By Dr Victoria McBride, GP & Chief Medical Director, Courtyard Health Clinic
Barely a day goes by in clinic without a conversation about weight loss medication. Patients ask me about Ozempic, Wegovy, and Mounjaro, often assuming they are all the same thing, or that any of them can simply be requested. I wanted to write something general that explains what this class of medication actually is, who it is genuinely appropriate for, and how we approach prescribing it at the clinic, because I think that context gets lost in a lot of the online noise around these drugs.
What are weight loss medications?
GLP-1 is short for glucagon-like peptide 1, a hormone the gut naturally produces after eating. Medications in this class mimic that hormone, acting on the areas of the brain that regulate appetite. This helps people feel fuller for longer, reduces hunger between meals, and lessens food cravings, which in turn supports a genuine and sustained reduction in food intake.
Ozempic and Wegovy both contain the same active ingredient, semaglutide, though they are licensed for different purposes and given at different doses. Ozempic is licensed for type 2 diabetes. Wegovy is licensed specifically for weight management, at a higher dose. Mounjaro contains a different molecule, tirzepatide, which acts on two related hormone pathways rather than one, and trial evidence has generally shown somewhat greater average weight loss with tirzepatide than with semaglutide, although individual response varies considerably.
Who these medications are genuinely for
This is where I think the most clarification is needed. These are prescription only medications, not lifestyle products, and they are not appropriate for everyone who would simply like to lose some weight. They are licensed for adults with a body mass index (BMI) of 30 or above, or a BMI between 27 and 30 alongside a weight related health condition such as type 2 diabetes, high blood pressure, or obstructive sleep apnoea, and they are intended to be used alongside a reduced calorie diet and increased physical activity, not instead of them.
They are not suitable for everyone who meets those thresholds. A proper assessment needs to consider personal and family medical history, current medications, and any contraindications, including certain thyroid conditions and a personal or family history of certain cancers. This is exactly why we do not offer these treatments on request. Every prescription follows a full clinical assessment, in the same way it would for any other long term condition requiring ongoing medication.
Why we only prescribe on an evidence based basis
I want to be clear about this because I know there is a great deal of promotional material online that blurs the line between a genuine medical treatment and a lifestyle product. At Courtyard Health Clinic, prescribing decisions are based on licensed indications, published trial evidence, and an individual clinical assessment of the patient in front of us. That means some patients who ask about these medications will be advised that they are not appropriate for them, and that other approaches would serve them better. I think that is the responsible position for any prescriber to take.
A new option has entered the picture: oral semaglutide
Until recently, every version of these medications required a weekly self injection. For many patients that has been perfectly manageable, but I know it has genuinely put others off, whether because of needle phobia, discomfort with the idea of self injecting, or simply difficulty fitting it into a routine.
In June 2026, the Medicines and Healthcare products Regulatory Agency approved a semaglutide tablet specifically for weight management, becoming available through regulated private prescribing routes the following month. It is a different product to the low dose semaglutide tablet that has been available for some time for type 2 diabetes, and it is prescribed under the same eligibility criteria and clinical assessment as the injectable versions.
The trial evidence is reassuring. In the key study, adults taking the tablet at its maintenance dose lost an average of around 16.6 % of their body weight over 64 weeks, compared to roughly 2% on placebo, broadly in line with the injectable form of semaglutide. The tablet does require a specific routine, taken on an empty stomach first thing in the morning after a fast of at least eight hours, with food, drink, and other medications avoided for a further 30 minutes, and a gradual increase in dose over several months. It will suit some patients better than others, and I do not think it should be seen as automatically superior to an injection, simply as a further evidence based option for patients who prefer it.
Moving between treatments
Patients already established on the weekly 2.4 mg semaglutide injection can be transitioned directly to the 25 mg tablet, without needing to work back up through the lower tablet doses first. Moving between semaglutide and tirzepatide is a different matter, since these are different molecules with different dosing schedules, and any change of that kind needs a full clinical review rather than a simple swap. Any change in treatment, in either direction, should happen under proper clinical supervision, with a review of how the patient has responded so far and any side effects experienced.
My overall view
These medications have a genuine place in the treatment of obesity, which I regard as the chronic health condition it is, deserving the same thoughtful, individualised approach we would apply to any other long term condition. But they are not a substitute for the fundamentals. Nutrition, activity, sleep, and psychological support remain central to sustainable weight management, and any prescribing decision should sit within a proper assessment of a patient’s overall health, not in isolation, and not on request alone.
Find out more
If you would like to discuss whether any of these treatments might be appropriate for you, I would be glad to talk this through at a consultation at Courtyard Health Clinic, where any prescribing decision follows a full and honest clinical assessment.
You can reach us at hello@courtyardhealthclinic.com or call 01312976655 to arrange an appointment.
Dr Victoria McBride is a GP and Occupational Health Physician, and Clinical Director of Courtyard Health Clinic, based at Eskmills, Musselburgh. She has a particular interest in weight management, chronic disease prevention, and personalised, evidence based care.
