Skin&Spirit Medical Weight Loss Programme

If you are unsure whether weight loss medication is for you, which medication you would like or whether you qualify, please choose the free, no-obligation Online Consultation or book the In Clinic Consultation option and our Registered Nurse Prescriber will go through all the options with you based on a medical consultation.

There are currently 3 different weight loss medications available for prescription via the Skin&Spirit Medical Weight Loss Programme:

• Wegovy® (semaglutide) GLP-1
• Mounjaro® (tirzepatide) GLP-1
• Orlistat (fat binder)

Below are the minimum screening criteria for consideration for the Skin&Spirit Medical Weight Loss Programme and weight loss medication.  If you do not meet these criteria, you will automatically be refused entry onto the programme.  (However, we may still be able to provide alternative non-medication based services, such as counselling and/or nutrition advice):

• Minimum age 18
• Not pregnant or breastfeeding
• No history of anorexia nervosa or have a severe mental health diagnosis 
• A BMI ≥30 kg/m² (obesity), or a BMI ≥27 kg/m² with weight/obesity-related comorbidities (e.g., type 2 diabetes, hypertension).

There are also medical contraindications depending on the specific medication required and these will be covered as part of your consultation, along with how to store and take the medication safely, risks, side effects and what to do regarding any issues, concerns, questions or complaints.

 It should be noted that different patients have different preferences for their medication selection.  There are many factors to consider when choosing between Wegovy®, Mounjaro® and Orlistat.  Some patients experience more side effects on one than the other and find that one is more effective for them than the other.

Read on further for more details about each available medication.  This information is provided for education and awareness only to help you make an informed decision.  Requesting a specific mediation will not guarantee you are suitable.  Medicines will only be dispensed by our UK pharmacy partner once our Registered Nurse Prescriber has reviewed and approved your consultation or interim clinical review.

Wegovy® (Semaglutide) is a once weekly self-administered injection.  

Wegovy® works by mimicking a hormone called GLP-1 (part of the group of homornes called incretins) which targets areas of the brain involved in regulating blood sugar, appetite and food intake. It also slows stomach emptying (leading to feelings of fullness for longer) and increases satiety (satisfaction).

These combined effects lead to a calorie deficit and enhanced fat metabolism, which leads to weight loss.

Evidence from STEP trials show that patients using Wegovy® (2.4 mg weekly) lost an average of 15% of their body weight over 68 weeks, compared to 2.4% in the placebo group.

In addition, 50–60% of patients achieved at least 15% weight loss, while approximately 30–35% achieved over 20% weight loss.

Wegovy® is delivered using a prefilled, single-use, disposable injection pen designed for subcutaneous (under the skin) injection. 

Key administration information: 

• Each Wegovy® pen is prefilled with 4 x weekly doses of semaglutide, as per the dose agreed by our Registered Nurse Prescriber.
• Wegovy® comes in 5 different strengths.  Doses available are 0.25 mg (start dose), 0.5 mg, 1.0 mg, 1.7 mg and 2.4 mg (therapeutic and maximum dose).
• It is a once-weekly subcutaneous (into skin and fat) injection, minimizing the frequency of injections.
• Each Wegovy® pen is supplied with 4 disposable, single use, screw-on  27-gauge, 12.7 mm needles.
• The injection is self administered by screwing on the needle, turning the click-based dial all the way, pushing the needle into the skin and pressing the auto-injection button at the end of the pen.  This delivers the medication into the skin and fat.
• Common injection sites include the abdomen, thigh and upper arm.  Patients are advised to rotate injection sites with each dose to prevent irritation or lipoatrophy.
• Needles should be disposed of in a sharps bin.

Mounjaro® (Tirzepatide) is a once weekly self-administered injection.  

Mounjaro®  combines the effects of GLP-1 and GIP, another hormone that regulates blood sugar and fat metabolism. This dual-action approach helps in weight reduction and glucose control. 

Evidence from the SURMONT-1 trial identified that participants on the highest dose of Mounjaro® (15 mg) achieved up to 22.5% weight loss of their body weight on average.

Mounjaro® is delivered using a prefilled, single-use, disposable injection pen designed for subcutaneous (under the skin) injection. 

Key administration information: 

• Each Mounjaro® pen is prefilled with 4 x weekly doses of tirezepatide, as per the dose agreed by our Registered Nurse Prescriber.
• Mounjaro® comes in 6 different strengths.  Doses available are 2.5 mg (start dose), 5.0 mg, 7.5 mg, 10.0 mg, 12.5 mg and 15.0 mg (therapeutic and maximum dose).
• It is a once-weekly subcutaneous (into skin and fat) injection, minimizing the frequency of injections.
• Mounjaro® pens are not supplied with needles by the manufacturer.  However, Skin&Spirit will prescribe and supply 4 needles of any of the following 4 mm, 5 mm, 6 mm, 8 mm, 12.7 mm/gauges: 29G, 31G, 32G, 33G, 34G free of charge.
• The injection is self administered by screwing on the needle, turning the click-based dial all the way, placing the needle into the skin and firmly pushing the button at the end of the pen which pushes the medication into the skin and fat.
• Common injection sites include the abdomen, thigh and upper arm.  Patients are advised to rotate injection sites with each dose to prevent irritation or lipoatrophy.
• Needles should be disposed of in a sharps bin.

Orlistat is a fat binder medication.  This medicine works by decreasing the amount of dietary fat absorbed by the intestine.  It achieves its effect by blocking an enzyme called lipase.  Lipase is responsible for breaking down dietary fat into smaller molecules during the digestion process so that the fat can be used by the body for energy (burning calories) or stored as fat on the body for later use (leading to weight gain).  By blocking lipase, the undigested fat is then passed through the intestines and exits the body through normal bowel movements. 

Orlistat is in capsule form and is taken with meals containing fat, no more than 3 times per day.

There can be some unpleasant side effects with this medication if you eat too much fat, ie. the passing of raw dietary fat via a bowel movement.  This looks orange in colour and is the consistency of oil.  Depending on the dosage and how much fat has been consumed, this can be quite unpleasant for the patient.  However, if taken correctly and the correct diet is followed, Orlistat is a viable alternative to GLP-1 based medication for weight loss.

Each medication has a different recommended dosing schedule, based on evidence obtained from manufacturer clinical trials.  The recommended schedule for each medication is described below, however, note that your Registered Nurse Prescriber may advise a different schedule for you based on your specific circumstances.  For example, many people find they lose weight consistency at a particular dose and they can delay moving up for longer than the standard regime.

Wegovy® (Semaglutide):

• Weeks 1-4:  0.25 mg (start dose)
• Weeks 5-8:  0.5 mg
• Weeks 9-12:  1.0 mg
• Weeks 13-16:  1.7 mg
• Weeks 17+:  2.4 mg (therapeutic and maximum dose

Mounjaro® (Tirzepatide):

• Weeks 1-4:  2.5 mg (start dose)
• Weeks 5-8:  5.0 mg
• Weeks 9-12:  7.5 mg
• Weeks 13-16:  10.0 mg
• Weeks 17-20:  12.5 mg
• Weeks 21+:  15.0 mg (therapeutic and maximum dose

Orlistat:

• 60 mg or 120 mg three times per day with meals that contain fat.

As part of your consultation and acceptance onto the Skin&Spirit Medical Weight Loss Programme, you will be provided with detailed safety information, risks, side effects, how to store and take the medication safely and how to report issues, adverse reactions and complaints.  You will be provided with a detailed patient information pack, access to the Skin&Spirit Medical Weight Loss Programme patient portal and online resources for healthy eating, nutrition and wellness.

You will be able to communicate directly with our Registered Nurse Prescriber via the portal's instant confidential messaging system and will be able to upload your food diaries, medical reviews, blood test results and complete questionnaires and outcome measures via the portal.  This ensures you can get the most out of the programme, stay safe while taking your medicine and be confident that you are following the correct advice if your personal or medical situation changes.

Skin&Spirit is registered with the Care Quality Commission (CQC) (Registration No. 1-2070977895).  We are fully medically licensed to treat obesity and provide medical weight loss services.

Our obesity and weight loss service is also a certified National Medical Weight Loss Programme™, so you can be confident in our professional and regulatory accreditations, experience and commitment to patient safety.

Common Side Effects (GLP1 Agonists, ie. Wegovy® and Mounjaro®):

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Stomach pain
• Loss of appetite
• Indigestion
• Fatigue
• Headache
• Dizziness

Common Side Effects (Orlistat):

• Oily stools
• Diarrhea
• Stomach cramps
• Flatulence (gas)
• Frequent bowel movements
• Inability to control bowel movements
• Nausea
• Headache

Lists above not exhaustive.  For most people, the side effects are usually mild.  

For GLP-1 agnonists, the side effects may lessen over time as the body adjusts to the medication.  However, there are some people who do experience stronger side effects.  This is why is it important that you have medical supervision while taking your medicine.

Losing weight can bring significant health benefits, particularly for individuals who are overweight or obese.  Achieving and maintaining a healthy weight reduces the risk of developing serious health conditions such as type 2 diabetes, heart disease, hypertension, and certain cancers. Furthermore, weight loss can help improve joint health, reduce inflammation, and enhance overall quality of life by increasing energy levels and improving mood and self-esteem.

Obesity, classified as having a body mass index (BMI) of 30 or higher, is associated with numerous health risks that can affect both physical and mental wellbeing.  These risks include an increased likelihood of chronic diseases, difficulty managing other health conditions, and impaired mobility.  When weight gain becomes difficult to control through diet and exercise alone, or when it leads to significant health concerns, losing weight may become essential for overall health improvement.  In such cases, professional medical support, tailored plans, and supervised care can be life-changing, not only in terms of weight loss but also in reducing the risks of these associated health problems.

The Skin&Spirit Medical Weight Loss Programme offers a holistic and medically supervised approach to weight loss. Combining clinically proven medication with comprehensive support and supervision from our Registered Nurse Prescriber, this programme is tailored to meet individual needs and provides the tools necessary for sustainable weight management.  With careful monitoring, expert guidance, and a focus on long-term success, our programme ensures that each patient receives the care they deserve in a safe, supportive environment.

For those who may not be suitable candidates for medication-based weight loss, Skin&Spirit also offers alternative solutions such as counselling, nutrition advice, and personalised diet planning.  We can provide bespoke weight management strategies, especially for individuals with complex needs such as hormonal imbalances, emotional eating, or medical conditions that require additional support.  These services ensure that patients can still access the care they need to reach their weight loss goals, even if medication is not the right choice.

If you're ready to start your weight loss journey, the Skin&Spirit Medical Weight Loss Programme is here to guide and support you every step of the way, helping you make informed choices that will benefit your health and wellbeing in the long term.

 The Skin&Spirit Medical Weight Loss Programme offers a comprehensive, medically supervised approach to weight loss that combines prescribed weight loss medications with full medical oversight by a Registered Nurse Prescriber. 

Unlike purchasing weight loss medication from an online pharmacy, which often lacks personalised support, our programme ensures safety, effectiveness, and continuous care throughout your weight loss journey. With our tailored medical intervention, we focus on your individual health needs, ensuring the right treatment plan and adjustments are made as required. 

Additionally, our programme includes access to an online patient portal and app with instant messaging, giving you direct access to our Registered Nurse Prescriber for any questions or concerns. This ongoing support creates a safe and structured environment for weight loss that is critical to success.

When you choose Skin&Spirit, you benefit from our free, confidential online patient portal, which provide a wealth of resources to enhance your weight loss experience. These features include:

• Instant Messaging: Direct, secure communication with our Registered Nurse Prescriber for ongoing support and advice.
• Tracking Tools: Easily monitor your progress with features that allow you to log weight, meals, physical activity, and more.
• Access to Recipes: Suggested receipes that align with your weight loss goals, including receipes for those with more complex dietary needs or medical conditions.
• Educational Resources: Expert content on topics such as weight loss, nutrition, mental wellbeing, and exercise to empower you with the knowledge needed for success.
• Questionnaires and Outcome Measures:  To track and trend results.

Personalised Weight Loss or Diet/Nutrition Plans: Tailored recommendations and diet plans based on your medical history, lifestyle, and goals can be requested as an optional extra.  This service is chargeable, quotes provided upon request.

In contrast, purchasing medication from an online pharmacy, while often convenient, comes with significant safety risks.  Without medical supervision, there's no ongoing professional assessment after the initial prescribing to ensure the medication continues to be appropriate for your individual needs.  Additionally, online pharmacies do not offer ongoing guidance on dosage adjustments, how to get the most out of your medication, how to come off the medication while maintaining your weight loss or provide any real time advice or support at all.  Instead you are expected to contact your GP/the NHS in the event of issues, which is a signfiicant drain on NHS resources.

Inadequate monitoring could lead to complications such as adverse reactions, improper dosing, or unaddressed underlying health issues, which could be harmful to your wellbeing.

Furthermore, many online pharmacies may not provide direct access to healthcare professionals for ongoing support or troubleshooting, leaving you without expert guidance in case of problems or concerns. With Skin&Spirit, you receive not only the medication but also a robust support system, ensuring you have the safety, accountability, and guidance needed to achieve lasting weight loss in a secure and healthy manner.

Choosing Skin&Spirit means opting for a comprehensive, safe, and medically supervised solution, providing peace of mind and a structured approach to reaching your weight loss goals.