Weight, managed medically.
A programme built around your health and history rather than a target date — a full assessment, a plan, and ongoing review with Dr Sam Lua.
Ask about weight managementWeight is physiology, not willpower.
When intake drops sharply the body defends itself: appetite signalling rises, energy expenditure quietly falls, and the weight tends to return once the diet ends. That is a well-documented biological response rather than a personal failure.
Most people who come to us about weight have already tried hard, often for years. Medical weight management works with that biology instead of against it, changing things gradually enough that the body does not fight back.
What we look at first.
A full history, your patterns, the medications you are on, and blood tests where relevant — along with the conditions that often travel with weight: blood pressure, blood sugar, cholesterol and sleep. Weight rarely sits on its own, and treating it without looking at the rest misses the point.
Consult & assessment → A plan for you → Ongoing review & support
You are told the consultation fee beforehand. Medication and tests, if needed, are charged separately.
Built around your actual life.
From the assessment we build a plan around food, movement, sleep and habits that fit how you actually live. Where medication has a role, your doctor will explain it plainly alongside the alternatives — what it does, what it does not, and what monitoring it needs.
Medication is never the starting point on its own, and anything prescribed is reviewed with you as you go.
Any medication is prescribed and monitored by your doctor as part of your plan, discussed with you at consultation.
Slower is not failure.
A modest, sustained change delivers most of the health benefit. Blood pressure, blood sugar and joint load all respond to smaller losses than people expect, and progress that holds is worth more than progress that reverses.
We review at sensible intervals and adjust, rather than chasing a number against a deadline.
What actually happens the first time.
An unhurried appointment, and no treatment decided before the end of it. We take a history — what your weight has done over time, what you have already tried, what worked for a while and what stopped working. We go through your current medications, because several common ones make weight harder to shift and it matters whether one of yours is doing that.
We measure what is worth measuring rather than everything measurable: weight, waist, blood pressure, and blood tests where your history suggests them — thyroid function, blood sugar, lipids, liver.
Then we go through what the results mean and what the realistic options are, including the option of changing nothing yet. You leave with a plan you have agreed to, not a programme you have been signed up for. Weight is a long condition: it is managed, not cured, and follow-up is part of the plan rather than an afterthought.
What the medicines do, and what the trials found.
Medication is one option among several, appropriate for some people and not others. It is discussed at consultation and prescribed only where it is clinically justified. What follows is what the published trials report, so the numbers you have in mind are the real ones.
The first class, GLP-1 receptor agonists, was tested in 1,961 adults with overweight or obesity, treated for 68 weeks alongside lifestyle change. Average weight reduction was 14.9 per cent, against 2.4 per cent on placebo. Some 86.4 per cent of participants lost at least 5 per cent of their body weight, against 31.5 per cent on placebo; 69.1 per cent lost at least 10 per cent, against 12.0 per cent; and 50.5 per cent lost at least 15 per cent, against 4.9 per cent. Nausea and diarrhoea were the most common side effects, usually mild to moderate and transient, and 4.5 per cent stopped treatment because of them, against 0.8 per cent.
The second class, dual GIP/GLP-1 receptor agonists, was tested in 2,539 adults over 72 weeks. Average reductions were 15.0, 19.5 and 20.9 per cent at the three doses studied, against 3.1 per cent on placebo. At least 5 per cent of body weight was lost by 85 to 91 per cent of participants depending on dose, against 35 per cent on placebo, and a fifth or more of body weight was lost by 50 per cent at the middle dose and 57 per cent at the highest, against 3 per cent. Side effects were again mostly gastrointestinal, mild to moderate, and concentrated during dose escalation; between 4.3 and 7.1 per cent stopped because of them, against 2.6 per cent.
Two things are worth saying plainly about those figures. They are averages, and individual response varies widely — some people sit well above the average and some well below it, and there is no reliable way to know in advance which you will be. And every one of those trials paired medication with lifestyle change. The numbers are not what a medicine does on its own.
Sources: N Engl J Med 2021;384:989–1002; N Engl J Med 2022;387:205–216; Diabetes Obes Metab 2022;24:1553–1564.
What happens if you stop.
This is the part that rarely makes the headlines, and it is the single most important thing to understand before starting.
A trial extension followed 327 people for a year after they stopped. They had lost 17.3 per cent of their body weight on treatment. One year off it, they had regained 11.6 percentage points of that — about two-thirds — leaving a net reduction of 5.6 per cent from where they started. The improvements in blood pressure, blood sugar and lipids had also drifted back toward baseline.
That is not a failure of willpower, and it is not an argument against treatment. It is the same physiology described in why diets keep failing: the body defends its previous weight, and removing what was countering that lets it do so.
Practically, it means this is a long-term decision rather than a course of treatment. Anyone presenting it as a few months’ fix is not describing what the evidence shows. We would rather you knew that before you start than discovered it afterwards.
Who this is not for.
Medical weight management is not appropriate in pregnancy, and it is not the right route if what you are describing is a disordered relationship with eating — that needs different help, and we will say so and point you toward it.
It is also not a shortcut for a specific area. If your concern is a pocket of fat rather than your health or your overall weight, that is a different question, and the honest answer is on our body contouring page — including what that cannot do.
And it is not for anyone who wants a prescription without an assessment. That is not a service we offer.
What it costs.
You are told the consultation fee beforehand. Blood tests, follow-up visits and any medication are charged separately, and you are told the cost of anything before it happens rather than after. Nothing is bundled and nothing is sold in packages.
Weight questions, answered plainly.
Is medical weight management right for me?
It starts with an assessment. Dr Sam Lua reviews your health history, medications and goals before recommending a plan — lifestyle first, with medical options discussed only where they are appropriate.
Who is weight-loss medication suitable for?
Medication is only part of the picture, and only where it is clinically appropriate — generally a BMI of 30 or above, or 27.5 or above alongside a weight-related condition such as type 2 diabetes, high blood pressure or obstructive sleep apnoea. If you are below that, we will say so and talk through what would actually help instead.
How much does it cost?
You are told the consultation fee beforehand. Medication and tests, where they are part of your plan, are charged separately and the cost is explained before anything goes ahead.
How quickly should I expect to see change?
Sustained change is gradual by design. We review progress at sensible intervals and adjust the plan rather than setting a deadline and chasing it.
Will I have to stay on treatment permanently?
Not necessarily, but the evidence is clear that stopping is usually followed by regaining most of the loss — in one trial extension, about two-thirds of it within a year. That is worth planning for at the start rather than deciding later.
Does medication work without changing anything else?
The published trials all combined medication with lifestyle change, so there is no reliable figure for medication on its own. In practice the two are managed together.
Can I get a prescription without a consultation?
No. An assessment is required, including blood tests where they are indicated.
Page reviewed: August 2026
Start with a conversation, not a commitment.
Tell us what you have already tried and how it went — that is the most useful place to begin.
Ask about weight management