 months) found no meaningful difference between low-fat and low-carbohydrate diets when food was minimally processed, added sugars were reduced, and fibre intake was high. Diet quality matters as much as calorie counting.

What helps people maintain weight loss long term?

Successful long-term weight maintenance tends to rely on continuous and sustainable eating patterns rather than extreme restriction, low energy density foods (high volume, lower calorie), and a behaviour-focused rather than purely restrictive approach. Key predictors of long-term success include regular self-monitoring of body weight, ongoing medical or behavioural support, consistent eating patterns, regular breakfast consumption, lower intake of high-fat or energy-dense snacks, high levels of physical activity, and a slower eating rate, which may enhance satiety signalling and fullness.

Does eating more slowly actually help with weight management?

Preliminary evidence suggests that slower eating may improve the satiety hormone response and increase feelings of fullness compared to rapid eating. However, more research is needed to confirm long-term effects on body weight regulation.