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Mounjaro is a prescription medicine used to support weight management. It is also licensed for type
2 diabetes. It works best when combined with healthy eating, increased activity, and regular
medical follow-up.
■ How Does it Work?
Mounjaro works by mimicking two natural hormones in the body, GLP-1 and GIP. Together they
help to:
• Reduce appet
Mounjaro is a prescription medicine used to support weight management. It is also licensed for type
2 diabetes. It works best when combined with healthy eating, increased activity, and regular
medical follow-up.
■ How Does it Work?
Mounjaro works by mimicking two natural hormones in the body, GLP-1 and GIP. Together they
help to:
• Reduce appetite – you feel full sooner and stay full longer
• Slow down stomach emptying – food stays in your stomach longer
• Improve blood sugar control – especially helpful if you have diabetes or are at risk
■ How Do I Take It?
Mounjaro comes as a once-weekly injection using a pen device. It is injected under the skin
(tummy, thigh, or upper arm). You can take it at any time of day, with or without food.
Week Dose
1–4 2.5 mg once weekly (starting dose)
5–8 5 mg once weekly
9–12 7.5 mg once weekly
13–16 10 mg once weekly
17–20 12.5 mg once weekly
21+ 15 mg once weekly (maximum dose)
■ Tips for Taking Mounjaro
• Inject once a week, on the same day each week
• Rotate injection sites each week
• If you miss a dose, take it within 4 days; if more than 4 days have passed, skip it and continue
as normal
• Store unused pens in the fridge; once in use, pens can be kept at room temperature (up to
30°C) for 21 days
■ Common Side Effects
• Nausea, vomiting, diarrhoea, or constipation
• Reduced appetite
• Tiredness or headache
• Mild redness or swelling at the injection site
Contact your doctor if symptoms are severe, persistent, or if you notice abdominal pain that does
not go away.
■ Monitoring
Your doctor will review your weight, progress, and any side effects regularly. Treatment may be
adjusted depending on how you respond. Progress is usually checked after 16 weeks on the 5 mg
dose or higher.
https://www.medicines.org.uk/emc/files/pil.15481.pdf

Wegovy is a prescription medicine used for weight management. It works best when combined with
healthy eating, increased activity, and regular medical follow-up.
■ How Does it Work?
Wegovy mimics a natural hormone in the body called GLP-1. It works in several ways to support
weight loss:
• Reduces appetite – helping you feel full sooner and st
Wegovy is a prescription medicine used for weight management. It works best when combined with
healthy eating, increased activity, and regular medical follow-up.
■ How Does it Work?
Wegovy mimics a natural hormone in the body called GLP-1. It works in several ways to support
weight loss:
• Reduces appetite – helping you feel full sooner and stay full longer
• Slows down stomach emptying – food stays in your stomach longer
• Supports blood sugar control – reducing cravings and stabilising energy levels
■ How Do I Take It?
Wegovy is taken once a week as an injection under the skin (in your tummy, thigh, or upper arm).
You can take it at any time of day, with or without food.
Weeks Dose
1–4 0.25 mg once weekly
5–8 0.5 mg once weekly
9–12 1.0 mg once weekly
13–16 1.7 mg once weekly
17+ 2.4 mg once weekly (maintenance dose)
■ Tips for Taking Wegovy
• Inject once a week, on the same day each week
• Rotate injection sites each week
• If you miss a dose and it is within 5 days, take it as soon as possible. If more than 5 days
have passed, skip it and continue as normal
• Store unused pens in the fridge; once in use, pens can be kept at room temperature (up to
30°C) for 6 weeks
■ Common Side Effects
• Nausea, vomiting, diarrhoea, or constipation
• Headache or tiredness
• Mild redness or swelling at the injection site
Contact your doctor if symptoms are severe, persistent, or if you notice abdominal pain that does
not go away.
■ Monitoring
Your doctor will review your weight, progress, and any side effects regularly. Treatment is usually
reassessed after 16 weeks on the 2.4 mg dose to check effectiveness.

Saxenda is a prescription medicine used to support weight management. It works best when
combined with healthy eating, increased activity, and regular medical follow-up.
■ How Does it Work?
Saxenda is similar to a natural hormone in the body called GLP-1. It helps to:
• Reduce appetite – you feel full sooner and stay full longer
• Slow down st
Saxenda is a prescription medicine used to support weight management. It works best when
combined with healthy eating, increased activity, and regular medical follow-up.
■ How Does it Work?
Saxenda is similar to a natural hormone in the body called GLP-1. It helps to:
• Reduce appetite – you feel full sooner and stay full longer
• Slow down stomach emptying – food stays in your stomach longer
• Support blood sugar control – helpful if you are at risk of diabetes
■ How Do I Take It?
Saxenda comes as a daily injection using a pen device. It is injected under the skin (tummy, thigh,
or upper arm).
Week Dose
1 0.6 mg once daily
2 1.2 mg once daily
3 1.8 mg once daily
4 2.4 mg once daily
5+ 3.0 mg once daily (usual full dose)
■ Tips for Taking Saxenda
• Take it at the same time each day, with or without food
• Rotate injection sites each day
• Store unused pens in the fridge; once in use, can be kept at room temperature for 30 days
• Never share your pen with anyone else
■ Common Side Effects
• Nausea, vomiting, diarrhoea, or constipation
• Headache or tiredness
• Mild redness or swelling at the injection site
Contact your doctor if symptoms are severe, persistent, or if you notice abdominal pain that does
not go away.
■ Monitoring
You will have regular follow-up with your doctor to review your progress, weight loss, and any side
effects. Treatment is usually reassessed after 16 weeks to check effectiveness.
LBP4.086
Innovative Digital Weight Management: Real-World Outcomes
from Weight Loss Wales
Davies, A. L.
Clinical Director, Weight Loss Wales, United Kingdom
Obesity remains a significant public health burden in the UK, with prev-
alence continuing to rise, leading to increased rates of type 2 diabetes,
cardiovascular disease, and reduced quality of life. Despite the growing
availability of pharmacological treatments, adherence to anti-obesity
medications remains a challenge, necessitating smarter, more innovative
approaches to ensure safe and effective weight management.
Weight Loss Wales became the first Healthcare Inspectorate Wales accred-
ited and approved virtual weight management clinic in Wales, utilizing
a fully digital approach to patient consultations. By integrating virtual
assessments with close, ongoing patient engagement via WhatsApp, text
messaging, and email, the service provided continuous support while
optimizing adherence to treatment.
This study presents real-world data from the first 100 patients initiated on
semaglutide or tirzepatide for weight management. Key findings include:
• 96% of patients remained on treatment for at least six months.
• The average weight loss at six months was 19kg, demonstrating signif-
icant efficacy.
• The average dose of tirzepatide used was 7.7mg, highlighting a gradual
patient centric titration approach within a virtual setting.
Davies, A.L. (2025) ‘Innovative digital weight management: real-world outcomes from Weight Loss Wales’, Obesity Facts, 18(Suppl 1), p. LBP4.086. Presented at the 32nd European Congress on Obesity (ECO 2025), Málaga, Spain, 11–14 May. doi:10.1159/000545968.
Davies, A.L. et al. (2025) ‘12-Month Real-World Outcomes From Wales’ First Fully Accredited Remote Obesity Clinic’, ObesityWeek 2025, Atlanta, GA, USA, 5 November. Poster presentation (Poster 264).LBP4.086
Background:
Obesity remains a major contributor to chronic disease in the UK, driving increased rates of type 2 diabetes, cardiovascular events, and healthcare system strain. The advent of GLP-1 receptor agonists, such as semaglutide, marked a significant advancement in pharmacological weight management. More recently, the introduction of dual GIP/GLP-1 receptor agonists, such as tirzepatide (launched in the UK in February 2024), has offered further promise, delivering greater efficacy through combined hormonal pathways. However, real-world data evaluating long-term outcomes, persistence, and tolerability—particularly within virtual care models—remain limited. Objective: To evaluate 12-month real-world outcomes from Weight Loss Wales, Wales’ first fully remote, Healthcare Inspectorate Wales-accredited obesity clinic, in patients initiated on semaglutide or tirzepatide during the first year of dual once-weekly therapy availability in the UK.
Methods:
Between February 2024 and February 2025, the first 100 patients who were initiated on semaglutide or tirzepatide and managed entirely remotely were followed up. Care included digital onboarding, virtual consultations, monthly reviews, and open clinician access via WhatsApp, SMS, and email. Consultations included education on the mechanism of action, expected effects, and side effect management strategies. Clinical outcomes, treatment persistence, dose adjustment, safety, and healthcare utilisation were assessed and benchmarked against STEP and SURMOUNT trial data.
Results:
• 91% of patients remained on therapy at 12 months, demonstrating strong long-term persistence. • Of the 9% who discontinued, only 2% did so due to side effects, while 7% discontinued due to financial constraints. • Average weight loss was 24.8kg, sustained across the cohort. • 23% of patients required a dose de-escalation at some point over the 12-month treatment period, typically in response to tolerability or patient preference. • Patients initiated an average of 3.2 clinical contacts per month, excluding administrative or medication-related interactions, supported via WhatsApp. • No A&E attendances or primary care consultations related to treatment were recorded. • No prescriptions were required for the management of side effects, indicating effective anticipatory support and minimal need for adjunctive interventions. • These real-world results compare favourably with discontinuation rates due to side effects seen in SURMOUNT-1 (6.2%) and STEP-1 (4.5%).
Conclusions:
This first-year evaluation following the UK introduction of tirzepatide demonstrates that a fully remote model of obesity care can deliver high treatment retention, substantial weight loss, and excellent tolerability. The low discontinuation rate for side effects (2%), absence of healthcare resource use, and no requirement for side-effect prescriptions reflect the success of early, accessible, and proactive support. Importantly, careful consultation—including explanation of mechanism of action and anticipatory guidance—may have contributed to improved adherence and patient confidence. These findings confirm that remote care, when structured and supported by direct clinician access, is not substandard—it is gold standard. Weight Loss Wales offers a scalable, effective, and sustainable blueprint for delivering high-quality obesity management across the NHS and beyond.
Davies, A.L. et al. (2025) ‘12-Month Real-World Outcomes From Wales’ First Fully Accredited Remote Obesity Clinic’, ObesityWeek 2025, Atlanta, GA, USA, 5 November. Poster presentation (Poster 264).
Background:
GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists have transformed obesity pharmacotherapy, offering clinically significant weight loss. However, gastrointestinal side effects remain a leading cause of treatment discontinuation in clinical trials and real-world settings. While virtual care offers accessible treatment models, concerns persist about adequate support and patient retention. Patient understanding of the mechanism of action (MoA) may be a critical but under-recognised driver of adherence and tolerability.
Methods:
This observational analysis examined outcomes from the first 100 patients initiated on semaglutide or tirzepatide at Weight Loss Wales, the first fully remote, Healthcare Inspectorate Wales-accredited obesity clinic following the launch of the 2nd once weekly agent indicated for weight management in the UK . Between February 2024 and February 2025, patients received structured education explaining the mechanism of action, titration, and anticipated side effects during virtual consultations. Ongoing support was provided via WhatsApp, SMS, and email, allowing rapid intervention and real-time communication. Clinical outcomes, persistence, healthcare utilisation, and use of adjunctive medications were assessed and benchmarked against published STEP-1 and SURMOUNT-1 trial discontinuation rates.
Results:
At 12 months, 91% of patients remained on therapy. Only 2% discontinued due to side effects, significantly lower than rates in SURMOUNT-1 (6.2%) and STEP-1 (4.5%). No prescriptions for antiemetics or other side-effect management medications were required. Dose de-escalation occurred in 23% of patients, typically in response to patient-reported tolerability issues, addressed proactively. The average weight loss was 24.8 kg. No A&E attendances or primary care consultations related to treatment were recorded.
Conclusions:
Structured education on mechanism of action and proactive, accessible clinician communication were associated with reduced discontinuation, fewer side effects, and no requirement for adjunctive prescribing. These findings support the hypothesis that informed patients are more adherent and better prepared to manage treatment expectations. Remote care, when grounded in education and real-time support, can match or exceed traditional models in safety, tolerability, and persistence.
Davies, A.L. et al. (2025) ‘MoA Education Reduces Side Effects and Enhances Persistence in Remote Obesity Treatment’, ObesityWeek 2025, Atlanta, GA, USA, 5 November. Poster presentation (Poster 265)
Acquisition costs and weight reduction
Evans, M., Evans, W., Godbeer, F., Edgar, L., Spaepen, E. and Davies, A.L. (2025) ‘Analysis of tirzepatide acquisition costs and weight reduction outcomes in the United Kingdom: insights from the SURMOUNT-1 study’, Advances in Therapy, 42(6), pp. 2821–2832. doi:10.1007/s12325-025-03194-8.
Wang, W., Chen, R., Lloyd Davies, A., Guo, J., Bo Jensen, T., Li, Y., Luo, B., Ye, X., Zhang, K. and Ning, G. (2023)‘IDF2022-0613 PIONEER 11: Efficacy and safety of oral semaglutide versus placebo in predominantly Chinese patients with T2D treated with diet and exercise’, Diabetes Research and Clinical Practice, 197 (Suppl 1), 110316. doi:10.1016/j.diabres.2023.110316.
Knop, F.K., Cariou, B., Christiansen, E., Davies, A.L., Montanya, E., Abildlund, M.T. & Rosenstock, J. (2021) ‘Time spent in glycaemic control after initiating treatment with oral semaglutide vs empagliflozin: an exploratory analysis of the PIONEER 2 trial’. 57th Annual Meeting of the European Association for the Study of Diabetes (EASD 2021), Abstract 480, pp. 249–250.
Davies, A.L., Khunti, K., Capehorn, M., Artime, E., Spaepen, E., Adam, A., Lin, X., Shang, M., Seager, S. and von Arx, L.-b. (2024) ‘The UK Obesity Landscape: Results from the UK Primary Care Cohort of the IMPACT-O Study’, International Journal of Obesity, 48(Suppl 1), P84. doi:10.1038/s41366-023-01431-0.
Mounjaro v Wegovy
Tirzepatide 10 and 15 mg were associated with statistically significant
greater reductions in weight, BMI and HbA1c versus semaglutide.
Mounjaro v Wegovy
The pooled analysis showed greater
weight loss with tirzepatide compared to semaglutide

Mysimba is a prescription-only oral medication used alongside a reduced-calorie diet and increased
physical activity. It is licensed for adults with BMI ≥30, or BMI ≥27 with a weight-related condition
such as type 2 diabetes, high blood pressure, or dyslipidaemia.
■ How Does it Work?
Mysimba combines two medicines – naltrexone and bupropion – that act on the brain to:
• Reduce appetite and cravings
• Help you feel full with less food
■ How Do I Take It?
Mysimba is taken as tablets by mouth. The dose is increased gradually over 4 weeks.
Week Dose
1 1 tablet in the morning
2 1 in the morning + 1 in the evening
3 2 in the morning + 1 in the evening
4+ 2 in the morning + 2 in the evening (maximum dose)
■ Effectiveness & Review
Treatment should be stopped after 16 weeks if you have not lost at least 5% of your starting weight.
Studies show average weight loss of around 8% after 56 weeks with Mysimba.
■ Common Side Effects
• Nausea, vomiting, constipation
• Headache, dizziness, dry mouth
• Insomnia (trouble sleeping)
■■ Mysimba may cause drowsiness or dizziness. Do not drive or operate machinery until you know
how it affects you.
■ Monitoring
Regular follow-up with your doctor is important to review progress, side effects, and whether
treatment should continue.

Orlistat is a medicine used to help with weight loss. It works best when combined with a
reduced-calorie diet and regular physical activity. It is suitable for adults with a BMI ≥30, or BMI ≥28
with a weight-related health condition.
■ How Does it Work?
Orlistat works in your digestive system by blocking the absorption of around one-third of the fat from
the food you eat. This undigested fat passes through the gut and out of the body in your stool. By
reducing the calories you absorb from fat, Orlistat helps with weight loss.
■ How Do I Take It?
• The usual dose is 120 mg three times a day.
• Take immediately before, during, or up to 1 hour after a main meal containing fat.
• If a meal is missed or contains no fat, skip the dose.
• Swallow the capsule whole with water.
■ Tips for Taking Orlistat
• Follow a balanced, reduced-calorie diet with about 30% of calories from fat.
• Spread your daily fat intake evenly across three meals.
• Take a daily multivitamin at bedtime (or at least 2 hours after taking Orlistat) to prevent
vitamin deficiencies (A, D, E, K).
■ Common Side Effects
• Oily or fatty stools
• Urgent or increased bowel movements
• Flatulence with oily spotting
• Abdominal discomfort
These side effects are more likely if you eat a high-fat meal.
■ Monitoring
Your doctor will review your progress after 12 weeks. If you have not lost at least 5% of your
starting weight, treatment may be stopped. Regular follow-up ensures safe and effective use.

The most common side effects observed in clinical trials were nausea and diarrhoea, these were mild/moderate in severity, and usually of short duration and most frequently reported during the first few months on treatment.
Read the patient leaflet and information you have been provided and contact us on the number you have been given or via the contact us page.
Following the 4th dose of Tirzepatide there will be a quantity of solution left in the pen device.
Patients have the autonomy to choose their preferred exercise modality, thereby optimizing treatment outcomes. In addition, this novel systematic review included a dose-response meta-analysis, which showed that aerobic exercise required 140 min per week to improve depressive symptoms
Effective: January 3, 2026
“We”, “us” or “our” means Weight Loss Wales, with its principal place of business located at 3 Dan-Y-Bryn Close Radyr Cardiff South Glamorgan GB CF15 8DJ.
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If you have any questions, concerns or complaints regarding this Privacy Policy or how we use your personal information please contact us via e-mail at enquiries@weightlosswales.com.
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If you have questions or concerns about the information in this Privacy Policy, our handling of your personal information, or your choices and rights regarding such use, please do not hesitate to contact us at:
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Weight Loss Wales
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