Weight loss medicines

What are weight loss medicines?

Weight loss medicines, also known as GLP-1 medicines, mimic a natural hormone which helps control blood sugar levels and appetite. They can:

• trigger your body to make more insulin
• reduce the amount of sugar made by your liver
• slow down digestion
• reduce appetite

Together these effects often lead to weight loss. Research also shows that these effects can reduce liver fat, inflammation and fibrosis.

The main ways to manage your weight are with healthy eating and regular physical activity. But this doesn’t work for everyone, especially if they are trying to lose a lot of weight. For these people, weight loss medicines might be an option.

Like with other medicines, you should only take a weight loss medicine if it has been prescribed for you. If you have liver disease it’s also important to talk to your clinical team so they can check if it will be safe for you.

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What medicines are available and who are they for?

There are several different medicines that are approved for use in the UK. Approved means they have been tested in trials to check they do what they are meant to and are safe for most people. The approval process also says who the medicines are for and who might not be able to take them safely – for example if you have certain health conditions, or are pregnant or breastfeeding.

These medicines are approved for use in the UK:

• Orlistat
• Semaglutide
• Liraglutide (the NHS do not recommend this for people with a liver condition)
• Tirzepatide

How the medicines work, who they are for and how they are prescribed is slightly different for each one. So the best thing to do is to have a conversation with your GP.

There is more information about these medicines on the NHS website.

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Getting a precription

Weight loss medicines should be prescribed by a healthcare professional. This could be your GP or in some cases a pharmacist or a weight management specialist. If you have a liver condition you should also speak to your clinical team who can check it will be safe for you.

As part of prescribing the medicine, your doctor or pharmacist will:

• check which medicine is most suitable for you
• check the medicine will be safe to take alongside any other conditions or medicines you have
• advise you on anything else you should do to help the medicine work, such as eating healthily or being physically active
• review your progress after a certain amount of time to check the medicine is working for you

It can be tempting to look online for medicines, or go to an aesthetic clinic, especially if it is hard to get an appointment with your GP. But this can be dangerous.

• Not all websites and clinics check your medical history and that it will be safe for you personally.
• Some medicines can damage your liver and might be harmful if you already have a liver condition or take certain medicines.
• It can also be hard to know whether you are being sold the real thing – fake versions at best don’t work and at worst can make you very ill. Make sure you know what to expect and check the packaging and product match.

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Pregnancy and contraception

We do not yet have enough evidence to know if it is safe to take these medicines when you are pregnant or breastfeeding. There is a chance that they could be harmful for the baby or increase the risk of miscarriage.

The MRHA, who regulate medicines the UK, say that you should not use these weight loss medicines if you are pregnant, trying to become pregnant, or breastfeeding.

These medicines might also make it more likely that you could become pregnant. This seems to work in two ways:

• Obesity can reduce fertility, so losing weight can mean it is easier to get pregnant.
• The medicines may reduce the effectiveness of the oral contraceptive pill.

More research is needed into how these medicines effect the contraceptive pill. The MRHA recommends using a barrier contraceptive, such as a condom to reduce the chance of pregnancy.

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More support with weight management

If weight loss medicines aren’t right for you, don’t give up. It’s still worth sticking to healthy eating and activity plans – they help stop you gaining weight even if your weight loss has stalled.

Talk to your GP, they’re there to help. For example, they can suggest changes to what you’re already doing to help you start losing weight again. They can refer you for cognitive behavioural therapy (CBT) to help make changes stick. And they can refer you to specialist weight management services, who can help in lots of ways, including talking to you about options such as very low calorie diets and weight loss surgery.

Your local pharmacist is also a good source of information about what is available locally. They can give you information to help you prepare for a conversation with your GP or weight management services.

Visit the NHS website to read more about the different ways they can help with weight management.

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