4.5. Drugs used in the treatment of obesity
4.5.1. Anti-obesity drugs acting on the gastro-intestinal tract
Restricted to use for patients with BMI >30 with relevant co-morbidities and BMI >35 without co-morbidities. Other conditions for prescribing should be in accordance with the Glasgow and Clyde Weight Management Service protocol. It should be prescribed only on the advice of the Glasgow and Clyde Weight Management Service.
4.5.2. Centrally acting appetite suppressants
Restricted to initiation only on the advice of the Glasgow and Clyde Specialist Weight Management Service as an adjunct to a reduced-calorie diet and increased physical activity for weight management in adult patients with an initial Body Mass Index (BMI) of BMI ≥35kg/m² (obesity class II and above) with:
- Non-diabetic hyperglycaemia (prediabetes) at high risk of type 2 diabetes which is defined as having either:
- Fasting plasma glucose level of 5.5 to 6.9mmol/L or
- HbA1c of 6.0 to 6.4% (42 to 47mmol/mol), and
- High risk of cardiovascular disease (CVD):
- Total cholesterol >5mmol/L, or
- High-density lipoprotein (HDL) <1.0mmol/L for men and <1.3mmol/L for women, or
- Systolic blood pressure (SBP) >140mmHg
The Weight Management Service has developed a prescribing pathway where the service undertakes the following:
- makes the recommendation to initiate treatment
- provides appropriate training and support materials to the patient
- continues to monitor the patient's weight loss progress and advises on response
The patient's GP will undertake the prescribing of the medicine.
Further details on the prescribing pathway are available in this Medicines Update blog.