When lifestyle measures alone are insufficient, anti‑obesity medications (AOMs) can augment weight loss, improve metabolic risk and support long‑term maintenance.
Pharmacotherapy
When We Use Medication
• BMI and comorbidity criteria met per current UK guidance
• Previous lifestyle attempts insufficient
• Part of a supervised, multidisciplinary plan
Medications in Current UK Guidance (overview)
• Tirzepatide (Mounjaro®): dual GIP/GLP‑1 RA; NICE‑recommended for adults typically with BMI ≥35 kg/m² + comorbidity.
• Semaglutide (Wegovy®): GLP‑1 RA; indicated for weight management within defined BMI thresholds.
• Liraglutide (Saxenda®): GLP‑1 RA; for adults with BMI ≥35 kg/m² with hyperglycaemia/CV risk.
• Orlistat (Xenical®/Alli®): lipase inhibitor; BMI ≥30 kg/m², or ≥28 kg/m² with risk factors.
Safety and Side‑Effects (key points)
GLP‑1 receptor agonists:
• Common GI effects during titration: nausea (≈20–40%), vomiting (≈10–20%), diarrhoea (≈15–30%), constipation (≈5–10%).
• Less common risks: gallbladder issues, pancreatitis, delayed gastric emptying (peri‑anaesthetic risk), rare renal effects; avoid with personal/family history of medullary thyroid cancer or MEN2.
Orlistat:
• GI side‑effects (oily stools, urgency, cramps) that usually improve with time and diet.
Medications are prescribed alongside dietetic/behavioural therapy with regular monitoring, dose adjustments and long‑term maintenance planning to minimise weight regain.
Why Dr. Spyros Panagiotopoulos?
Mr. Panagiotopoulos integrates pharmacotherapy within a clear, safe protocol—careful selection, gradual titration, close follow‑up, and coordination with nutrition and psychology to maximise benefit and safety.