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Procedure Time: Ongoing medically-led weight loss programme
Recovery Time: No downtime
Results Duration: Long term, lifestyle changes and medical supervision required
Cost: Varies, often a monthly payment programme
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The need to achieve significant weight loss, due to obesity, is a growing problem. For those seeking medical intervention to help them through this journey, there are medically-led, anti-obesity solutions such as prescribed weight loss medication or slimming pills. These are available through private clinics. Anti-obesity medication and advice from a weight loss specialist clinic is a safe alternative to bariatric surgical procedures such as gastric banding, sleeve gastrectomy or gastric bypass. Weight loss medication works by either reducing your appetite, so you consume fewer calories, by reducing absorption, so fewer calories enter your blood stream, or by increasing fat burning. Slimming pills are a safe option to assist with a weight loss programme for some people, but must be prescribed and monitored by a medical professional following proper consultation. Do not be tempted to purchase slimming pills from unknown sources online as this can be very dangerous.
Obesity is a growing problem within the UK and across the globe, with many people now seeking professional help to achieve significant weight loss through both surgical and non-surgical solutions, as well as weight loss programmes and medically-led interventions such as prescribed anti-obesity medication, more commonly referred to as slimming pills.
A distinction needs to be made between those seeking medical intervention for obesity, and those seeking a cosmetic or health benefit if they are above their ideal weight. There are also others who are seeking an ideal size, but who are not overweight, and therefore may be more suited to body contouring treatments. These are all very different problems, and the solutions for each group are not the same.
In all cases, embarking on a weight loss programme involving supplements or prescribed slimming pills, should only be done in conjunction with medical advice. There have been some well publicised cases where people have used self-sourced slimming pills, without seeking medical advice and a proper prescription for approved medication, and this has led to fatal consequences.
All weight loss medication has one of three modes of action. They either work by:
• reducing your appetite (anorectics), so you consume fewer calories;
• by reducing absorption, so fewer calories enter your blood stream;
• or they increase fat metabolism (fat burning).
There are some prescribed treatments that can achieve the first two modes of action, but drugs that boost metabolism often have side effects that may be counterproductive, and are therefore not widely used.
Dangers of Buying Slimming Pills on The Internet
There are numerous types of slimming pills available online. Most of them are plant extracts and are used as a supplement to your diet, so are not classified as a drug. They do not have to conform to medicines regulation, or be approved by the Medicines and Healthcare products Regulatory Agency (MHRA). They vary considerably in price and concentration of active ingredients.
Up to 50% of the slimming drugs or medicines available over the Internet are counterfeit. At best, they may be harmless, but without a license, proof of what they contain, and without medical supervision, they could and do endanger life. Most of their benefits are claimed with no research into how they are metabolised or incorporated into the body, let alone their effect on cells or biochemistry. Most of them have failed any of the few independent tests in trials that have been conducted on them. They also frequently fail quality and quantity testing, and none have been tested extensively in a large scale clinical trial. You should not risk attempting to purchase and use such unrecognised medication. There are no short cuts to sustained weight loss and taking a gamble on pills bought over the Internet is simply not worth the health risk, despite the lure of a cheap and quick solution.
Properly licensed medication is used by private healthcare clinics who specialise in weight loss management. Although it is tempting to research the types of medication that they use, and then attempt to source it yourself; using it without medical supervision is very dangerous. Private clinics are usually working with people whose health is compromised from their excessive weight, and have been diagnosed with clinical obesity. The type of medication prescribed is generally not meant for those who are seeking to just ‘lose a few pounds’ so this is why medical consultations and proper evaluation of your particular weight loss journey is paramount.
In medically-led clinics, anti-obesity medication and supplements are being used as part of a whole, supported weight loss programme. The medicines prescribed by a medical professional will be licenced drugs, which have been extensively tested in clinical trials and found to be effective and safe.
If you are considering a programme of anti-obesity treatment, including medically prescribed weight loss or slimming drugs; the following information will give you a basic understanding of the treatment. It can't answer all your questions, since a lot depends on the individual. Please ask a practitioner about anything you don't understand.
Obesity is defined as having a Body Mass Index (BMI) of greater than 30. The BMI is calculated by the body mass or weight in kilograms divided by the height of the person in metres squared. A healthy BMI should be between 18.5 and 24.9. The NHS website has a handy calculator that will calculate it for you using imperial or metric measurements.
These days it is considered a somewhat crude assessment tool, and can be misleading, but still gives an idea of your weight situation, and likelihood for being obese. Muscle weighs more than fat, so if you take a lot of exercise and have a lot of body muscle, this can sometimes make your BMI increase, but lean healthy muscles are naturally preferable to body fat.
A reduction in fat, or body mass, is achieved by reducing food intake (eating fewer calories) or by increasing food expenditure (through more physical activity). In practice, the combination of both maintains muscle mass so that body fat is used to provide the energy that the body needs. Without exercise any loss in body mass will include a reduction in muscle protein. It is the muscles in your body that use energy from food, so any weight loss programme should address this to ensure that you are not metabolising the useful muscle component of your body.
Seeking advice from a specialist, medically-led weight loss clinic is probably the safest and most reliable method of achieving life changing weight loss without resorting to bariatric surgery procedures such as gastric banding, sleeve gastrectomy or gastric bypass.
However, it can be expensive. Generally, slimming down with a bespoke weight loss programme, including medication, can be costly, but if it can help you to regain long-term control of your eating, then it is worth consideration. The OMA has worked out that paying for a medically-led weight loss treatment programme might only be as costly as paying for ineffective medication or supplements, which could be harmful, or for any other weight loss course of food supplements or meal replacements (shake drinks etc.) or diet meal plans, all of which are widely available online and through high street chemists. The most important benefit from seeking professional help is the input you will get from a medically qualified practitioner, who is motivated to help you to lose weight responsibly and successfully, whilst also considering all medical concerns.
Bariatric surgery is also available privately, but is more expensive than a specialised diet, exercise and medication programme for weight loss. Surgical options are the last resort for successful weight loss.
There are many clinics offering weight loss solutions and programmes. Some specialise in obesity, others offer a more general weight loss plan. Whatever anti-obesity treatment or medically-led weight loss programme is prescribed for you, you should be able to regularly attend the clinic.
Seeking a specialist clinic, who can provide you with proven solutions, which may include prescribed medication, is the best option for a successful outcome to your weight loss journey. Those clinics belonging to the Obesity Management Association would be recommended.
Medically-Led Weight Loss
As with many aspects of life, sharing your concerns about your body size allows you to begin to tackle it. This is how programmes such as Weight Watchers work, or other groups set up to share and support for an issue, such as a drug or alcohol addiction. Just making the decision to attend, and sign up for a group, brings the problem out into the open and to the attention of those around you who can offer support.
Deciding to seek medical advice from a private clinic has the added benefit of a financial commitment and support from a doctor. Those clinics that offer a long-term solution, which includes an on-going health check to ensure that you keep the weight off, are the greatest incentive. Knowing that you have paid for the sessions and that all aspects of your diet, exercise routine, and general wellbeing are going to be under scrutiny can provide the incentive to those who fail on their own.
These clinics approach weight loss from a results-led, evidence-based standpoint which relies on solid clinical research. Most medically-led clinics specialising in weight loss medication offer a medical consultation and assessment prior to starting on a course of treatment and support. A health check to calculate BMI is a common starting point. In adults, over the age of 20, a BMI of 30 or higher is categorised as obese; over 25 is overweight.
For people who are within a BMI of 25-34 and who do not want to put on any more weight, anti-obesity treatment with a medically-led medication and weight loss programme may be a valid option, but it is always advisable to seek help and advice from your own GP beforehand.
Private clinics can take a slightly different approach than public healthcare professionals, to treating those who are overweight or obese. They are willing to help people who would like to avoid becoming obese, as well as those who already have this treatable illness. It is worth noting that the consensus is that over eating is an illness and can be treated. Most private weight loss specialist clinics will treat people with a BMI of 27 if they have co-morbidity factors such as hypertension (high blood pressure), type II diabetes, cardiovascular (heart) disease, sleep apnoea, osteoarthritis, dyslipidaemia (high blood cholesterol) or certain types of cancers. Or they will treat those with a BMI of 30 and above, who present with no co-morbidity factor.
Prescribed Medication (Slimming Pills) and Weight Loss Programmes
The most commonly prescribed medication, in conjunction with a restricted diet and increased exercise programme, contain either phentermine or diethylpropion as an appetite suppressant, or xenical to prevent the absorption of fats. Appetite suppressants are most commonly used as they present fewer side effects.
Some may also offer a gel-like bulking agent, which is added to food, or as a supplement, to make you feel full. The doctor may also prescribe anti-depressant or anti-insulin medication, depending on your medical needs. Some may offer harmless herbal pills, rather than a prescribed drug, alongside a programme that reduces food intake and promotes exercise.
Some clinics offer nutritional replacement meals or snacks that are high in protein, and low in fat and sugar, and can also act as an appetite suppressant.
All practitioners will advise a low fat and low sugar diet and promote healthy eating, such as plenty of vegetables, salads and fresh fruit, which are all high in fibre and contain vitamins and minerals. An increase in activity is also advised. This can be quite gentle to begin with, for example, walking more frequently and taking stairs rather than lifts or escalators. The programme then progresses to include more aerobic activity such as brisk walking, jogging or swimming.
Many people find the beneficial effects of exercise improves their mood and general well-being. Moderate exercise has been shown to be beneficial in mild cases of depression, which is a known factor in those suffering from weight issues.
Anyone whose BMI shows that they are overweight or obese should be able to access anti-obesity and weight loss programmes with medically-led clinics. Depending on the clinic, and the methods that they employ, they should be able to help you to lose weight over an agreed period using a combination of medication or supplementation and a weight loss programme, which will vary depending on each person’s circumstances. The programmes tend to last from 3 months to 2 years, but can be renegotiated as progress is made.
Careful discussions regarding your reasons for wanting weight loss treatment or anti-obesity medication are very important. You must also make sure that this treatment can deliver what you want, and how you would like to look and feel afterwards. Your practitioner should be able to answer all these questions.
A medical history should be taken to make sure that there are no reasons why you shouldn’t undertake a weight loss programme. All medical conditions and medication should be disclosed to avoid any potential problems, even if they don’t seem to be relevant to your weight problem. You may be asked to sign a consent form which means that you have understood the potential benefits and risks associated with any prescribed medication or weight loss programme.
The clinic will then measure your height and weight to calculate BMI. They will also measure your vital statistics for example your waist size, chest size and thighs. Your blood pressure will be taken, and some clinics may measure your body fat percentage. These statistics can be used to monitor your progress and to help to motivate you.
Photographs may also be taken by the practitioner for a "before and after" comparison at a later date.
You will be asked to keep a record of your eating in a food diary, and record your activity, so that your diet can be tuned to your metabolic rate, which varies depending on the amount of exercise you do. Calculations of body fat percentage and regular checking of other vital statistics may be offered as a means of following progression.
You will be set a restricted diet and exercise plan and will return to the clinic for assessment regularly during the programme. The appointments may begin weekly, and then reduce to every two weeks, or once a month, as progress is made. The diet and exercise programme should keep changing as weight is lost to prevent plateauing and maintain a steady loss in body fat. There should always be good communication between you and the clinic. It is important that you know where to access support and encouragement.
Some of the clinics offering these specialist weight loss programmes and anti-obesity treatments are also cosmetic clinics and can offer medical aesthetic treatments such as ultrasound bodying contouring or radiofrequency treatment to speed up the breakdown of fat under the skin, or target problem areas which are considered stubborn and harder to shift through diet and exercise.
Prescribed medication or slimming pills to tackle obesity do carry some known risks which should be explained to you.
The most commonly reported side effects include: bowel urgency, frequent bowel movements, oily evacuation, oily rectal leakage, steatorrhea (fatty stools), and flatulence with discharge and faecal incontinence.
Phentermine or Diethylpropion
Common side effects include: feeling restless or hyperactive, headache, dizziness, tremors, sleep problems (insomnia), dry mouth or an unpleasant taste in your mouth, diarrhoea or constipation, upset stomach and increased or decreased interest in sex, impotence.
If there are any symptoms other than these common side-effects you should report them to your clinic or doctor immediately.
Only those whose overall health is at risk from being over-weight or obese should be treated with anti-obesity medication. BMI acts as a useful indicator and advice should be given to anyone who is not suitable for this treatment so that they can pursue other weight loss solutions. Pregnant mothers or those breast feeding should not be treated.
Only doctors can prescribe anti-obesity medication, but other medically and non-medically trained staff may take medical background information before your consultation with the specialist. You may have subsequent appointments with a clinic nurse, or other practitioner, to monitor your progress, but the doctor is responsible for your medication and treatment, and altering the programme over time.
The Obesity Management Association (OMA) is a self-regulating, professional association for Doctors, weight management clinicians, private clinics and those engaged in the provision of weight management solutions. OMA is the ethical voice of the obesity management private clinic sector. Look for this accreditation and a locally registered OMA member when choosing a clinic.
Clinics offering weight management, weight loss services, including advice and treatment which may or may not include prescribed medicines (slimming pills) under the supervision of a registered medical practitioner are generally required to be regulated and inspected by a national, government regulator. Look for a clinic that is registered with the Care Quality Commission in England, Health Inspectorate Wales or Health Improvement Scotland.
We would always recommend that you visit your General Practitioner (GP) before embarking on private treatment for weight loss. As well as their advice and guidance, they may also be able to refer you to a local NHS Hospital who can treat you depending on any additional health conditions associated with your weight.
The BMI check, together with a waist measurement and blood pressure check, is also available free of charge through the NHS if you are concerned about being obese. However, if your BMI is less than 30 it is unlikely to result in any intervention, such as prescribed weight loss pills or surgery on the National Health Service. You will likely be provided with diet plans and exercise programmes.
Your GP surgery should always be contacted before you undertake a private consultation for weight loss treatment. This is to ensure that you are aware of any medical conditions that might make your condition a cause for concern, and any medical history can also be made accessible to the private clinic with your permission.
Prices vary depending on which clinic you attend and how long your weight loss programme needs to be. Consequently, clinics are reluctant to advertise their prices. However, if you are making an enquiry they should be able to tell you how much the initial consultation fee would be, and give you a quote for an average six-month programme.
The initial consultation may be free of charge, or can be offset against the cost of the treatment programme. Some clinics offer monthly finance plans and payment schemes.
It is true that there is only one sure fire way to lose weight: eat less and exercise more; yet we know that the number of people who are over-weight or obese in the UK continues to rise, so we must accept that it isn’t straightforward at all.
The National Health Service (NHS) does not have finite resources and there are now strict restrictions on who qualifies for their anti-obesity treatments. Private clinics offer an alternative healthcare solution and a medically-led private clinic can prescribe medication and treat you in much the same way as you would experience through public health services and hospitals, where your progress will be overseen by a doctor.
Anti-obesity medication or slimming pills are a safe option to assist with a weight loss programme for some people, but must be prescribed for the individual and their use monitored. You should not be tempted to purchase slimming pills via the Internet due to the risks of unregulated and unchecked products and ingredients which have been known to kill. Always seek medical advice if you are considering medication for weight loss.
Before embarking on any medicated weight loss programme, you need to ask certain key questions.
• What are the active ingredients in the medication prescribed or recommended?
• What are the side effects?
• What concentration of the active ingredient does the medication contain?
• Is that an appropriate concentration for you?
• What information has been used to back up the claims?
• Is there any evidence that it can achieve weight loss which is sustainable?
As with most things if the claims are too good to be true then they are probably just that!
Sustained and sensible weight loss is a journey, it takes time and commitment and a medically-led weight loss programme can provide you with the advice, support and monitoring which will improve your chances of successful weight loss and improved health.