Weight Loss Services
Indication for use of Wegovy or Mounjaro*:
BMI 30 or over.
BMI 27 or over for those with cardiovascular risk factors.
These conditions are strictly adhered to.
At TWP, Dr Dan has assembled a team of experts- gastroenterologists, endocrinologists, gynaecologists, nutritionists and psychotherapists- to provide a range of treatments and bespoke plans for each of our patients. We understand the complex physical and psychological issues behind weight and our aim is to ensure our patients lead their happiest and healthiest lives, through healthy, sustainable weight loss.
Wegovy (Semaglutide) and Mounjaro for weight loss
In 2022, ‘Wegovy’ was licensed in the UK and the US for assisting with weight loss. This was a result of the excellent data of their sister drug, Ozempic, in assisting those living with diabetes with weight loss.
Obesity causes low-level chronic inflammatory changes in the body. Systems that can be affected include:
Cardiovascular (Heart and blood vessels): Heart disease, Hypertension, Stroke.
Musculoskeletal (joints): Arthritis, Gout.
Liver function malfunction.
Decreased immunity.
Poor blood sugar control and increased risk of diabetes.
Hormone irregularities:
Men: Decreased testosterone and increased oestrogen.
Women: Menstrual cycle interruption and decreased fertility.
By combining one of these medications with a healthy diet and exercise, you can lose the weight that you’ve been struggling with. Wegovy is indicated for treating obesity (BMI between 30 and 40).
Wegovy and Mounjaro work in similar but different ways
Both Wegovy and Mounjaro work by mimicking gut hormones called incretins. Incretins signal the pancreas to release insulin after eating and tell the liver to make less glucose (sugar). They also slow the passage of food through the digestive tract and act on areas of the brain responsible for regulating your appetite.
When a medication mimics an incretin, it can help you feel fuller faster and for longer when you eat, and it can reduce feelings of hunger. It can also help your body regulate your blood glucose levels. Wegovy and Mounjaro act slightly differently because they mimic different incretins.
Wegovy is part of the glucagon-like peptide-1 (GLP-1) agonist medication class. After injecting a dose, it acts like the incretin GLP-1.
Similarly, Mounjaro acts like GLP-1 in the body. However, it also mimics an incretin called glucose-dependent insulinotropic polypeptide (GIP). So it belongs to a different medication class: dual GIP/GLP-1 agonists. Medications in this class can help manage blood glucose levels better than GLP-1 agonists for people with Type 2 diabetes.
How they work
Wegovy
Wegovy is a glucagon-like peptide-1 receptor agonist that until recently has primarily been used for people with Type 2 diabetes by helping to regulate their blood sugar. It has also been found to be very effective in weight loss. It works by both decreasing your appetite and by promoting energy burning. It is a weekly injection.
How it works:
It activates the pancreas to produce insulin in response to an increase in blood sugar levels
Reduces food cravings, stopping snacking, resulting in decreased calorie intake
Reduces glucagon production. This is the molecule that is produced when you’re hungry. This regulates blood sugar levels by increasing blood sugar levels
Slows down gastric emptying. This prevents a fast rise in post-meal blood sugar levels. It also causes you to become full more quickly and for longer, helping to decrease your portion size and to stop snacking between meals.
What it contains
Semaglutide: a synthetic version of a molecule in the body called Glucagon-like peptide-1. This molecule helps reduce appetite and regulate how the body uses blood sugars
Cost
Initial consultation counseling and teaching on injection technique £195
£210 per 0.25 mg Wegovy injection pen 1 month’s treatment
Repeat prescription £55
Quarterly review consultation:
Face to face: £185
Virtual (telephone or video) or Email consult: £165
For more information, do book an appointment with us to discuss this further.
Are they safe?
Semaglutide was developed 10 years ago as an adjunct medication for those living with Type 2 Diabetes. This is reassuring, especially since the diabetic population often has multiple complex medical problems.
How are they administered?
By a very small injection under your skin (sub-cutaneously) once weekly. Dr. Dan will show you how this is done initially.
Are there foods to avoid while taking either medication?
No, you don’t have to avoid any specific foods during your Wegovy treatment. Also, the drug can be taken with or without food.
Do I need blood tests before or during my treatment?
If you haven’t had recent blood tests, Dr Dan will ask for these to be performed. These can be either done in the clinic or elsewhere with another provider if preferable for you. This is so that any other conditions that may cause weight gain (such as Hypothyroidism) may be ruled out.
Hormone irregularities or deficits can also impact our ability to lose weight. We can measure women’s oestrogen/progesterone/testosterone and men’s testosterone to ensure there is no underlying issue.
Will my weight bounce back quickly when I stop?
There will not be an accelerated increase in weight when you stop the medication. However, you will need to continue monitoring your calorie intake and combine it with healthy eating and exercise.
Do I need to change my lifestyle along with taking either medication?
Yes- Wegovy should be used as a supportive treatment- as part of a number of lifestyle changes to help you lose weight. These include exercise, a healthy diet and calorie control.
How often do I need to be seen by a doctor during the treatment?
Dr. Dan would like to check in with you every 3 months to discuss the progress of your weight loss.
He is happy to discuss any concerns you have at any point in between these catch-up sessions, however.
How much weight will I Iose?
This all depends on a number of factors including your initial weight and your lifestyle.
What should I do if I miss a dose?
If you miss a dose of either medication, take the missed dose as soon as you remember it, if within 4 days after the missed dose. However, if it has been more than 4 days since your last dose, then skip the missed dose and continue your regular dosing schedule. Do not inject two doses within 3 days of each other.
What are the more common side effects of either medication?
Like all medication, Wegovy may cause side effects in some people. The more commonly reported side effects of either medication include:
abdominal pain
constipation
diarrhoea
nausea or vomiting
What are the mild side effects of either medication?
Wegovy can cause mild side effects in some people. These may include:
change in the way things taste
abdominal pain
burping
constipation or diarrhoea
dizziness
headache
Flatulence
Tiredness
Indigestion
nausea or vomiting
In most cases, these side effects should be temporary. Some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with Dr. Dan.
What are the serious side effects of either medication?
In rare cases, Wegovy may cause serious side effects. Before starting treatment, Dr Dan will talk with you about your risk for serious side effects from this drug.
Serious side effects of Wegovy can include:
gallbladder problems, including gallstones or cholecystitis (gallbladder pain and swelling)
kidney problems
Pancreatitis
Increased risk of thyroid cancer.
Allergic reaction
Side effects explained
Learn more about some of the side effects either medication may cause.
Thyroid cancer risk
Wegovy has a boxed warning about the possible risk of thyroid cancer. Semaglutide has caused thyroid cancer in animals. It’s unclear if this drug also increases thyroid cancer risk in humans.
However, to lower the possible risk of thyroid cancer, don’t use Wegovy if:
you have a rare genetic condition called multiple endocrine neoplasia type 2
you or a family member has had medullary thyroid cancer.
Gas and burping
Flatulence and burping can occur with either medication, but they aren’t the most common digestive system side effects. Some more common digestive system side effects include constipation, diarrhea, nausea, and vomiting.
Burping is also a symptom of acid reflux or indigestion. These are both digestive system side effects that can occur with either medication, too.
What might help
In most cases, gas and burping are considered mild side effects. But if they bother you or don’t go away during your either medication treatment, tell Dr. Dan. He may suggest diet changes or an over-the-counter medication, to help relieve gas and burping.
Contact Dr. Dan right away if you have gas or burping along with vomiting or severe pain in your back or abdomen (belly). These could be symptoms of pancreatitis (swelling of the pancreas), which is a serious side effect of Wegovy.
Pancreatitis
In rare cases, either medication may cause pancreatitis (swelling of the pancreas).
What might help
Before starting either medication, tell Dr. Dan if you’ve had pancreatitis or other pancreatic problems before. It may be unsafe for you to use either medication.
While using either medication, watch for pancreatitis symptoms, such as:
abdomen (belly) pain that may radiate to your back
nausea or vomiting
bloating
fever
Contact Dr. Dan right away if you experience any of these symptoms. If he suspects that you have pancreatitis, he’ll stop your Wegovy treatment and manage your condition.
Does the medication increase my risk of blindness?
A 2024 study suggests that semaglutide, the active ingredient in Ozempic and Wegovy, may be linked to an increased risk of non-arteritic anterior ischemic optic neuropathy (NAION), a rare eye disease that can cause sudden blindness:
The study found that people with diabetes who took semaglutide were more than four times more likely to develop NAION than those taking other medications, and those taking semaglutide for weight loss were more than seven times more likely than those taking other weight loss drugs.
The link was especially strong in the first year of taking semaglutide
"It is premature to conclude that the association is a causal association. More research is necessary to test the hypothesis. Until then, patients should be aware of this information and, in consultation with their care team, make a careful, informed choice based on their individual risk profile," said neuro-ophthalmologist Andrew Lee, MD.
Irrespective of whether you’re taking Semaglutide or not, it is important to have regular eye tests. If you notice any change in your vision whilst on the medication or are at all concerned, then do organise an eye test.
Are the medications readily available?
There is a UK shortage of both Wegovy and Mounjaro. We have a number of pharmaceutical suppliers who will provide us with the medication if clinically indicated for our patients. We ensure that all our suppliers prioritise stocks for our and other practice’s diabetic patients, however. These patients have priority for this medication.
Are you taking on new patients due to this supply shortage?
We will consider taking on new patients on a case-by-case basis; only those with a clear clinical need, meeting the criteria will be considered.
Stopping the medication
Can You Have Withdrawal Symptoms from Semaglutide (Ozempic)?
When it comes to semaglutide, withdrawal symptoms can involve changes related to weight, appetite, blood sugar levels, and cardiovascular health.
When you regularly take a medication that alters processes in your body, stopping that medication can create a state of internal imbalance. This is known as withdrawal.
For semaglutide, the active ingredient in Ozempic, Wegovy, and Rybelsus, withdrawal symptoms tend to fall under the category of rebound effects.
What happens when you stop taking semaglutide?
Understanding how semaglutide works in your body is key to understanding what happens when you stop taking this medication.
Semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 receptor agonists imitate your body’s natural hormone GLP-1.
GLP-1 is involved in many different physiological processes. It has protective effects on your cardiovascular system and is involved in several functions of blood sugar (glucose) regulation, including stimulating insulin secretion, inhibiting glucagon, and slowing how quickly nutrients are absorbed into the body.
GLP-1 also affects neurological pathways in your brain, reducing appetite and promoting feelings of satiety (fullness).
By taking semaglutide, you’re supplementing your body’s natural GLP-1 with a GLP-1 receptor agonist, enhancing your body’s natural processes.
When you stop taking semaglutide, you’re no longer providing your body with the medication that’s been boosting your natural GLP-1’s effects. This can result in a resurgence of your original symptoms, also known as a rebound effect.
Potential withdrawal symptoms
Possible withdrawal symptoms from semaglutide can occur as a result of decreased GLP-1 activity.
When you stop taking semaglutide, you may experience:
increased appetite
decreased satiety
elevated blood sugar levels
weight gain
cardiovascular changes, like elevated blood pressure
According to results from the 2022 STEP 1 clinical trialTrusted Source for the use of semaglutide in weight loss, after 1 year of semaglutide withdrawal, participants regained two-thirds of their initial weight loss. Many also experienced an increase in blood pressure (though some cardiovascular benefits remained) as well as a return to their previously elevated blood sugar levels.
As your body returns to your natural GLP-1 levels, rebound symptoms can come with their own secondary effects. For example, elevated blood sugar levels, also known as hyperglycemia, can cause:
nausea and vomiting
dry mouth
shortness of breath
sweet-smelling breath
Symptoms associated with adverse cardiovascular effects can include:
headaches
chest pain
dizziness
difficulty breathing
nausea and vomiting
nosebleeds
abnormal heartbeat
vision changes
confusion
buzzing in the ears
Discussing any new symptoms with your doctor after stopping semaglutide can help ensure your withdrawal process is as safe as possible.
How long does it take semaglutide to get out of your system?
At its typical dose, semaglutide has a half-life of 7 days and is administered once weekly for 4–5 weeks to achieve steady state, or consistent levels in the body. After stopping semaglutide, it can take that same amount of time for it to be fully eliminated from your system.
Ways to limit withdrawal symptoms
It’s not always possible to eliminate withdrawal symptoms when stopping a medication, but several factors can help.
Tapering
Semaglutide is intended to be a long-term medication, but if you need to stop, your doctor may taper your dose to help your body gradually adjust to less GLP-1 support.
Stopping under professional guidance
If you’re using the Food and Drug Administration (FDA)-approved semaglutide weight loss formulation, Wegovy, it can be tempting to stop taking it without consulting your doctor once you’ve lost weight. Stopping completely, or trying to self-taper your dosage, could result in worse withdrawal symptoms or side effects.
Having a plan in place
When you know you’re going to stop semaglutide, creating a plan with your doctor to compensate for possible rebound effects can help. Setting dietary goals, for example, or adding protein to help you feel fuller at mealtime, may help combat the natural effects of coming off semaglutide.
Bottom line
Semaglutide is the active ingredient in Ozempic, Wegovy, and Rybelsus. As a GLP-1 receptor agonist, it works in your body to support natural GLP-1 hormone functions.
When you stop taking semaglutide, your body will go through a process of re-regulation which may cause rebound effects and other symptoms of withdrawal.
Tapering medication slowly and working closely with your doctor as you stop semaglutide can help reduce the severity of semaglutide withdrawal symptoms.