Guidance issued for GPs managing weight-loss injection patients

Academics at King’s College London and the University of East Anglia have released guidance for GPs on how to manage patients who may be privately accessing weight loss drugs.

The medications are not routinely prescribed for obesity management in primary care. But it is estimated 1.5million people used weight-loss jabs in March 2025, with 80% of purchases through online retailers. As these users are privately accessing the medication, providers do not always provide wrap-around care such as dietary advice or psychological support.

The authors of the guidance, published in Obesity Facts, say the 10 evidence-based tips aim to help GPs who see patients using these medications in primary care. Patients may not disclose the use of the jabs but may have a myriad of symptoms or signs of use.

Lead author Dr. Laurence Dobbie, Academic Clinical Fellow in General Practice, from King’s College London, said, “More than a million people are taking these medicines privately and seeing GPs with lots of different problems. We want GPs to have the basic knowledge to prioritize patient safety and demystify side effects. I’ve seen patients in primary care who are clearly taking the medications, but they haven’t been given wrap-around care.”

Key recommendations include:

• Ask about use: Adopt a non-judgemental approach to uncover undisclosed weight loss injection use when patients present with dizziness, falls, gastrointestinal symptoms or rapid weight change.
• Review medicines early: Consider the need to downtitrate insulin, sulphonylureas and antihypertensives to avoid hypoglycaemia and postural hypotension as weight reduces.
• Watch for red flags: Severe abdominal pain may signal acute pancreatitis or biliary disease; urgent assessment is advised.
• Consider fertility and surgery: Advise women of child-bearing age to stop GLP-1 drugs two months before conception attempts, and stop weekly medications one week before surgery to lower the chance of liquid/food entering the lungs.

The guidance is the first output of Obesity Management Collaborative UK, a network set up in 2024 to support clinicians managing patients with obesity. The network is chaired by Professor Barbara McGowan at King’s.

Professor Barbara McGowan from King’s College London and a Consultant Endocrinologist at Guy’s and St Thomas’ NHS Foundation Trust:

“OMC-UK was developed to provide education, professional development and support to health care professionals working in weight management services. These ten top tips aim to upskill GPs in the management and monitoring of patients on these medications. By embedding these recommendations into routine clinical practice, we can ensure patient safety and optimize the care of individuals living with obesity.”

Dr. Helen Parretti, joint first author and Consultant Clinical Associate Professor in Primary Care at the University of East Anglia, said, “We hope that these ten top tips will help support GPs, and other health care professionals working in primary care, when managing patients on these medications. They offer practical, evidence-based guidance that has been designed to be easily accessible to busy health care professionals.”

The article was developed through collaboration between experts in primary care (Dr. Laurence Dobbie, Dr. Helen Parretti, Dr. Ellen Fallows, Dr. Stephanie De Giorgio), endocrinologists (Prof Barbara McGowan, Dr. Dipesh Patel) and experts through lived experience (Sarah Le Brocq).