Weight loss treatment options

NHS weight management programmes

Changes to eating and activity come first, and they stay part of every treatment on this page. A GP can refer you to a local weight management programme, and some local services let you refer yourself.

If you have a condition linked to your weight, such as type 2 diabetes or high blood pressure, you may be offered more specialist support, such as the NHS Digital Weight Management Programme. The medicines and surgery below are used alongside this kind of support, not in place of it.

Orlistat

Orlistat (Xenical) is a capsule taken with each main meal that contains fat, usually three times a day. It reduces how much of the fat in food your body absorbs, and the rest passes out in your poo. A lower strength, sold as Alli, can be bought from a pharmacy.

Its common side effects come from that fat: oily or fatty poo, needing the toilet urgently or more often, wind and stomach pain. It’s used alongside a lower fat, reduced calorie diet, and its leaflet lists who shouldn’t take it.

Weekly injections

Tirzepatide (Mounjaro) and semaglutide (Wegovy) are injected under the skin once a week, into the stomach area, the thigh or the upper arm. They work like hormones the gut makes, slowing digestion and reducing appetite.

They’re used alongside a reduced calorie diet and more activity. NICE sets out who the NHS offers them to, based on BMI and health conditions linked to weight.

Feeling or being sick, diarrhoea and constipation are among the common side effects. Neither is used in pregnancy or while breastfeeding, and each leaflet lists who shouldn’t take it.

Daily tablets

Oral semaglutide (the Wegovy pill) and orforglipron (Foundayo) are tablets taken once a day. Oral semaglutide is the same medicine as the semaglutide injection. It’s swallowed on an empty stomach with a little water, and then you wait before eating, drinking or taking other medicines.

Orforglipron is a different medicine that works on the same hormone pathway, and its leaflet sets out how to take it. Both are used alongside a reduced calorie diet and more activity.

As with the injections, the most common side effects are on the stomach and gut, such as feeling sick, diarrhoea and constipation, and each leaflet lists who shouldn’t take it.

Weight loss surgery

Weight loss surgery, such as a gastric band or a gastric bypass, makes the stomach smaller. On the NHS it’s usually considered with a BMI of 40 or more, or 35 or more with a condition linked to weight, with lower thresholds for some ethnic backgrounds.

It’s a major operation. Most people stay in hospital for one or two days and take three to four weeks to recover. It means lifelong changes to eating, with regular check-ups for the first two years.