Prescription Weight Loss Pills and Injection

When Should you Consider Losing Weight?

To understand when it may be time to lose weight you should consider your body mass index (BMI). This tool uses your height and weight to give a number determining how healthy your current weight is. 

• Underweight = <18.5
• Healthy range = 18.5 to 24.9
• Overweight = 25-29.9  
• Obese = >30

While useful in identifying whether you are carrying too much weight, it does not consider what type of weight this is. BMI will not distinguish the difference between fat, muscle or bone. It often classes very muscular adults as overweight or very low muscle adults as healthy even when they have high body fat percentages. 

For this reason, body fat percentage is a more reliable indicator of obesity. Body fat percentages of over 25% are defined as obese.

Obesity in the UK is a major health concern with 64.2% of UK adults and 37% of children considered overweight or obese.

The Risks of Obesity

Whilst being obese generally does not pose immediate threats to your health, the long term risks of being overweight or obese are:

• Cardiovascular diseases - high blood pressure, heart attack, stroke.
• Sexual dysfunction - women: infertility and irregular menstrual. Men: erectile dysfunction.
• Cancer of the uterus, ovary, breast, prostate, liver colon, oesophagus, and kidney.
• Low self-esteem 
• Sleep apnea 
• Osteoarthritis
• Digestive diseases
• Type 2 diabetes

What are the Health Benefits of Weight Loss?

The risks of obesity listed above have all have been proven to drop a clinically significant amount with this 5% drop in weight.

What Causes Weight Gain?

The body will gain weight if the calories taken if by food and drinks exceeds what the body is using. This excess of calories is stored as energy in the form of fat resulting in weight gain.

Poor Diet

Men on average will use 2500 calories daily and woman 2000 calories. A diet having less than these amounts will result in weight loss. Eating habits that tend to put people over these limits are:

• Fast food - high in fats and sugars
• Alcohol - high in calories and sugars
• Overeating - Large portion sizes 
• Sugary drinks- Juices, soft drinks, and milkshakes are all high in sugars.

Lack of Exercise

Exercise increases the number of calories burned each day. This plays a large role in balancing whether your body uses or stores fat each day. 

Medicines

Side effects of some medicines may cause weight gain. Some examples include:

• Antipsychotics
• Birth control
• Antiepileptics
• Oral corticosteroids

Weight gain that you suspect your current medicines are causing should be discussed with your GP.

Medical conditions

A number of medical conditions can cause you to gain weight including:

• Cushing’s syndrome
• Depression
• Insomnia
• Hypothyroidism
• Diabetes types 1 and 2 

If you believe your medical condition is causing you to gain weight, seek out medical advice for long term treatments for both the underlying condition and weight loss.

Treatments

Orlistat and Saxenda are both designed to help assist with weight loss alongside diet and exercise. For the best results create a weight loss plan that includes healthy eating, physical activity, and weight loss pills and injections only if necessary to help reach a healthy weight.

Weight Loss Pills

A weight-loss treatment we can prescribe is Orlistat (Xenical/ Alli). This medicine stops the body from absorbing 30% of the fat from meals. This reduction in fat absorption reduces overall daily calorie intake. Orlistat is taken before, during or one hour after each major meal.

It may only be prescribed to patients with a BMI of over 30 or >28 with other weight-related conditions.

Orlistat also acts as a deterrent for high-fat foods due to the stomach discomfort experienced if you do eat a high-fat meal.

Side effects may include fat in the stool, poorly smelling stool (due to high-fat content), increased flatulence, floating stools, gastric upset if taken with a high-fat meal.

Weight Loss Injection

A new type of weight loss medication in the UK is Saxenda, an injectable medicine. This medicine is used much like insulin and comes in an injectable pen that’s injected into the fat under the skin. 

It works by regulating the way the body naturally gets hungry. Changing your appetite leads to eating few calories and losing weight.

Saxenda’s dose is started low and increased slowly up to the maintenance dose.

Saxenda can only be prescribed to patients with a BMI of over 30 or >27 with other risk factors at a doctor’s discretion.

Side effects of this weight loss injection include:

• Nausea
• Vomiting
• Diarrhoea or constipation

Refer to our Saxenda page or the patient information leaflet for more information

Weight Loss Surgery

This is also known as bariatric or metabolic surgery. It is typically used only for the treatment of people who are very obese with few options remaining. The NHS will sometimes cover this surgery for patients if they fit the criteria.

Lap Band

An inflatable band is placed around the stomach creating a small pocket above. Smaller meals then result in you feeling full.

Gastric Bypass

A part of your stomach is attached further down the intestine, thus bypassing a large section where calories are usually absorbed. 

Gastric Sleeve

The majority of the stomach is removed during this procedure (80-85%). This smaller stomach requires less food to make you feel full.

Lifestyle Changes to Lose Weight

Diet

Changes to eating habits are the most important changes to make to lose weight. Keeping the number of calories you consume under your daily intake guarantees weight loss. This can be difficult which is why medicines are aimed at assisting with reducing daily calories, while the long term eating habits are changed.

Short term diet changes may yield good results, however, these are usually short-lived as the weight tends to return after the diet ends and eating habits revert back.

Short term fad diets tend to be unsustainable as they restrict eating to very few food groups which are unrealistic long term. The best sustainable solution to long term weight loss is a balanced diet containing an appropriate amount of each food group. For more information, you should speak to a dietitian or GP who can tailor a weight loss plan diet for you.

Exercise

Once calory intake has been lowered, now increased exercise can be introduced. Exercise will increase the number of calories the body uses, burning fats once calories used exceeds intake. Thirty minutes of physical activity a day can drastically increase weight loss. 

You may want to talk to a personal trainer for instruction and safety while your body adjusts to the change in daily exercise.