Weight Loss Clinic

The new GIP and GLP-1 agonist weight loss injectable medications generally work in 4 different ways: reduce appetite, increase satiety (make you feel full with less), increase your metabolism and decrease the pleasure/reward feeling associated with overindulging.

There are several different brands of GIP and GLP-1 agonists available now for doctors to prescribe such as Saxenda (liraglutide), Ozempic (semaglutide), Wegovy (semaglutide) and Mounjaro (tirzepatide). Dr. Hughes will explain about the different types during your consultation and explain how to use whichever medication she decides to prescribe for you. It is also possible to switch to a different one if you are finding side effects are not manageable or if after a discussion with your doctor it is recommended to change for better efficacy.

Dr. Hughes usually advises people to try to eat 3 small meals a day and not to skip meals. It is important not just to be slim, but also to be nutritionally healthy. Please remember to try to eat your 5 a day, oily fish and dietary fiber. Calcium, iron, vitamin D are important especially in ageing people. Sources of calcium are milk, yoghurt, cheese. Sources of vitamin D and iron are red meat, oily fish and egg yolks. Drink plenty of fluids, preferably water while on your medication. Regular, consistent weight resistance exercise is the most efficient method for increasing muscle mass and metabolic rate and changing body shape. However, many people will not be ready for this type of exercise at the beginning, so start at a realistic target of walking steps and build on this over time. European guidelines for exercise are >150 mins/week of brisk walking or 10,000 steps per day. You should think about taking a multivitamin containing all the B complex vitamins, biotin and omegas whilst on a GLP-1 agonist or GLP-1 and GIP agonist.

GLP-1 agonists will also increase your metabolic rate as part of their mode of action.

Depending on your individual sensitivity to this type of medication you may have side effects or might not get any side effects at all. The most common side-effects of anti-obesity medication are nausea, heart burn, wind and constipation.

Side effects tend to occur at the beginning of the journey with these medications as your body is trying to adjust to the new medication, which is why it is very important to seek out a thorough consultation where your doctor takes you through a sensible dosing regimen in details. Side effects tend to subside over time as your body acclimatises, so it is important to go at the correct pace.

Depending on the medication, you will be advised on how to best manage any side effects by your doctor who will also be at hand to answer any questions.

Studies show that weight loss – whether from GLP-1s or diet alone – can lead to muscle loss. That’s why maintaining a high protein diet & doing weight bearing muscle building exercise is essential.

We are a medical clinic and Dr. Hughes is a medical doctor, we are not a chemist, therefore medication is prescribed at the clinic, but not dispensed.  The weight loss medications are prescription only medicines, so it cannot be bought over the counter, and you will need a prescription from a doctor. Please do not buy from people pertaining to sell these over the internet, on Instagram or via WhatsApp as these are scams and are selling fake product, but could be dangerous for your health.

Semaglutide is the scientific name of the drug what is contained within Ozempic and Wegovy pens, tirzepatide is the scientific name for Mounjaro, these drugs can only legally be prescribed by a doctor and dispensed at a chemist the same as for antibiotics, contraceptives, steroids, insulin etc.

If you are prescribed medication, you can attend any pharmacy of your choice to get your prescription filled.

Once Ozempic or Mounjaro has completely left your system; 6 weeks after last dose for Ozempic and 1 month after last dose for Mounjaro usually you will find that the thinking and urges which drove weight gain will return and you might find the weight going back on. Remember that obesity is a chronic illness and just because you have reached a healthier weight doesn’t mean that the causes which drove the  behavior to gain weight have gone away.

A maintenance dose is usually preferable going forward in order to maintain your weight and eating habits in a healthy way. How to maintain your healthy weight is discussed with each patient at the end of their weight loss journey and the pros and cons discussed of continuing on a maintenance dose and trying to establish what that is. At Blush Clinic this is done at an appointment called ‘Target reached – establishing maintenance dose’ and is a 30 minutes appointment.

You CAN take a GLP-1 medication long-term because it is designed for chronic use, helping to manage blood sugar levels and support weight loss or maintenance safely over time when monitored by a healthcare provider.

Patients may decide to stay on a maintenance dose once they reach target weight and after reflecting on past habits and behaviors and acknowledging that it is likely they will relapse and regain the weight without the continued support of a GLP-1 agonist. Obesity is a chronic disease and our bodies have developed to protect ourselves in times of limited food, so for some people it is very difficult to maintain a healthy weight in ‘times of easy access to high calorie, tasty food’.

Tirzepatide (Mounjaro’s active ingredient) has shown greater weight loss in the SURMOUNT-5 clinical trial compared to semaglutide (Ozempic and Wegovy’s active ingredient).  This trial had 751 study participants. The increased effect is likely due to its dual action on both GLP-1 and GIP receptors, while semaglutide only targets GLP-1 receptors.

However, individual responses to these medications can vary significantly. What works well for one person might not work for another.

Both medications share similar potential side effects, primarily gastrointestinal issues like nausea, vomiting, and diarrhea, though some studies suggest these may occur more frequently or severely with higher doses of tirzepatide compared to semaglutide.

There are also cost considerations of being on Ozempic (semaglutide) versus Mounjaro (tirzepatide) to factor in, which will be discussed with you during your consultation.

GLP- agonists are suitable for most people who are living with obesity. However, the following is a list of criteria, which would mean it is NOT the solution for you.

Exclusion Criteria:

• People who are living with Type 1 Diabetes.

• Anyone below the age of 18 years

• A person who is planning a pregnancy in the next three months

• A person who is currently Pregnant

• Currently, breastfeeding

• A person living with end Stage Kidney Disease

• A person living with end Stage Liver Disease

• A person with a history of Pancreatitis, if not due to gallstones.

• A person with active inflammation from gallstones
• A person with a family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia Syndrome

You do not need to have blood tests done prior to being prescribed weight loss medication.

However, as a matter of course  and to have a general knowledge about your own health, we recommend certain routine blood tests are done if you have not had them in the past 12 months. These are a lipid profile, HbA1C, liver profile, renal profile, thyroid function tests and hormonal profile and perhaps a Vitamin B12 and Vitamin D depending on nutritional and medical history.

Emerging research suggests GLP-1s like semaglutide may help reduce the risk of Alzheimer’s and improve cardiovascular health, reduce liver fat & liver inflammation, reduce migraine frequency, reduce inflammation in conditions like endometriosis and PCOS. While more studies are needed the potential for GLP-1s is looking very promising.

After your weight loss consultation you will receive your invoice via email which details the reason for your consultation, the date, amount and name of our clinic etc. this can be sent to your insurance company. The coverage of each company and policy will vary.