Medication with Slimmr

Wegovy and Mounjaro are both once-weekly injections. The active ingredient in Wegovy is semaglutide and the active ingredient in Mounjaro is tirzepatide. They help people lose weight by relieving feelings of hunger and reducing cravings. They do this by targeting key areas of the brain that regulate appetite and calorie intake. This means you feel less hungry and feel fuller for longer. You may also find that you do not enjoy high-fat and sweet foods as much. This helps reduce your calorie intake further.

The idea of injecting yourself can be a little daunting at first. Don’t worry, it’s straightforward and the needle is very small. You will receive a step-by-step guide on how to inject when you receive your medication. You can also speak to our prescribing team who will be happy to go through it with you. If you need extra help, they will even arrange a video-call to take you through it step by step and check you’re doing it right.

There’s a few places that you can inject, it’s up to you where you choose. Areas you can inject are:

• Upper arms
• Tummy/abdomen (3-5cm away from your belly button)
• Upper legs (front of thighs)

If you haven’t used your pen yet:

• Keep your medication refrigerated between 2°C and 8°C.
• Keep your pen away from the refrigerator’s cooling element to ensure it doesn’t get too cold!
• Do not freeze your medication and do not use it if it has been frozen.

Once you have used the pen:

• You can keep it at room temperature (up to 30°C).
• If you can, you should continue keeping it refrigerated between 2°C and 8°C.
• Keep the pen cap on when the pen is not in use.
• Do not expose the pen to direct sunlight.

You should not store your pen at room temperature for more than 6 weeks for Wegovy, or 4 weeks for Mounjaro.

It’s understandable that people are sometimes wary of new medications. The first thing to say is that GLP-1s aren’t new. While they have only recently been licensed for use in weight loss, this group of medications have been in use in diabetic patients for many years. This first one was licensed in 2005, so we they have been around for nearly 20 years. The first trials of semaglutide, the active drug in Wegovy, was in 2008 and was developed as a once weekly injection in 2012. All medications that are licenced have to go through extensive, in-depth trials and studies before they are approved to be prescribed to the public.

Wegovy and Mounjaro aren’t suitable for everyone so it’s important you answer the questions on the consultation form as honestly and accurately as possible. Not all patients are eligible for our programme. There are strict rules outlined in the drug license about who is and isn’t suitable for these medications. You must have a BMI of 30 or over, or a BMI of 27-30 along with a diagnosed complication of obesity, such as high blood pressure or high cholesterol.

Having Type II diabetes does not exclude you from the programme providing you are either diet-controlled or are on a regular stable dose of metformin that is managed by your GP. People with Type II diabetes who are under a specialist hospital diabetes service or are on other medications for their diabetes apart from metformin are not eligible. We are very sorry but for safety reasons, people with Type I diabetes are not suitable for our service.

All medications have potential side effects, and this includes GLP-1 agonists. This doesn’t mean that they affect everyone who takes it but it’s important to be aware of the most common ones. Remember that everyone is different. People often report occasionally feeling sick at the start of taking the medication. This usually passes after a few weeks.

The most common side effect is mild to moderate nausea, which usually improves over time.

Very common (more than one in 10 people will experience these)

• Headaches
• Vomiting
• Diarrhoea
• Constipation
• Nausea
• Abdominal pain
• Fatigue
• Weakness

These side effects usually reduce in frequency over time and are mainly seen during the dose titration period. Although most patients tolerate the medication very well, if you do have any side effects then don’t worry, you can speak to the Slimmr prescribing team who can help you and offer advice on how to manage them.

Your prescriber will start you on a low initiation dose, increasing it every 4 weeks until you reach the maintenance dose. For Wegovy, the starting dose is 0.25mg and for Mounjaro, it is 2.5mg. If you are moving to Slimmr from another service and are already on a higher dose then we can start you on this higher dose but you will need to provide evidence of the dose you’ve been taking, such as a current prescription.

The dose of Wegovy and Mounjaro is designed to be increased gradually over several months. The reason for this is that it gives your body time to adjust to the medication and this helps to minimise side effects. The manufacturers of Wegovy and Mounjaro have produced a ‘titration regime’ – this is the rate that the medications can be increased month by month. The starting dose is 0.25mg and the maintenance dose is 2.4mg a week for Wegovy, and the starting dose for Mounjaro is 2.5mg with maintenance doses of 5mg, 10mg, and 15mg, depending on how you respond to the medication. However, everyone is different and while the highest dose is recommended for the most effective weight loss, some people prefer to maintain at a lower dose and this can be discussed with your prescriber and together you can decide on the maintenance dose that’s right for you.

To order your next pen, you’ll need to complete the monthly check-in form. Every month you’ll need to fill in the check-in form on our website in order to get your next pen – this will let us know how you are getting on with the medication and if you are happy to increase your dose. Once you’ve submitted the form and paid, the prescriber will review your answers and check it’s appropriate for you to continue. If they have any concerns or questions we will contact you.

We’ve been surprised and saddened by some of the resistance patients have encountered from doctors about the new medications. There’s still a lot of stigma around obesity and some view these injections as ‘cheating’, as though those who are overweight need to be punished and to suffer in their pursuit of a healthy weight. Yet we don’t apply this logic to other problems people have – no one says the same about nicotine replacement therapy for smokers, for example. Being on weight loss medication isn’t a quick fix – patients still need to put in effort and work on ensuring long-term change to their relationship with food. But for many people who have battled with their weight it really does help them shed the pounds. It can give them the kick-start they need to address their weight and take up regular exercise and healthy eating. We believe passionately that for many people this medication will be a life-saver, literally. No one should feel shamed or made to feel guilty for trying to improve their health and well-being, however they choose to do it.

The first step on your weight loss journey with Slimmr is completing the medical consultation form. This form is carefully designed to ensure we have all the information we need to prescribe safely. It covers things like your weight, height, past medical history, your current medication and allergies. We’ve tried not to make it too long and boring but the questions we do ask are important. Towards the end of the consultation, you’ll be asked if you would like Wegovy or Mounjaro. If you aren’t sure, then you can select the ‘let my prescriber decide’ button and the prescriber will look through all your answers and prescribe the medication they think is most suitable for you based on the information you have provided.