Treatment: medicines - Obesity

Orlistat works by preventing fat from being absorbed into your body. The undigested fat is passed out with your poo. This can help you avoid gaining weight, and may help you to lose weight.

Brands of orlistat include Xenical.

Orlistat is only available on prescription. It is not covered by the medical card, Long-Term Illness Scheme or Drugs Payment Scheme (DPS).

Who can take orlistat?

You may be prescribed orlistat alongside a low-calorie diet if you have:

• a body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes
• a BMI of 30 or more

How long to take orlistat

When you start taking orlistat, your doctor will monitor how well the medicine is working for you. They may advise you to stop taking orlistat if there is not at least 5% weight loss in 3 months. This is because it is likely not working well enough for you.

Continue taking orlistat until your doctor tells you to stop.

If you have another health condition

Before starting orlistat, tell your doctor or pharmacist if you have any medical condition - for example, liver or kidney problems. Orlistat may not be suitable for you.

Side effects of orlistat

Common side effects of orlistat include:

• fatty or oily poo
• needing the toilet to poo urgently
• pooing more frequently (diarrhoea)
• an oily discharge from your bottom (you may have oily spots on your underwear)
• farting (flatulence)

You're less likely to get these side effects if you are following a low-fat diet when you’re taking the medicine.

Orlistat may stop you absorbing fat-soluble vitamins. Ask your pharmacist to recommend a multi-vitamin. You take this at least 2 hours before or after taking orlistat, or before bed.

Orlistat may affect other medicines you take. Check with your doctor or pharmacist for advice.

Your contraception may not protect you from pregnancy if you:

• take the combined contraceptive pill or the progestogen-only pill
• have severe diarrhoea for more than 24 hours

Check the pill packet for advice.

Liraglutide is an obesity medicine that works by making you feel fuller and less hungry. It is given as an injection under your skin.

The best places to give the injection are the front of your upper arm, upper legs or stomach. Your doctor, nurse or pharmacist can show you how to take it.

Liraglutide is taken once a day. It is also called Saxenda.

Who can take liraglutide

Your doctor will complete a health assessment and check that it is safe for you to take liraglutide.

Liraglutide can be prescribed if you:

• have a BMI over 30
• have a BMI over 27 and at least one weight-related health problem, such as high blood pressure, pre-diabetes or high cholesterol

It can be prescribed for use in children and young people in certain circumstances.

Not everyone who is prescribed liraglutide can get it with their medical card or the Drugs Payment Scheme (DPS).

When liraglitude is covered by your medical card or DPS

Liraglitude may be covered by your medical card or the DPS if you:

• have a body mass index (BMI) of 35 or more
• have pre-diabetes
• are at high risk of a heart heart attack or stroke - for example, because you have high blood pressure (hypertension) or high cholesterol
• are age 18 to 74 years

The medicine is covered for up to 6 months. This can be extended if there is at least 5% weight loss within the first 6 months of taking it.

Side effects of liraglutide

Common side effects of liraglutide include:

• nausea (feeling sick)
• constipation
• diarrhoea
• heartburn and indigestion
• stomach cramps
• vomiting (being sick)
• headaches
• fatigue
• hypoglycaemia (low blood glucose) - if you take other medicines that can also lower your blood glucose levels

Reducing the side effects

Certain eating and drinking habits can help to reduce symptoms. This makes it more likely that the medicine will work well.

It can help to:

• eat small, regular meals and spread your food over the day
• eat slowly and stop eating as soon as you start to feel full
• include lean protein foods (such as fish, chicken, dairy, eggs and vegetarian alternatives) and a variety of vegetables, salads and fruits at your meals
• choose high-fibre foods, such as wholegrain breads and cereals, beans, peas, lentils and oats
• eat less fried and high-fat foods
• stay hydrated by drinking water over the day
• avoid fizzy drinks
• avoid lying down immediately after eating

You're less likely to get side effects if you follow your doctor’s instructions and increase your dose slowly over the first 4 weeks.

The food pyramid can guide you to the types of foods that contain the key nutrients needed for health.

The common side effects are usually mild and will get better as your body gets used to the medicine. Contact your doctor if the side effects bother you or do not go away after a few weeks.

Reducing the dose, or staying at a lower dose for a longer period, may help prevent or reduce side effects.

Semaglutide medicines are obesity medicines that work by making you feel fuller and less hungry.

They’re given as an injection under your skin. The best places to give the injection are the front of your upper arm, upper legs or stomach. Your doctor, nurse or pharmacist can show you how to take it.

Semaglutide is taken once a week, on the same day each week.

Types of semaglitude include:

• Ozempic - for treating type 2 diabetes
• Wegovy - for treating obesity

Who can take Ozempic

Ozempic can be prescribed by your doctor if you have type 2 diabetes. It is prescribed to help manage blood glucose levels.

It is only available on the medical card and Long-Term Illness Scheme if you have type 2 diabetes.

Medical card

Long-Term Illness Scheme

Who can take Wegovy

Wegovy can be prescribed by your doctor if you:

• have a BMI of 30 or more
• have a BMI of 27 or over and at least 1 weight-related health problem, such as high blood pressure, pre-diabetes or high cholesterol

It can be prescribed for use in children and young people in certain circumstances.

Wegovy is not covered by the medical card, Long-Term Illness Scheme and Drugs Payment Scheme.

Side effects of semaglutide

Common side effects of semaglutide include:

• nausea (feeling sick)
• constipation
• diarrhoea
• heartburn and indigestion
• stomach cramps
• vomiting (being sick)
• headaches
• fatigue
• hypoglycaemia (low blood glucose) - if you take other medicines that can also lower your blood glucose levels

Reducing the side effects

Certain eating and drinking habits can help to reduce symptoms. This makes it more likely that the medicine will work well.

It can help to:

• eat small, regular meals and spread your food over the day
• eat slowly and stop eating as soon as you start to feel full
• include lean protein foods (such as fish, chicken, dairy, eggs and vegetarian alternatives) and a variety of vegetables, salads and fruits at your meals
• choose high-fibre foods, such as wholegrain breads and cereals, beans, peas, lentils and oats
• eat less fried and high-fat foods
• stay hydrated by drinking water over the day
• avoid fizzy drinks
• avoid lying down immediately after eating

You're less likely to get side effects if you follow your doctor’s instructions and increase your dose slowly over the first 4 weeks.

The food pyramid can guide you to the types of foods that contain the key nutrients needed for health.

The common side effects are usually mild and will get better as your body gets used to the medicine. Contact your doctor if the side effects bother you or do not go away after a few weeks.

Reducing the dose, or staying at a lower dose for a longer period, may help prevent or reduce side effects.

Tirzepatide works by making you feel fuller and less hungry. It also increases the amount of insulin that the pancreas releases in response to food. This can help lower blood glucose levels in people with type 2 diabetes.

It is taken as an injection under your skin once per week, on the same day each week. The best places to give the injection are the front of your upper arm, upper legs or stomach. Your doctor, nurse or pharmacist can show you how to take it.

Tirzepatide is also called Mounjaro.

Who can take tirzepatide

Tirzepatide can be prescribed to adults by your doctor if you:

• have a BMI of 30 or more
• have a BMI of 27 or over and at least one weight-related health problem, such as high blood pressure, pre-diabetes or high cholesterol

Tirzepatide cannot be prescribed for use in children and young people.

Tirzepatide is not covered by the medical card, Long-Term Illness Scheme and Drugs Payment Scheme.

Side effects of tirzepatide

Common side effects of tirzepatide include:

• constipation
• diarrhoea
• heartburn and indigestion
• stomach cramps and abdominal pain
• vomiting (being sick)
• fatigue
• dizziness and low blood pressure
• hypoglycaemia (low blood glucose) - if you take other medicines that can also lower your blood glucose levels

Tirzepatide may affect other medicines you take. Check with your GP or pharmacist for advice.

Reducing the side effects

Certain eating and drinking habits can help to reduce symptoms. This makes it more likely that the medicine will work well.

It can help to:

• eat small, regular meals and spread your food over the day
• eat slowly and stop eating as soon as you start to feel full
• include lean protein foods (such as fish, chicken, dairy, eggs and vegetarian alternatives) and a variety of vegetables, salads and fruits at your meals
• choose high-fibre foods, such as wholegrain breads and cereals, beans, peas, lentils and oats
• eat less fried and high-fat foods
• stay hydrated by drinking water over the day
• avoid fizzy drinks
• avoid lying down immediately after eating

You're less likely to get side effects if you follow your doctor’s instructions and increase your dose slowly over the first 4 weeks.

The food pyramid can guide you to the types of foods that contain the key nutrients needed for health.

The common side effects are usually mild and will get better as your body gets used to the medicine. Contact your doctor if the side effects bother you or do not go away after a few weeks.

Reducing the dose, or staying at a lower dose for a longer period, may help prevent or reduce side effects.

Naltrexone and bupropion work on different parts of the brain to reduce your appetite and how much you eat. They come as a mixed tablet with the brand name Mysimba.

Naltrexone and bupropion is available on prescription only. It is not covered by the medical card, Long-Term Illness Scheme and Drugs Payment Scheme.

Who can take naltrexone and bupropion?

Naltrexone and bupropion can be prescribed if you:

• have a BMI of 27 or more, and other weight-related conditions, such as high blood pressure, pre-diabetes or high cholesterol
• have a BMI of 30 or more

You will usually start on a low dose. The dose will be increased every week for 4 weeks. Take the tablets with food. Always take the tablets exactly as your doctor tells you to.

This medicine may not be suitable if you are also taking other medicines - for example, anti-depressants or opioid painkillers such as codeine. If you have any questions about how many tablets to take, ask your doctor or pharmacist.

How long to take naltrexone and bupropion

When you start taking naltrexone and bupropion, your doctor will want to monitor how effective the medicine is for you. They may advise you to stop taking it if there is not at least 5% weight loss in 16 weeks, or if you have side effects.

Talk to your doctor or pharmacist if you want to stop taking naltrexone and bupropion.

Side effects of naltrexone and bupropion

Naltrexone and bupropion can cause side effects. Many people do not get side effects, or have minor ones.

They usually go away after a few weeks, as your body gets used to the medicine

If you are concerned about side effects, contact your doctor. They may prescribe a different medicine.

Common side effects of naltrexone and bupropion include:

• constipation
• feeling sick (nausea)
• headaches
• dizziness and vertigo
• feeling shaky or tremors
• difficulty sleeping
• not being able to concentrate
• feeling tired or sleepy
• dry mouth
• increased blood pressure

You're less likely to get these side effects if you follow your doctor’s instructions and increase your dose slowly over the first 4 weeks.