Weight management

At the Oxford Hormone Clinic, we offer expert Weight Management Consultations and individualised treatment plans using Mounjaro (tirzepatide) to support effective weight loss for men and women at all stages of their lives.
‍
During the initial consultation, our doctor conducts a thorough review of your medical history, current medications, and overall health status to ensure Mounjaro is appropriate, eligible and safe for you. Baseline blood tests based on your individual needs can be added to establish a clear picture of your metabolic health before starting treatment.
‍
Once Mounjaro is initiated, we provide ongoing follow-up to monitor your response, adjust the dose as needed, and repeat relevant blood tests where needed to ensure continued safety and optimal results. Follow-up consultations can be supported by our nutritionists to help advise how to maintain the weight loss once coming off the medications, as patients might struggle with rebound weight gain.

Our goal is to offer a medically supervised, supportive, and tailored approach to help you achieve sustainable weight loss, maintain it and improve well-being in the long run.

Weight: Why is it so important?

New studies have shown that weight loss is critically important for overall health because excess fatty tissue drives chronic, low-grade inflammation, causing increased atherosclerosis, increasing cancer risk, impairing insulin signalling and placing undue strain on the cardiovascular system. Weight loss not only makes you feel, move and look better, but it lowers the underlying detrimental inflammation, improves vascular health and reduces blood pressure. Additionally, shedding excess weight decreases cardiac workload, improves lipid profiles, and enhances glucose metabolism, collectively lowering the risk of cancer, heart disease, stroke, and type 2 diabetes. In natural ageing, when metabolism slows and insulin resistance increases , maintaining a healthy weight is especially crucial for long-term health.
‍

MOUNJARO BENEFITS:
‍
·  Type 2 Diabetes: Mounjaro enhances insulin sensitivity and lowers blood sugar levels.
·  Cardiovascular Disease: Weight loss decreases blood pressure, cholesterol, and inflammation.
·  Cancer Risk: Obesity correlates with several cancers; maintaining a healthy weight reduces this risk.
‍·  Improved Mobility & Joint Health: Reduced pressure on joints lowers the risk and severity of osteoarthritis, a common age-related issue.
‍·  Better Cognitive Function: Obesity is linked to an increased risk of dementia and Alzheimer’s.
‍·  Improved Sleep & Mood: Weight loss can alleviate sleep apnea and enhance mental health, both of which often decline with age.
·  Increased Longevity: Weight management is strongly associated with a longer lifespan and improved quality of life in older adults.
‍

- and why even more important during peri/menopause?

In menopause, women are already predisposed to unfavourable shifts in body composition and cardiometabolic risk; achieving and maintaining a healthy weight is especially crucial for preventing long-term complications and preserving quality of life. Menopause brings hormonal changes (especially estrogen decline) that contribute to fat gain, especially visceral fat, and metabolic slowdowns. Mounjaro helps counteract these effects. In addition to the above-mentioned general effects, in menopausal women, it is crucially helpful with:
‍
· Visceral Fat Reduction: Postmenopausal women frequently accumulate abdominal and visceral fat, which poses significant health risks. Mounjaro effectively targets this type of fat and effectively 'shrinks' fat cells.
· Improved Insulin Sensitivity: Menopause heightens insulin resistance; Mounjaro aids in restoring glucose control by enhancing insulin sensitivity.
· Cardiovascular Protection: Low oestrogen increases the risk of heart disease. Mounjaro helps by promoting weight loss, improving lipid profiles, and lowering blood pressure.
· Easier Weight Maintenance: Diet and exercise may become less effective during menopause. Mounjaro provides a pharmacological boost to help overcome this resistance.
‍· Mood and Energy Improvements: Weight loss and better glucose control can positively influence mood swings, fatigue, and depression, which are often experienced during menopause.
‍· Improved Cognitive Function: Chronic inflammation is linked to dementia and Alzheimer’s, and reducing weight may help decrease inflammation, improving brain fog and lowering the risk of long-term health issues such as dementia and Alzheimer's.
‍

Mounjaro versus Ozempic and Wegovy: How does it work?

Mounjaro has emerged as a promising treatment for weight loss, particularly for women undergoing menopause, a stage often associated with hormonal changes that contribute to weight gain and metabolic slowdown. Compared to Wegovy (semaglutide) and Ozempic (also semaglutide, but primarily used for type 2 diabetes), Mounjaro (tirzepatide) offers enhanced efficacy in promoting weight loss, making it a superior option for people struggling with weight gain. While both Wegovy and Ozempic are GLP-1 receptor agonists, Mounjaro is unique in its dual action on both GIP(glucose-dependent insulinotropic polypeptide) and GLP-1 receptors. This dual mechanism amplifies the hormone-driven effects on appetite suppression, satiety, and glucose metabolism, resulting in greater and more consistent weight reduction. Clinical trials have shown that Mounjaro can lead to significantly more weight loss than semaglutide, even at its highest doses. For menopausal women, who often face compounded challenges related to hormonal shifts, insulin resistance, and fat redistribution, the added GIP pathway may provide a crucial metabolic advantage. Additionally, Mounjaro has demonstrated comparable or superior improvements in cardiometabolic markers, which are critical in this population at increased risk for cardiovascular disease. Its main effects are:

· Appetite Regulation: Mounjaro reduces hunger, helping users feel full faster and reducing food cravings.
‍· Significant Weight Loss: Clinical trials have shown that people taking Mounjaro lost up to 15-20% of their body weight over time.
‍· Improved Metabolism: By enhancing insulin sensitivity, Mounjaro helps regulate blood sugar and reduces chronic inflammation.

Relevant studies:
1. Willard FS, Douros JD, Gabe MB, et al. Tirzepatide is an imbalanced and biased dual GIP and GLP-1 receptor agonist. JCI Insight. 2020;5(17):e140532.
2.Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216.
3. SURMOUNT-1 Protocol I8F-MC-GPHK(b).
4. Data on File. Eli Lilly and Company. Summary results 2022.
5. Garvey WT, Frias JP, Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity in people with type 2 diabetes (SURMOUNT-2): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial. Lancet. 2023;402(10402):613-626.

Mounjaro eligibility:

In the UK, the MHRA has authorised Mounjaro for for weight management, including weight loss and weight maintenance, as an adjunct to a reduced-calorie diet and increased physical activity in adults with an initial BMI of:

≥30 kg/m² (obesity)

or

≥27 kg/m² to <30 kg/m² (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, dyslipidaemia and other metabolic disorders, obstructive sleep apnoea, cardiovascular disease, prediabetes, or T2D)

‍
If you are considering Mounjaro, check your BMI here and consult a doctor to determine if it’s right for you and establish the best, safest treatment plan and dosing for you.

‍‍

Mounjaro treatment - what to expect?

Application and Dosing:
Mounjaro is administered as a once-weekly subcutaneous injection, typically into the abdomen, thigh, or upper arm. It should be taken on the same day each week, with or without food, and patients should rotate injection sites to avoid irritation. Starting doses are usually low (2.5 mg) to minimise side effects and are gradually increased every four weeks based on tolerance and treatment goals, up to a maximum of 15 mg. It’s important to follow the dosing schedule provided by a healthcare provider and never to increase the dose without medical guidance. Patients should also monitor for signs of low blood sugar if taking Mounjaro with insulin or other diabetes medications.

Side effects:
Common side effects of Mounjaro include nausea, vomiting, diarrhoea, constipation, and decreased appetite—most of which are mild to moderate and tend to decrease over time as the body adjusts. Some individuals may also experience indigestion, fatigue, or abdominal discomfort. In rare cases, more serious side effects can occur, such as pancreatitis, gallbladder disease or allergic reactions hence, regular blood tests are recommended. Mounjaro is not recommended for individuals with a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

Follow-up:
Regular follow-ups and blood tests are recommended to ensure safe dosing and application.
Initially, we recommend a monthly check to safely increase the dose, and once on the maintenance dose, we recommend 6-monthly follow-ups to ensure no adverse effects.

Mounjaro treatment - timeline

INITIAL CONSULTATION – 30 minute consultation with a private doctor.
·      Medical history and general health reviewed
·      Current medication and any allergies discussed
·      BMI calculated, eligibility confirmed
·      Weight loss goals agreed (Target weight established)
·      Baseline blood tests offered
·      Mounjaro prescribed
·      Potential side effects explained
·      Dosing explained and administration with kwikpen demonstrated
·      Starting dose: 2.5mg injection once per week.

·      What to expect during month 1:
·      Mild appetite suppression, possible nausea, bloating, constipation, fatigue
·      Tips – Avoid greasy food and keep hydrated
·      Most people begin to lose weight
‍

FOLLOW UP at 4 weeks: 15-minute call with doctor to review progress:
·      Typically increase dose to 5mg once per week. (Standard dose)

·      What to expect during month 2:
·      Appetite significantly reduced and decreased food cravings
·      Feeling full quite quickly
·      Further weight loss (2-5% of body weight for some)
·      Nausea usually settled, gut symptoms may come and go
‍

FOLLOW UP at 8 weeks: Email review to assess progress and any side effects. Monitoring blood tests offered.
·      Dose increase to 7.5mg if appropriate depending on tolerability

‍·      What to expect during 3rd month:
·     Weight loss accelerates
·     Many will lose up to 1kg per week.
·     Clothes fit differently and energy improves
·     BP, cholesterol and glucose may improve
‍

FOLLOW UP at 4-6 months: Email review to adjust dose when necessary.
·     Dose adjustment where necessary. Estimate time to reach target weight.

·      What to expect during month 4-6:
·      Continued fat loss
·      Easier to stick to portion control without hunger
·      Exercise easier due to less weight
·      15-20% body weight loss is common by this point
‍

FOLLOW UP at 6-12 months : Continued support from doctor on request.
·     Dose adjustment where necessary.

·       What to expect during months 6- 12:
·      Total weight loss by 12 months is often 20-25% of the starting weight
·      Consolidate habit changes to ensure maintenance of weight
·      Ensure regular meal planning with sufficient protein and fibre
·      Consistent exercise to include resistance training

FOLLOW UP at 12 months and onwards: Review appointment with the doctor.
·      Blood tests offered
·      Maintenance strategy agreed‍

NICE guidance for longterm use:

Regular blood tests are recommended for the safe and effective use of Mounjaro (tirzepatide), especially during long-term treatment. Key blood tests recommended, depending on your individual needs, can include:

Blood Glucose and HbA1c: Measures of immediate and long-term blood sugar control are important for patients using Mounjaro for type 2 diabetes or those at risk of hypoglycaemia when combined with other glucose-lowering medications.
‍Liver Function: GLP-1-based therapies can occasionally impact liver function; therefore, monitoring liver enzymes (ALT, AST, ALP, and bilirubin) helps to detect early signs of liver stress or damage.
‍Pancreatic Enzymes: These are important for detecting early signs of pancreatitis, a rare but serious potential side effect of Mounjaro.
Kidney Function: Monitoring renal function is crucial, particularly for patients with pre-existing kidney disease, as gastrointestinal side effects like dehydration could worsen kidney function.
Lipid Profile: Regular checks of cholesterol and triglyceride levels help track improvements in cardiovascular risk or detect any adverse changes.
Thyroid Function: Though rare, there is a theoretical risk of thyroid C-cell tumours; hence, monitoring thyroid function may be considered, especially in patients with a family history of thyroid disease.
‍
Gobaseline before starting Mounjaro and repeated periodically (typically every 3 to 6 months) based on individual risk factors and the clinical judgment of the prescribing healthcare provider. Regular monitoring ensures that any emerging issues can be addressed promptly, supporting safe and effective treatment.