The starting point: BMI
Body mass index is the first thing a prescriber looks at. UK prescribing practice generally follows the thresholds set out in NICE guidance, which treat weight-loss medication as appropriate for:
- BMI of 30 or above, or
- BMI of 27 or above where you also have a weight-related health condition — raised blood pressure, type 2 diabetes, high cholesterol, obstructive sleep apnoea or prediabetes among them
BMI is a starting point rather than a verdict. It does not distinguish muscle from fat, and for people of South Asian, Chinese, Black African or African-Caribbean family background the health risks associated with weight begin at a lower BMI, so a prescriber will take that into account.
Work out your BMI
You will need your height and current weight. The consultation calculates it for you as part of the questionnaire — there is nothing to work out in advance.
The rest of the picture
Alongside BMI, a prescriber needs to know about your general health before deciding. The consultation asks about:
- Your medical history, including any thyroid, pancreas, kidney or gallbladder problems
- Medicines you already take, so interactions can be checked
- Whether you are pregnant, breastfeeding or planning a pregnancy
- Previous experience with weight-loss medication, and how you got on with it
- Any history of eating disorders
You also need to
- Be 18 or over
- Live in the UK, with a UK delivery address
- Be able to give an accurate account of your health
When treatment is not appropriate
A prescriber will decline where the risks outweigh the benefit. That includes, among other situations, pregnancy and breastfeeding, a personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2, previous pancreatitis, and a known allergy to the medicine itself.
Being declined is not a dead end. The prescriber will explain the reason, and where something can be resolved — a test result, a conversation with your GP — you can come back.
What happens if you are eligible
A prescription is issued, our pharmacy dispenses it, and it is delivered to you. Your treatment is then reviewed as you go, because the right dose changes over time. See what each dose costs, or read what side effects to expect.
Find out where you stand
The questionnaire takes a few minutes and a prescriber reads every answer. Start your consultation.