Obesity and weight management

Weight is affected by hormones, sleep, medicines, mood, genes and circumstances, and obesity is recognised as a medical condition in its own right. If you have already tried hard to lose weight, often more than once, a medical assessment can help work out what is getting in the way. The clinic offers time to take a proper history, a plan agreed with you, and follow-up to see whether the plan is working.

What the assessment covers

• Your weight history and what you have already tried
• Eating patterns, including night eating and binge eating, which change what is appropriate
• Medicines that can cause weight gain, such as steroids, insulin, and some antidepressants and epilepsy medicines
• Sleep, including possible sleep apnoea
• Hormonal causes where there are clues: thyroid function, cortisol excess, PCOS / PMOS
• Changes around the menopause, when fat tends to shift towards the abdomen
• Fat on the legs or arms that does not shrink with weight loss, which can be lipoedema, a separate condition that needs a different approach
• Conditions linked to weight: blood pressure, blood glucose, cholesterol and fatty liver

Weight and type 1 diabetes

Dr Spiliotis has a particular interest in this. In one UK hospital clinic, just over half of adults with type 1 diabetes were overweight or living with obesity. Losing weight with type 1 diabetes has to be planned around insulin: eating less without adjusting insulin causes hypos, and cutting insulin too far risks ketoacidosis. It is best done with specialist input.

Treatment

Every patient has a full assessment before any treatment is considered. Specific treatments, and whether any of them suits you, are discussed at the consultation rather than online, and any treatment is reviewed at follow-up. For some people an NHS specialist weight service or a surgical opinion is the better route, and Dr Spiliotis will say so.

The clinic sees adults aged 18 and over.