Weight Loss Injections… Are you asking: “Are they for me?”

Broadly speaking, writing this at the start of 2025, I see a few groups of people where these medications may be very beneficial: patients who are overweight, particularly those with other risk factors for heart disease such as high blood pressure, raised cholesterol, smoking, a family history, diabetes, or who have already had a heart attack or stroke. Patients with heart failure also look to have great outcomes with these drugs according to latest trial evidence, more of this below.

Hyper-palatable, ultra-processed foods are ever more available. Time is increasingly scarce to exercise in our pressured lives. There is much mis-information online and social media about what lifestyle advice to take. It’s no wonder the world is in the midst of an obesity epidemic. We have never been more unhealthy.

However when it comes to weight management and exercise, the sad truth is that simply doing lots of exercise and eating whatever one wants just doesn’t work. It’s all a question of priorities. Don’y get me wrong, I am absolutely in favour of lots of exercise, and there is abundant research data for this, but not necessarily for weight loss reasons. Metabolic health, muscle growth and preservation, mental health, reducing a range of disease risks like cancer, heart disease and dementia are all great reasons.

At the start of every year, many people make New Year’s resolutions, and I bet many of these relate to a healthy lifestyle one way or the other. It’s always struck me as a little curious why we need the lever of a New Year to make changes that will make us feel better now, and in the future. Perhaps we just need a little push sometimes, a helping hand.

I read medical journals each and every week, and summarise the key take-away messages in simple terms in the members area of my website. Since early 2023, one of the research topics that appears in the medical literature probably more than much else are the ‘weight-loss wonder drugs’ called GLP-1 agonists.

I see pros and cons. Let’s deal with the cons first. Conceptually, I worry about a group of medications that in a few short years are likely to become the most prescribed drugs on the planet, without very long term (as in decades) data on safety. I also worry that human nature is often to take the easy option (which is why as a country two-thirds of us are obese), and a weight loss drug is an easier option than education, careful attention to nutrition, exercise and so forth. These drugs, as any drug, can have side effects (see below).

However, I do also see big upsides. The weight loss that some of my patients who have been on the drugs have achieved is amazing, in individuals who had tried all manner of ways to lose weight and been unsuccessful beforehand. My own brother has struggled with his weight his entire life, and has found the weight loss drugs game changing. He always used to succumb to sweet temptations, and his portion control dial typically was set to max. The drugs have fixed that. He not only looks and feels better, his blood pressure control is better too.

Check out his video here:

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In the trials, patients have typically lost around 4% of their body weight in 2 months, 8% after 4 months, and a whopping 15% by 17 months. The UK Medicines and Healthcare products Regulatory Agency (MHRA – the government agency tasked with approving/or not medicines for the UK population) have recently updated their guidance on semaglutide, one of the GLP-1 drugs in question. Previously, its licence was for overweight adults for the treatment of obesity (BMI >30, or 27-30 plus at least one weight related health condition, for example high blood pressure).

Based on new trial evidence, the MHRA have expanded the indication. In a multi-national, multi-centre, placebo-controlled double-blind trial (ie – a high standard of medical evidence) that randomly assigned over 17,600 participants to receive either Wegovy (semaglutide) or a placebo, Wegovy significantly reduced the risk of major adverse cardiovascular events by 20%, such as cardiovascular death, heart attack and stroke.

To put that a different way, one fifth of people taking semaglutide had a reduced risk of a bad health outcome, an incredible result.

The licence now says that adults with a BMI equal to or greater than 27 and cardiovascular disease can now access the drug. To calculate your BMI, use the following calculation on your phone – (weight in Kg / height in metres squared), or use an online tool via the NHS website. If you’re not sure if you qualify, please get in touch and I will help.

There is also huge interest in the heart failure community, where latest research shows enormous benefit for patients with heart failure taking semaglutide (Wegovy) or tirzepatide (mounjaro). I expect it will take some time for UK guidelines and licencing to catch up, but i’m confident it will in due course.

However, these drugs are not currently easily available on the NHS. I get a number of enquiries about these medications, and as GPs can’t often prescribe it either, I haven’t had a good answer until now. Given the benefit, I have decided to work with the manufacturers to access a supply for my patients who meet the MHRA criteria. As you may know, access to these drugs has been a worldwide issue for supply reasons, but I am assured by the manufacturer this would not be an issue for my patients.

Accessing these medications through me and my medical business Coastal Cardiology has a number of advantages. My patients often tell me they don’t like the idea of buying medication from random websites. By purchasing through me, you have the reassurance of a personal service from an experienced consultant with an established medical practice.

As a rule of thumb, for most patients I would envisage them taking the medication for around one year. This allows time to find the right dose for them (I always start with a small dose and build up as needed), and make the lifestyle changes that are so important to make this a long-term solution for when they stop the medication.

Ongoing support to get the most out of this

As I mention above, I worry about people being on these drugs long term. What I would like to see, is people using the period of weight loss whilst on the medication to make lifestyle changes that will benefit them in the long term. This will enable them to come off the drug safely in the future, whilst maintaining the health and wellness benefits. I therefore work with patients who I prescribe the drug for to help them with those lifestyle changes. I love this stuff, and am passionate in my own life about all the little things that can be done to maintain good health. Human nature is what it is: It’s a bit like visiting the dentist, do you find you brush better and floss more when you know you’ve got an appointment coming up? In my experience if patients know they have regular reviews with me they are more likely to be healthy in-between times.

What are the side effects?

Weight loss medication, like any other drug, can have side effects. Thankfully severe side effects are uncommon. In my experience the side effect profile has been very positive. In the trials, the most common side effects to be reported include nausea, vomiting, diarrhoea, but this rarely led to discontinuation of the drug. It is also important to note that in addition to losing fat, people can experience muscle loss. I am a huge fan of weight and resistance training for my patients, whoever they are. I will suggest this to ladies in their 90s as much as young men, maybe even more so as they have more to gain! Where at all possible, I therefore like my patients to try some resistance training whilst taking weight loss drugs to protect against muscle loss. There are many other benefits in addition, and I will discuss this with my patients when I consult with them.

What does it cost?

Please contact my office to get full details by clicking the ‘Book Consultation’ button below, or by calling 01202 084550. What I will say however, is that my prices are highly competitive with respect to what you may find online. However, I include regular ongoing follow-up, rather unlike those suppliers, making it much more likely you will achieve your goals. In addition, beware online retailers who deliberately heavily discount the starting dose to make a sale, before ramping up the costs considerably as doses increase.

If this is something you think you might be interested in, simpl get in touch. There’s absolutely no commitment at this stage. Weight loss is hard. If it were easy, everyone would do it. However it is possible, and I hope I can help you achieve your goals.