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Weight Loss Treatments
Weight loss treatments help adults living with overweight or obesity, a long-term condition where excess body fat, measured using body mass index (BMI) and waist circumference, raises the risk of type 2 diabetes, heart disease and other health problems. In England, 66% of adults are overweight or living with obesity (Health Survey for England 2024), often through a mix of diet, activity levels, genetics and hormones. Options range from the pharmacy medicine orlistat (Alli) to prescription-only treatments such as Wegovy, Mounjaro, the Wegovy pill and Xenical, each prescribed only after a short online consultation with our prescriber and dispensed by our UK-registered pharmacy.
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An Overview From Our Superintendent Pharmacist
"Weight loss treatments are used to help adults who are living with obesity, or who are overweight and also have a weight-related health condition such as type 2 diabetes, high blood pressure, high cholesterol or obstructive sleep apnoea. For almost everyone, the starting point is support with diet, physical activity and everyday habits, because that is the foundation any treatment is built on. Where lifestyle changes alone are not enough, a pharmacy medicine such as orlistat, or a prescription-only weight management medicine such as Wegovy, Mounjaro or the newer Wegovy pill, may be an option, but only after a proper clinical assessment of your health, your BMI and any other medicines you take. These are prescription-only medicines, not products you can simply add to a basket, and they work best as one part of a long-term change rather than a quick fix. If you are struggling with your weight and think you may benefit from support, the safest first step is to start an online consultation so a prescriber can review your health and talk through the options that are genuinely suitable for you."
Where can I buy weight loss treatments online?
You can access weight loss treatments online from Mail My Meds by completing a short online consultation that one of our prescribers reviews before anything is supplied.
The treatments available through our service include the pharmacy medicine orlistat (sold as Alli), the prescription capsule Xenical, and prescription-only weight management medicines such as Wegovy, Mounjaro and the Wegovy pill. Because the prescription options are prescription-only medicines, you cannot add them straight to a basket. A prescriber must confirm that a treatment is safe and suitable for you first.
How FitXpress supports a safe consultation
FitXpress is our online tool that helps you start your consultation and gather what a prescriber needs to assess you, but it supports our clinicians rather than replacing them. A registered prescriber reviews your case, independently confirms your weight, height and BMI, and makes the final decision on whether to prescribe. The steps below show how it works.
How FitXpress works
- Start: Tell us which type of treatment you are enquiring about, so we can ask the right questions.
- Consult: Complete a confidential medical questionnaire about your health and history.
- Scan: Upload two photos (fully clothed, in an A-pose) to help estimate your measurements as part of your assessment.
- Clinical review: A GMC-registered prescriber reviews your information, independently verifies your BMI, and issues a prescription only if treatment is appropriate and safe for you.
Top tips for a clear scan:
- Wear fitted rather than baggy clothing, so your shape is easier to see.
- Stand in a well-lit area against a plain, light-coloured wall.
- Use the voice assistant feature if you are taking the photos yourself.
- Make sure your whole body is visible in the frame.
If a treatment is suitable, it is dispensed by our UK-registered pharmacy and delivered discreetly to your door, with our team on hand for questions, repeat prescriptions and follow-up. If it is not suitable, the prescriber will explain why and suggest safer alternatives.
What is obesity?
Obesity is a common, long-term health condition where excess body fat builds up to a point where it can harm your health.
It is usually measured using your body mass index (BMI), a calculation based on your height and weight, along with your waist circumference. In general, a BMI of 30 or above is classed as obese and 25 to 29.9 as overweight, though the thresholds are lower for people from South Asian, Chinese, other Asian, Middle Eastern, Black African and African-Caribbean backgrounds, who can face a higher risk at a lower BMI. Obesity is now recognised as a chronic, relapsing condition rather than a simple lack of willpower, which is why long-term support and, for some people, medical treatment can help.1
How common is obesity in the UK?
Obesity is very common in the UK. In England, 66% of adults are overweight or living with obesity and 30% are living with obesity, according to the Health Survey for England 2024.2
Rates have risen steadily over recent decades and tend to be higher in more deprived areas. Because excess weight is so widespread, and because it raises the risk of serious conditions like type 2 diabetes and heart disease, the NHS and bodies such as the National Institute for Health and Care Excellence (NICE) treat weight management as an important part of everyday healthcare.3
What causes weight gain and obesity?
Weight gain happens when you regularly take in more energy (calories) from food and drink than your body uses, but many different factors influence how easily this happens.
It is rarely about willpower alone. Common contributing factors include:
- Diet: regularly eating energy-dense, high-fat or high-sugar foods and drinks, and larger portions.
- Physical activity: a sedentary lifestyle with long periods sitting and little exercise.
- Genetics and family history: some people are more prone to gaining weight or storing fat.
- Hormones and medical conditions: an underactive thyroid (hypothyroidism), polycystic ovary syndrome (PCOS) and Cushing's syndrome can all play a part.
- Some medicines: certain treatments, including some steroids, antidepressants and diabetes medicines, can cause weight gain.
- Sleep, stress and environment: poor sleep, ongoing stress and an environment where cheap, high-calorie food is everywhere all make weight harder to manage.
What weight loss treatments are available?
Weight loss treatments range from lifestyle and dietary changes to weight loss medication and, in some cases, surgery, and the right option depends on your BMI, your health and what you have already tried.
Treatment almost always begins with lifestyle support, which is the foundation every other option is added to. The table below sets out the main types.
| Treatment type | How it works | Typically considered for | Key points |
|---|---|---|---|
| Diet and lifestyle changes | A balanced, reduced-calorie diet, more physical activity and better sleep create the energy deficit needed to lose fat. | Everyone, as the first-line approach. | Free, sustainable and improves health beyond weight. Slower results and can be hard to keep up without support. |
| Behavioural and holistic support | Nutritional guidance, behavioural therapy and structured programmes help change eating patterns and habits for the long term. | Anyone wanting lasting change, alongside diet and activity. | Targets the reasons behind eating. Strong evidence for long-term maintenance. |
| Orlistat (Alli, Xenical) | A capsule that blocks the enzyme lipase, so around a third of the fat you eat passes through the body instead of being absorbed. | Adults with a BMI of 30 or above, or 28 with risk factors. | Taken with meals and a lower-fat diet. Alli is sold in pharmacies; Xenical is prescription strength. Digestive side effects are common. |
| Prescription-only weight management medicines | Medicines such as Wegovy, Mounjaro and the Wegovy pill reduce appetite so you feel full sooner and eat less. Given as a once-weekly injection or a daily tablet. | Adults meeting BMI and health criteria, after clinical assessment. | Prescription-only and closely monitored. Prescribed only after an online consultation. Suitability and results vary. |
| Specialist services and surgery | NHS specialist teams offer supervised support, and weight loss (bariatric) surgery reduces how much you can eat or absorb. | Higher BMIs or severe obesity (usually a BMI of 40 or above, or 35 with serious conditions). | Structured, supervised care. Surgery is the most effective option for severe obesity but a major operation. |
How the main prescription treatments and orlistat compare
The chart below compares the prescription weight loss medicines we can prescribe, alongside orlistat, including how much weight people lost in major clinical trials such as SURMOUNT-1 (tirzepatide), STEP 1 (semaglutide) and OASIS 4 (oral semaglutide). The figures are averages at the stated dose, in trials where people also followed a reduced-calorie diet and increased their physical activity, and individual results vary and are not guaranteed.
| Feature | Mounjaro | Wegovy (injection) | Wegovy pill | Orlistat (Xenical) |
|---|---|---|---|---|
| Active ingredient | Tirzepatide | Semaglutide | Semaglutide (oral) | Orlistat |
| Type | Dual GIP and GLP-1 receptor agonist | GLP-1 receptor agonist | GLP-1 receptor agonist | Lipase inhibitor |
| Average weight loss in trials | Around 22.5% at the 15mg dose over 72 weeks4 | Around 15% at the 2.4mg dose over 68 weeks5 | Around 16.6% at the 25mg dose over 64 weeks7 | Around 6% over one year8 |
| How it works | Acts on two gut hormone pathways to reduce appetite and slow stomach emptying | Mimics the GLP-1 hormone to reduce appetite so you feel full sooner | Works like the Wegovy injection to curb appetite, in tablet form | Blocks around a third of the fat in your food from being absorbed |
| How you take it | Once-weekly injection (KwikPen) | Once-weekly injection (FlexTouch pen) | Daily tablet | Capsule with meals, up to three times a day |
| Also shown in trials to | Improve obstructive sleep apnoea in people with obesity9 | Reduce the risk of major cardiovascular events10 and improve MASH (fatty liver with scarring)11 | Same active ingredient as the Wegovy injection | Lower the risk of developing type 2 diabetes8 |
| Prescription only | Yes | Yes | Yes | Yes (a lower dose, Alli, is sold in pharmacies) |
| How long you take it | Obesity is treated as a long-term condition, so weight loss medicines can be continued long-term to help you reach and maintain a healthier weight, always alongside diet and activity changes.3 | |||
The weight loss figures above are averages from clinical trials at the maximum dose studied. Wegovy has also been studied at a higher 7.2mg dose, at which average weight loss of around 20.7% was reported.6 Your own results depend on the dose you reach, your starting weight and how you combine treatment with diet and activity. Weight loss is not guaranteed, and a prescriber will discuss what is realistic for you.
What are the most commonly used weight loss treatments?
The most commonly used weight loss treatments are lifestyle changes first, then orlistat as the main pharmacy option, and prescription-only medicines such as Wegovy and Mounjaro for eligible people who need more support.
Demand for the prescription injections and tablets, including Wegovy, Mounjaro and the Wegovy pill, has grown quickly in recent years, but they are not right for everyone and they do not replace healthier habits. For most people, a combination works best: sustainable diet and activity changes, with a medicine added where a prescriber decides it is clinically appropriate after your consultation.
What are the common side effects of weight loss treatments?
Side effects depend on the treatment, but most are related to digestion and often settle as your body adjusts.
- Orlistat (Alli, Xenical): because it stops fat being absorbed, it can cause oily or fatty stools, wind, an urgent need for the toilet and stomach discomfort, especially after high-fat meals.
- Wegovy, Mounjaro and the Wegovy pill: the most common effects are gastrointestinal, such as nausea, vomiting, diarrhoea and constipation, particularly when a dose first increases.45 Less common but more serious risks are assessed and monitored by your prescriber.
Good side effect management makes a real difference. With orlistat, sticking to a lower-fat diet reduces symptoms. With the injections and tablets, starting at a low dose, eating smaller meals and staying hydrated can help. You can check any medicine's full side effect profile in the British National Formulary (BNF) or its patient information leaflet.14 As Rachael Clarke MRCPharm advises, the key is not to push through in silence:
"Most side effects from weight loss treatments are mild and ease within a few weeks. The important thing is not to suffer in silence. If something feels wrong, or a side effect is stopping you eating and drinking normally, speak to your pharmacist or prescriber rather than simply stopping treatment on your own."
What is it like living with obesity?
Living with obesity affects people physically and emotionally, and experiences vary a great deal from person to person.
Many people describe everyday effects such as tiredness, breathlessness when climbing stairs, joint and back pain, and disturbed sleep. Just as common are the emotional and social effects, including frustration after trying many diets, low confidence and the impact of weight stigma. It is also very common to feel stuck in a cycle of losing weight and regaining it. None of this is a personal failing. Obesity is a medical condition with many causes, and understanding that is often the first step towards getting the right support.
Who is suitable for weight loss treatments?
Suitability is based on your BMI, your health conditions and your medical history, and is always decided by a prescriber rather than by you alone.
Our Superintendent Pharmacist is clear that weight alone does not decide it:
"The number on the scales is only part of the picture. Two people with the same BMI can need very different advice, so the consultation looks at your whole health, the medicines you already take and your history, not just your weight."
As a general guide, the thresholds used in the UK are:
| Treatment | Usual BMI threshold |
|---|---|
| Orlistat | 30 or above, or 28 with a weight-related risk factor. |
| Prescription medicines such as Wegovy and Mounjaro1213 | Higher thresholds, usually 30 or above with a weight-related condition (sometimes 35 or above). |
| Weight loss surgery | Usually 40 or above, or 35 or above with a serious weight-related condition. |
These thresholds are reduced by 2.5 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African and African-Caribbean backgrounds. Weight-related conditions (comorbidities) that can lower the threshold include type 2 diabetes, high blood pressure, high cholesterol and obstructive sleep apnoea. A prescriber weighs all of this up during your consultation.
Are there any warnings and precautions?
Weight loss medicines, including Wegovy and Mounjaro, are not suitable for everyone, which is why a prescriber checks for contraindications before prescribing.
A treatment may not be safe or suitable if you:
- are pregnant, trying to conceive or breastfeeding;
- have certain digestive, gallbladder, kidney, liver, pancreas or thyroid conditions;
- have a history of an eating disorder;
- take medicines that could interact, such as some diabetes treatments or medicines with a narrow safety margin;
- are under 18 or, for some treatments, over a certain age.
This is not a complete list, and it is exactly why the online consultation asks about your full medical history. Never share prescription weight loss medicines with anyone else, as what is safe for one person may be harmful for another.
When should I see a doctor?
See a GP or pharmacist if you are worried about your weight, if you have symptoms of a weight-related condition, or before starting treatment if you have other health problems.
Seek advice sooner rather than later if you notice:
- rapid or unexplained weight gain or loss;
- symptoms such as excessive thirst, needing to urinate often, chest pain or severe breathlessness;
- side effects from a treatment that are severe or do not settle;
- low mood or anxiety linked to your weight.
If you develop sudden severe symptoms such as chest pain, severe abdominal pain or difficulty breathing, seek urgent medical help or call 999.
What lifestyle and risk factors affect your weight?
Everyday habits and circumstances have a powerful effect on your weight, and improving them supports every kind of treatment.
The main areas to focus on are:
- Nutrition: a balanced, mostly whole-food diet with plenty of vegetables, fibre and protein, and fewer ultra-processed and sugary foods.
- Physical activity: the NHS recommends at least 150 minutes of moderate activity a week plus muscle-strengthening on two days, and more may be needed for weight loss.15
- Sleep and stress: poor sleep and long-term stress raise hunger hormones and make weight harder to manage.
- Alcohol: alcoholic drinks are high in calories and can undo other efforts.
Small, consistent changes tend to last longer than drastic ones, which is why holistic, long-term support is such an important part of sustainable weight loss.
How do I start weight loss treatment?
You can start by completing an online consultation with Mail My Meds, or by speaking to your GP or pharmacist about your options.
To begin with us, complete the online consultation, which a prescriber reviews to check your suitability and medical history. If a treatment such as orlistat, Wegovy, Mounjaro or the Wegovy pill is clinically appropriate, it is dispensed by our UK-registered pharmacy and delivered discreetly, with support available whenever you need it. If it is not appropriate, you will be pointed towards safer options. There is no pressure and no obligation to proceed, and as Rachael Clarke MRCPharm often reminds patients, the safest weight loss is the kind you can keep off.
Are there non-medical ways to lose weight?
Yes. Many people reach and maintain a healthier weight without medicines, using diet, activity and behavioural support.
Effective non-medical, alternative options include:
- Nutritional guidance: practical, sustainable changes to what and how you eat, rather than restrictive crash diets.
- Exercise and physical activity: a mix of aerobic activity and strength work that fits your life.
- Behavioural therapy: approaches such as cognitive behavioural therapy (CBT) that address the habits and triggers behind eating.
- Structured programmes and peer support: group or app-based support that helps with motivation and accountability.
- Self-monitoring: tracking food, activity and progress to stay on course.
These approaches are the foundation of long-term maintenance, and structured lifestyle change has been shown to make a real difference to long-term health.16
Weight loss treatments: frequently asked questions
Can I get Wegovy or Mounjaro online?
Yes, if they are suitable for you. Wegovy and Mounjaro are prescription-only medicines, so they cannot be bought over the counter or added straight to a basket. You complete an online consultation, a prescriber checks your health and eligibility, and treatment is only supplied when it is clinically appropriate and safe for you.
What is the difference between Wegovy and Mounjaro?
Both are once-weekly injections that reduce appetite, but they use different active ingredients. Wegovy contains semaglutide, which acts on one gut hormone pathway (GLP-1), while Mounjaro contains tirzepatide, which acts on two (GIP and GLP-1). In a head-to-head trial, the SURMOUNT-5 study17, tirzepatide led to greater average weight loss, but the right choice depends on your health, so a prescriber will advise which is more suitable for you.
Is the Wegovy pill as good as the injection?
The Wegovy pill is a daily tablet form of semaglutide, offering an alternative for people who would rather not inject. In the OASIS 4 trial, the 25mg tablet produced weight loss broadly in the range of the injections, but whether it is right for you depends on your health and preferences, which your prescriber will discuss during your consultation.
Is orlistat available without a prescription?
A lower-dose version of orlistat, sold as Alli, is available from a pharmacy without a prescription for suitable adults. The higher-strength version, Xenical, is prescription-only. Orlistat should always be used alongside a reduced-calorie, lower-fat diet.
Do weight loss injections work without diet and exercise?
No. Weight loss injections and tablets are designed to be used alongside a healthier diet and more physical activity, not instead of them. In every trial the weight loss figures come from people who also changed their diet and activity, and the best, most lasting results come from combining both.
How much weight can I expect to lose?
It varies from person to person and depends on the treatment, the dose you reach and how it is combined with diet and activity. In clinical trials, average weight loss ranged from around 6% with orlistat (the XENDOS trial) to around 15% for Wegovy (STEP 1) and 22.5% for Mounjaro (SURMOUNT-1) at their maximum studied doses, but results are individual and not guaranteed.
What happens if I stop treatment?
Some people regain weight after stopping a weight loss medicine, especially if earlier habits return.1819 This is why building sustainable diet, activity and behavioural changes during treatment is so important for long-term maintenance.
How do I know which treatment is right for me?
The right treatment depends on your BMI, your health and your history, so it is decided with a prescriber rather than chosen from a shelf. An online consultation is the simplest way to get a personalised recommendation.
Sources and references
Average weight loss figures are taken from published clinical trials in which participants also followed a reduced-calorie diet and increased their physical activity. Figures are averages at the stated dose and individual results vary.
- National Health Service. Obesity: symptoms, causes and treatment. NHS, UK. Back to text
- NHS England Digital. Health Survey for England 2024: adults' overweight and obesity. 2025. Back to text
- National Institute for Health and Care Excellence. Overweight and obesity management (NICE guideline NG246). NICE, 2025. Back to text
- Jastreboff AM, et al. Tirzepatide Once Weekly for the Treatment of Obesity (SURMOUNT-1). New England Journal of Medicine, 2022. Average weight loss 22.5% at the 15mg dose at 72 weeks. Back to text
- Wilding JPH, et al. Once-Weekly Semaglutide in Adults with Overweight or Obesity (STEP 1). New England Journal of Medicine, 2021. Average weight loss around 14.9% at the 2.4mg dose at 68 weeks. Back to text
- Once-weekly semaglutide 7.2 mg in adults with obesity (STEP UP). The Lancet Diabetes & Endocrinology, 2025. Average weight loss around 20.7% at the 7.2mg dose at 72 weeks. Back to text
- Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity (OASIS 4). New England Journal of Medicine, 2025. Average weight loss around 16.6% at the 25mg dose at 64 weeks. Back to text
- Torgerson JS, et al. XENical in the Prevention of Diabetes in Obese Subjects (XENDOS). Diabetes Care, 2004. Around 6 to 8% weight loss and reduced progression to type 2 diabetes at one year. Back to text
- Malhotra A, et al. Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity (SURMOUNT-OSA). New England Journal of Medicine, 2024. Back to text
- Lincoff AM, et al. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT). New England Journal of Medicine, 2023. Back to text
- Sanyal AJ, et al. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis (ESSENCE). New England Journal of Medicine, 2025. Back to text
- National Institute for Health and Care Excellence. Semaglutide for managing overweight and obesity (NICE TA875). NICE. Back to text
- National Institute for Health and Care Excellence. Tirzepatide for managing overweight and obesity (NICE TA1026). NICE. Back to text
- Joint Formulary Committee. British National Formulary (BNF). NICE and the Royal Pharmaceutical Society. Back to text
- National Health Service. Physical activity guidelines for adults aged 19 to 64. NHS, UK. Back to text
- Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin (Diabetes Prevention Program). New England Journal of Medicine, 2002. Back to text
- Tirzepatide as Compared with Semaglutide for the Treatment of Obesity (SURMOUNT-5). New England Journal of Medicine, 2025. Back to text
- Rubino D, et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance (STEP 4). JAMA, 2021. Back to text
- Wilding JPH, et al. Weight regain and cardiometabolic effects after withdrawal of semaglutide (STEP 1 trial extension). Diabetes, Obesity and Metabolism, 2022. Back to text
Medical disclaimer
The information on this page is for general informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Always speak to a qualified healthcare professional, such as a GP, pharmacist or prescriber, for advice tailored to your individual circumstances. Never delay seeking medical advice because of something you have read here. If you have a medical emergency, call 999 or go to your nearest A and E.
Our commitment to content accuracy
Our health content is written in plain English and regularly reviewed by our team of medical experts, including our Superintendent Pharmacist, to make sure it stays accurate, evidence-based and up to date. We reference trusted sources such as the NHS, NICE, the BNF and peer-reviewed clinical trials. If you think anything here is unclear or out of date, please tell us so we can review it.
Medically reviewed by Rachael Clarke MRCPharm, Superintendent Pharmacist. Last reviewed August 2026. Meet our clinical team
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