Weight Management Service

The Weight Management Service is a medical, non-surgical pathway for losing weight and keeping it off. A gastroenterologist leads the assessment, because weight and digestive health are tightly linked: fatty liver, reflux, gallstones and diabetes all improve as weight comes down. Depending on your health, goals and preferences, the plan can combine a structured nutrition and activity programme, modern weight-loss medicines, and endoscopic options such as the gastric balloon or endoscopic sleeve gastroplasty (ESG), all with the same team following you for a year.

Diets fail when they are done alone. Weight is regulated by hormones, sleep, medicines and gut signals as much as by willpower, and a medical team can address all of them. Losing 5–10% of body weight already reverses early fatty liver, improves reflux and blood sugar, and reduces joint pain and sleep apnoea. A gastroenterology-led service is also the right place if your weight problem comes with digestive symptoms, or if you are considering an endoscopic procedure.

1. Assessment visit: weight history, BMI and waist, medical conditions, medicines, eating pattern and sleep
2. Baseline tests: liver tests and FibroScan when indicated, sugar and lipid profile, thyroid and other causes of weight gain
3. A shared decision on the path: lifestyle programme alone, medicines, gastric balloon or ESG
4. Start of the plan with a dietitian session and clear targets for the first 12 weeks
5. Follow-up every 4–8 weeks for a year, adjusting medicines and nutrition as the weight changes

First visit 45–60 minutes; a 12-month programme with visits every 4–8 weeks

• ✓Bring a list of your medicines and any previous weight-loss attempts, including medicines or procedures tried
• ✓Bring recent blood tests if you have them (liver, sugar, lipids, thyroid)
• ✓Come fasting if you can, so baseline tests can be done in the same visit
• ✓Think about your goal and what has made weight loss hard before; this shapes the plan

• •A realistic target: 5–10% of body weight in the first 6 months with lifestyle and medicines, 10–20% with endoscopic options
• •Honest discussion of what each option can and cannot do, including side effects and how long results last
• •A written plan you can follow at home, with WhatsApp check-ins between visits
• •Screening and treatment of linked conditions in the same clinic: fatty liver, reflux, gallstones, diabetes
• •A maintenance plan at the end of the year, because keeping the weight off is the real goal

• ✓Adults with a BMI of 30 or more, or 27 or more with a related condition (fatty liver, diabetes, reflux, sleep apnoea, joint pain)
• ✓People who have tried diets repeatedly without a lasting result
• ✓Those who want a non-surgical option, or are not suitable for surgery
• ✓Patients with weight regain after previous bariatric surgery (endoscopic assessment)
• ✓Anyone whose digestive symptoms are linked to weight

• •Lifestyle programmes are safe; the main risk is losing motivation, which is why follow-up is built in
• •Weight-loss medicines can cause nausea, constipation or reflux early on; doses are increased slowly and reviewed
• •Gastric balloon: nausea and cramps in the first days are common; rarely the balloon deflates or causes an ulcer
• •ESG: sore throat and abdominal discomfort for a few days; rarely bleeding or a leak, which is why it is done by experienced endoscopists
• •All options are discussed with their expected benefit and side effects before you decide

Progress is measured at every visit: weight, waist, blood pressure, and liver and sugar tests at 3, 6 and 12 months. A good first sign is 5% weight loss by 12 weeks; if it is not reached, the plan is changed rather than repeated. At the end of the year you receive a maintenance plan and the option of continued follow-up.