WEIGHT LOSS
Who Is Suitable for Private Weight Loss Injections?
Why suitability cannot be answered without context, and why medical review comes before treatment.
Suitability for weight loss injections such as Mounjaro or Wegovy depends on more than body weight alone. Medical history, previous weight-loss attempts, current medication, co-existing conditions, and whether there are clinical reasons not to prescribe all influence the decision. These medicines are considered for patients in whom excess weight is having a meaningful impact on health — raised blood pressure, pre-diabetes, joint pain, sleep apnoea, cardiovascular risk — or where clinically significant weight loss has been difficult to achieve and maintain through lifestyle measures alone.
There are equally clear situations where caution is needed or treatment should not be prescribed. These include pregnancy or planned pregnancy, a personal or family history of medullary thyroid carcinoma or MEN2 syndrome, active or recent pancreatitis, severe gastrointestinal disease, and certain gallbladder conditions. Patients with type 1 diabetes, eating disorders, or significant mental health conditions affecting food behaviours also require careful assessment before any prescribing decision.
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BMI thresholds and clinical context
As a general guide, GLP-1 medicines are typically considered for adults with a BMI of 30 or above, or 27 or above when there is at least one weight-related medical condition. However, BMI is a screening tool, not a definitive measure of health. Some patients with a BMI just above the threshold may benefit significantly, while others with a higher BMI may not be suitable due to other medical factors. In some ethnic groups, health risks associated with weight begin at lower BMI thresholds — for example, South Asian patients may warrant consideration at a lower BMI than the standard guidelines suggest.
Assessment
What the assessment actually involves
At Basuto, suitability is assessed through a 30-minute GP consultation. Your doctor will review your weight history, eating patterns, previous treatments, medical background, current medication, and what you are hoping to achieve. Baseline blood tests — typically including HbA1c, liver function, kidney function, thyroid function and lipids — may be recommended before treatment starts. This ensures prescribing is safe, proportionate, and grounded in a proper clinical picture rather than a tick-box questionnaire.
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Wider picture
When weight gain is part of a wider picture
Weight gain does not always exist in isolation. Some women present with weight change alongside perimenopausal or menopausal symptoms and may benefit from hormonal review as well as weight management. Some men with central weight gain may need assessment through men’s health for testosterone, cardiovascular risk and metabolic factors. Others need an initial GP consultation to understand the broader clinical picture before any specific treatment is discussed. If you are unsure whether you are suitable, that uncertainty is itself a reason to book a consultation.
Common questions
How is suitability for GLP-1 treatment assessed?
Through a 30-minute GP consultation reviewing weight history, eating patterns, previous treatments, medical background, current medication, and what you are hoping to achieve. Baseline blood tests — typically HbA1c, liver function, kidney function, thyroid and lipids — may be recommended before treatment starts.
Which medical conditions or situations are contraindications?
GLP-1 medicines are not appropriate for everyone. Pregnancy or planned pregnancy, personal or family history of medullary thyroid carcinoma or MEN2 syndrome, active or recent pancreatitis, severe gastrointestinal disease, and certain gallbladder conditions are contraindications. Type 1 diabetes, eating disorders, and significant mental health conditions affecting food behaviours require careful assessment before any prescribing decision.
Is BMI alone enough to decide suitability?
No. BMI is a screening tool, not a definitive measure of health. Some patients with a BMI just above threshold benefit significantly; others with a higher BMI may not be suitable due to other medical factors. Ethnic background also affects thresholds — risks may begin at lower BMI in some groups.
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