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Lifestyle Interventions (First-Line) Dietary modification: Caloric restriction, specific dietary patterns (Mediterranean, low-carbohydrate, DASH)

Some expect quick results, eat too little, or dont include enough protein in their diet

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Several clinical scenarios warrant discussion: You should consider speaking with your GP if: You have type 2 diabetes that is inadequately controlled despite lifestyle modifications and metformin therapy, and your HbA1c remains above target You are struggling with weight management despite optimised thyroid hormone replacement, and you might meet NICE criteria for medical weight management (typically requiring referral to specialist weight management services) You have cardiovascular disease alongside type 2 diabetes, as some GLP-1 agonists (semaglutide, liraglutide, dulaglutide) have demonstrated cardiovascular benefits Your current diabetes medications are causing problematic side effects or hypoglycaemia Before your appointment , it is helpful to: Ensure your thyroid function has been checked recently (within the past 6 months) Compile a list of all current medications, including levothyroxine dose and timing Document your weight history and any previous weight management attempts Note any family history of thyroid cancer or endocrine conditions Prepare questions about potential benefits, risks, and alternatives Your GP will assess your suitability for GLP-1 therapy by reviewing your medical history, current thyroid status, diabetes control (if applicable), and overall health

Body Mass Index (BMI) is calculated as weight in kilograms divided by height in meters squared (kg/m)

What happens if your BMI falls below 27 This is the question that generates the most debate