In short
- Assessment before prescription. Weight that will not move usually has a reason, and the reason is worth finding.
- What gets checked. Thyroid, insulin resistance, fatty liver, sleep apnoea, hormones and the medicines you already take.
- One written plan. Nutrition and protein, resistance training, sleep and stress, medication only where it fits.
- Medication is optional. Considered, never assumed.
- Regain is physiology. Losing weight lowers energy use and raises hunger. That is biology, not weak will.
Treatment Overview
Why has the weight not moved?
Most patients who come here have already tried hard, more than once, and lost weight before regaining it. That pattern is physiological, not a character flaw.
After weight loss the body burns less energy at rest and hunger signalling increases. It defends the previous higher weight for a long time. If muscle was lost on the way down, the effect is stronger.
On top of that sits a list of medical drivers that make weight loss unusually difficult, and each has its own treatment.
What gets looked for
| Driver | Why it matters |
|---|---|
| Insulin resistance | High insulin promotes fat storage and blocks fat release, which is why intake alone often fails |
| Thyroid disease | An underactive thyroid slows metabolism and is easily treated once found |
| Fatty liver | Common, usually silent, and both a consequence and a driver |
| Obstructive sleep apnoea | Poor sleep raises appetite hormones and makes training feel impossible |
| Low testosterone in men | Drives loss of muscle and gain of abdominal fat |
| PCOS in women | Insulin resistance is common and independent of weight |
| Medication | Several common drugs cause weight gain and can often be swapped |
What the plan contains
- A protein target, set to your body weight rather than described vaguely.
- Resistance training, at least twice a week, because that is what protects muscle.
- Sleep and stress, treated as medical factors rather than as advice.
- Any treatable condition found, managed directly.
- Medication where it fits, which may be a GLP-1 based medicine or something else, or nothing.
When is medication part of it?
Generally when your body mass index is 30 or above, or 27 and above with a weight related condition, and structured changes have not produced or held a result.
The three month rule then applies: if a medicine has not produced roughly 5 percent weight loss at a proper dose by then, the plan changes rather than the dose climbing forever.
What this programme is not
It is not a prescription service, and it is not a package of tests you decode alone. It is also not a place where you will be told a number you can expect to lose.
Who Is a Good Candidate?
- You have lost weight before and regained it, more than once.
- You suspect something medical is working against you and want it measured rather than guessed.
- You have a weight related condition such as prediabetes, high blood pressure, fatty liver or sleep apnoea.
- You want one doctor responsible for the whole picture instead of a trainer, an app and a separate prescription.
- You are prepared to keep changes going and to be reviewed on a schedule.
- You want a prescription without an examination or blood work.
- You want a fixed number of kilos guaranteed by a fixed date.
- You are pregnant or breastfeeding. Weight treatment waits, and other support is offered.
- Your main difficulty is a disordered relationship with eating. That needs specialist care first, and you will be told so directly.
What Happens During the Consultation
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1
History and pattern
What your weight has actually done over the years, what you have tried, what worked and for how long. How hunger behaves through the day, how you sleep, how you train, what your working week looks like.
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2
Examination and measurement
Weight, waist, body composition and blood pressure. Not the scale alone, because the split between muscle and fat is what decides the plan.
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3
Blood work and investigation
HbA1c and fasting glucose, insulin where indicated, lipids, liver and kidney function, thyroid, iron, vitamin D, and hormones where symptoms justify them. Sleep apnoea screening if your history points that way.
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4
Diagnosis and written plan
What is actually driving your weight, in plain language. Your two or three priorities, the protein and training targets, any treatment, and the review dates. You leave with the document, not a promise to send it.
Program Structure & Follow-Up
How the programme runs
- First review at around four to six weeks. Early enough to correct what is not working before three months are lost.
- Then every two to three months. Weight, body composition, blood pressure and repeat blood work at agreed points.
- Between appointments. Direct access through the membership programmes, so a side effect or a stall does not wait for the next slot.
Why body composition, not the scale
The scale cannot tell you whether you lost fat or muscle. During fast weight loss a meaningful share of the loss is muscle, and losing muscle lowers your energy use further and makes regain more likely.
Measuring composition is how the plan gets corrected in time.
The maintenance phase
Maintenance is a phase of treatment, not the end of it. Before you reach your target, the plan for holding the result is already agreed: what happens to any medication, what your calorie requirement now actually is, and how early regain will be detected.
See weight maintenance for how that phase is run.
Benefits, Limits & Safety
What you can reasonably expect
- A cause, or the honest absence of one. Sometimes the blood work is clean and the answer is structure rather than medicine.
- Health improvement before cosmetic change. A 5 to 10 percent loss already lowers blood pressure, improves glucose and reduces knee pain and liver fat.
- A plan that survives travel and a bad month. That is what the reviews are for.
The limits, stated plainly
- No number of kilos is promised. Individual response varies enormously.
- Medicine does not remove the need to eat and train differently.
- Weight regain after stopping treatment is the norm without a maintenance plan, not an exception.
- Some conditions need a specialist. Fertility, gynaecology and eating disorder care are referred, not improvised.
Safety points that matter here
- Muscle. Fast loss takes muscle. Protein, resistance training and measurement are the protection.
- Gallstones. Rapid weight loss raises the risk. Symptoms are explained so you know what to report.
- Medication interactions. Diabetes and blood pressure medicines often need reducing as weight comes down.
- Nutrient intake. Eating much less makes protein, fluid and vitamin intake something to plan rather than assume.
What counts as success
A 5 to 10 percent loss already improves blood pressure, glucose regulation, liver fat and joint pain. Health markers are the target, not a number on a scale.
How you are followed
First review at four to six weeks, then every two to three months. Weight, waist and body composition, blood pressure and repeat blood work, with direct access between appointments.
When this is not the right route
Pregnancy and breastfeeding. A disordered relationship with eating that needs specialist care first. Anyone seeking a prescription without assessment or a guaranteed result.
Cost & Program Investment
Cost depends on the investigations your case needs, whether medication is part of the plan and how long you stay in the programme, so a single number on a website would be misleading. You get the full figure in the consultation before anything is started, and there are no charges you have not been told about. What is included is the assessment, the interpretation, the written plan, the reviews and access between appointments through the membership programmes.
Frequently Asked Questions
No. Medication is considered, not assumed. Some patients need treatment for a condition found in the work up and nothing else. Others do better with a structured plan alone. Where a weight medicine fits, you hear why.
No honest answer exists before you have been assessed, and the range between individuals is very wide. What you will get is a checkpoint: roughly 5 percent within three months, or the plan changes.
Because weight that will not move often has a driver behind it, and several of them are silent. Thyroid disease, insulin resistance, fatty liver and low testosterone all change the plan and all show up in blood work.
No. After weight loss the body burns less at rest and hunger signalling increases, so it defends the higher weight. That is measurable physiology. It is also the reason maintenance is treated as part of the treatment here.
The loss phase is usually months rather than weeks, and maintenance continues after it. Obesity behaves like a long term condition, so care is structured for that rather than for a short course.
Yes, but body composition matters more. The scale cannot tell you whether you lost fat or muscle, and that difference decides whether the plan is working.
Then you have useful information: nothing medical is working against you, and the plan is structure, protein, training and follow up. Some patients still qualify for medication on their weight and risk profile.
Yes. That is a common starting point, particularly where nobody set a maintenance plan. Your current treatment is reviewed and either continued properly or changed.
No. Where the main difficulty is a disordered relationship with eating, that needs specialist care and you will be told so directly and referred.
That is planned for rather than treated as an excuse. Protein targets, training that works in a hotel, and review appointments that fit your diary are part of the plan.
Possibly. Diabetes and blood pressure medicines often need reducing as weight comes down. Some medicines cause weight gain and can be swapped. That review happens at the first appointment.
It depends on the investigations you need and whether medication is part of the plan, so a single figure would be misleading. You get the full cost in the consultation before anything is started.
Evidence
Where this information comes from
Every figure on this page is taken from the sources below. All of them are free to read, so you can check them yourself.
- Obesity and overweight
- Obesity: identification, assessment and management
- Semaglutide for managing overweight and obesity
- Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1)
This page is general medical information and does not replace a personal consultation. Trial results are averages across large groups, not a prediction for any one person.