Medical Weight Management ServiceMedical diet plans, Prescription weight loss treatment, Lifestyle modification
Since the coronavirus pandemic highlighted the increased risk to those of us who are overweight or obese, we have all become acutely aware of the “other epidemic” of being overweight. The stress of lockdowns, home-schooling, and general uncertainties we faced in 2020 all have led to increased comfort-eating. Add to this the empty calories from having more alcoholic drinks at home, and having access to the fridge all day while working from home, and it is no surprise that we have gained weight, developed unhealthy relationships with food. We have increased our risk of Type 2 Diabetes, heart disease, stroke, some cancers such as breast and endometrial cancer.
Our weight problems are not new, they have just come into the spotlight when we realised that Covid-19 was more dangerous to obese patients, those with diabetes and other complications of obesity. Also, weight management is not just about being overweight – the opposite is true as well.
The fashion of our age is thin. We are regularly surrounded by images supporting the myth that thin – often unhealthily thin – is beautiful. The myth is so prevalent that it is hard to remember that being underweight is associated with problems such as reduced fertility, bone thinning, rapid aging and hormone imbalance. Unfortunately there are many “quick weight loss” solutions being sold online. These may not be effective, and may cause harm when used without medical advise and supervision.
On the flip side, being overweight or obese is proven to increase your risk of most if not all age-related problems. Whether it is hip and knee pains from osteoarthritis, reflux symptoms, hiatus hernia, type 2 diabetes, heart disease, gallstones – all of these are associated with being overweight. It is advisable to address this early, before the health risks increase.
The body mass index or BMI is often used to assess healthy weight. As a rule of thumb:
- a BMI of below 18.5 is associated with menstrual problems, bone thinning, infertility, and general ill-health, and you should make lifestyle changes.
- a BMI of over 25 is considered overweight, can lead to fertility concerns, and means you should consider lifestyle changes to get out of the risk range.
- a BMI of over 30 is directly associated with Type 2 diabetes, osteoarthritis, infertility, increased risk of breast cancer and many more diseases.
However, if you are an athlete or bodybuilder, the standard BMI measures are less accurate, due to the different distribution of body fat.
For the rest of us (who are not professional athletes or bodybuilders), you can easily work out our BMI using this online calculator.
A more significant value is the measurement of your abdominal circumference (or girth), and the ratio of your waist measurement to your hip measurement. This gives valuable information about how the internal fat is distributed in your body. This “body shape” measurement tells us whether your visceral fat (the fat that surrounds your internal organs such as the liver and the heart) is more than it should be.
Dr Aarti Narayan-Denning will take your medical history and previous weight loss efforts to recommend an appropriate treatment plan including lifestyle changes and prescription medication where required. Where it is not advisable for you to take medication for weight loss, you will be advised about this.
What are the criteria for being eligible for the medical weight loss service?
You MUST be:
- over 18 years of age,
- not pregnant or breastfeeding;
- have a BMI over 30; or
- BMI over 27 with any of these conditions: obstructive sleep apnoea, raised cholesterol, raised triglycerides, osteoarthritis, fatty liver; Pre-diabetes – HbA1c 42 – 47; diet controlled diabetes.
For certain ethnicities, medical weight loss can be considered at lower BMI. Calculate your BMI and ethnicity-specific risk here.
The following are Exclusions. If any of these are true for you, you cannot self-refer to the medical weight loss service. However, you can ask your NHS GP, and we will be happy to liaise with them regarding alternative approaches to weight management, without medications.
We cannot currently accept by self-referral, patients who are:
- under 18 years of age
- currently pregnant or breastfeeding
- currently trying to become pregnant
- on injection treatment for diagnosed diabetes
- have a history of thyroid cancer or
- have severe mental health problems.
The medical weight loss service will to be most beneficial to anyone with a BMI of 27 or more. It is particularly suited to anyone who has previously struggled to lose weight, or who has lost weight only to regain it after time. This is because the medical weight loss service targets all aspects of weight loss not just diet alone. The programme also focuses on sustainability, helping participants access and enjoy long-lasting lifestyle changes to ensure their results endure the test of time.
Dr Aarti is registered with the Care Quality Commission, as required for all doctors who provide weight loss services and carry out blood tests for patients in clinic.
This is a prerequisite for the safe assessment of your weight management needs, and for prescription of FDA and MHRA approved prescription medications for weight loss such as Saxenda (Liraglutide 3mg injections), for those patients who are found to be suitable for this following consultation.
Take home messages: There is no magic weight loss bullet. But lifestyle and behaviour change supported by medication where safe will enable you to take control of your weight and future health risk.