The Online Weight Loss Consultation: What Prescribers Ask and Why

An online weight loss consultation is a structured medical assessment, carried out remotely, that a prescriber uses to decide whether a medicine such as Mounjaro (tirzepatide) or Wegovy (semaglutide) is safe and appropriate for you. It normally starts with a detailed questionnaire about your weight, health, medicines and history. Under General Pharmaceutical Council (GPhC) guidance, the prescriber must then verify key information independently, such as your weight, rather than relying on the form alone, and may contact your GP. This guide walks through each part of the process and explains why each question is asked. It is part of our eligibility guides; browse all our GLP-1 guides for more.

Why online consultations exist, and why they have changed

Mounjaro, Wegovy and other GLP-1 medicines are prescription-only medicines (POMs). By law, they can only be supplied against a prescription from a qualified prescriber: a doctor, or a pharmacist, nurse or other health professional with an independent prescribing qualification.

Online services grew quickly as demand for GLP-1 medicines rose and NHS access remained limited. Many people now have their assessment remotely, with treatment dispensed by a registered pharmacy and delivered. You can read more about how these services work in our guide to online doctor weight loss services in the UK.

Rapid growth brought concerns. Regulators received reports of people being prescribed weight-loss medicines who did not meet the criteria, including people who had understated their weight or concealed eating disorders. In February 2025, the GPhC published updated guidance for registered pharmacies providing services at a distance, including on the internet. It set out that:

• Prescribing decisions for higher-risk medicines, a category that includes weight-loss medicines, should not be based solely on an online questionnaire.
• Information provided by the person, including weight, height or BMI, should be independently verified. Examples of verification include timely two-way communication (such as a video consultation), access to clinical records, or contact with the person's GP or regular prescriber.
• Pharmacies should have robust processes for identity checks.

The General Medical Council (GMC), Nursing and Midwifery Council (NMC) and GPhC also set standards for individual prescribers working remotely. These require prescribers to have enough information to prescribe safely and to be satisfied that remote prescribing is appropriate for the person in front of them. You can read about the wider framework in our guide to who regulates online weight loss services.

Step 1: Identity and basic details

The first part of most consultations collects your name, date of birth, address, and contact details. Many services now carry out an electronic identity check, or ask you to upload photo ID.

Why it matters: Identity checks confirm you are an adult (Mounjaro is licensed for adults only), that you are the person the medicine is for, and that the same person is not creating several accounts to get around a refusal. They also mean your prescription and medical record are matched correctly. Our guide to why online pharmacies verify your ID and weight explains this step in more detail.

Step 2: Height, weight and BMI

You will be asked for your height and current weight, which are used to calculate your body mass index (BMI).

Why it matters: UK licences and NICE guidance are built around BMI.

Private online services usually work to the licensed indication rather than the narrower NHS criteria. Our guide to BMI and treatment eligibility and our BMI thresholds and ethnicity guide explain the detail. You can check your own BMI with our BMI calculator, but remember it is informational only and is not a prescribing decision.

How weight is verified

Because self-reported weight was the weak point in older questionnaire-only models, verification is now central. Depending on the service, this might involve:

• A live video consultation where you are seen
• Weighing yourself on camera, or submitting a photo or video of your scale reading alongside other checks
• Confirmation from your GP record, or a recent measurement from a pharmacy or clinic
• A full-length photo assessed by a clinician, used together with other information

GPhC guidance indicates that a photograph or phone call alone should not be treated as adequate verification for weight-loss medicines. Services combine methods, and expectations may continue to evolve.

Step 3: Weight-related health conditions

You will be asked whether you have been diagnosed with conditions linked to excess weight, for example:

• Type 2 diabetes or prediabetes
• High blood pressure
• Abnormal blood fats (dyslipidaemia)
• Obstructive sleep apnoea
• Cardiovascular disease, such as previous heart attack or stroke
• Osteoarthritis
• Polycystic ovary syndrome
• Fatty liver disease

Why it matters: These conditions matter in three ways. First, for people with a BMI between 27 and 30, at least one such condition is needed to meet the licensed indication. Second, they affect how much benefit treatment is likely to bring. Third, some of them change how treatment must be managed. For example, people with type 2 diabetes on insulin or a sulfonylurea have a higher risk of low blood sugar when starting a GLP-1, and may need other medicines adjusted. See our guide to GLP-1 medicines and type 2 diabetes.

Step 4: Safety screening questions

This section is where prescribers look for reasons a GLP-1 medicine might be unsafe. Our full guide to who should not take GLP-1 medicines covers each one, but in summary you will usually be asked about:

Allergies

Previous allergic reactions to semaglutide, tirzepatide, liraglutide or any other medicine. Hypersensitivity to the medicine or its ingredients is the formal contraindication listed in the UK SmPCs.

Pancreatitis and gallbladder disease

Whether you have ever had pancreatitis, gallstones or gallbladder removal. Pancreatitis has been reported with GLP-1 medicines, and people with a history of it were not studied in the main trials. Gallbladder problems were more common with treatment in the STEP and SURMOUNT trials.

Digestive conditions

Gastroparesis (slow stomach emptying), inflammatory bowel disease, previous stomach or bariatric surgery. GLP-1 medicines slow stomach emptying and commonly cause digestive side effects, so pre-existing problems matter.

Thyroid history

Personal or family history of medullary thyroid cancer or multiple endocrine neoplasia type 2 (MEN2). This is a contraindication in US labelling. It is not listed as a contraindication in the UK SmPCs, but many UK prescribers still ask.

Kidney, liver and eye disease

Severe kidney or liver disease, and diabetic retinopathy. Dehydration from vomiting or diarrhoea can harm the kidneys, and rapid blood sugar improvement can temporarily worsen diabetic eye disease.

Eating disorders and mental health

Current or past anorexia, bulimia, binge eating disorder or other disordered eating, and current mental health. Appetite-suppressing medicines can be harmful for people with restrictive eating disorders. Prescribers often use specific screening questions here and may decline or refer if there are concerns. Read more in our guide to GLP-1 medicines and mental health.

Step 5: Pregnancy, fertility and contraception

If you could become pregnant, you will be asked whether you are pregnant, breastfeeding or planning a pregnancy, and what contraception you use.

Why it matters: GLP-1 medicines should not be used in pregnancy. The SmPCs advise stopping Wegovy at least two months, and Mounjaro at least one month, before a planned pregnancy. The Mounjaro SmPC also advises that women using oral contraception switch to a non-oral method, or add a barrier method, for four weeks after starting and after each dose increase, because tirzepatide can reduce absorption of the pill. Our contraception guide covers this.

Step 6: Medicines and supplements

You will be asked to list every medicine you take, including prescribed medicines, over-the-counter products and supplements, and whether you are already taking, or have recently taken, another weight-loss medicine.

Why it matters: Two GLP-1 medicines should never be taken at the same time (for example, Wegovy with Ozempic or Rybelsus, which contain semaglutide). Insulin and sulfonylureas raise hypoglycaemia risk. Slowed stomach emptying can affect absorption of some oral medicines, including the contraceptive pill and certain medicines with a narrow safety margin, such as warfarin. See our medication interactions guide.

Step 7: Previous weight-loss treatment

You will usually be asked about previous attempts to lose weight, and whether you have taken a GLP-1 medicine before, including:

• Which medicine and dose
• When you last took it
• How you tolerated it
• Whether you are switching from another provider

Why it matters: If you are restarting after a break, or switching between medicines, the safe starting dose depends on this history. Restarting at a high dose after several weeks off can cause significant side effects. If you are moving from Wegovy to Mounjaro, there is no official dose conversion and the prescriber has to make a judgement; our guide to switching from Wegovy to Mounjaro explains the considerations. If you are changing provider, you may be asked for evidence of your previous prescription. See also switching providers mid-treatment.

Step 8: GP information sharing

Most services ask for your GP's details and your consent to share information.

Why it matters: Your GP record contains diagnoses, test results and medicines you may not remember or know about. Sharing works both ways:

• The online prescriber may check your record, or ask your GP to confirm key information.
• Your GP is told you are taking a GLP-1 medicine, so it appears on your record. This matters if you later see another clinician, need surgery or sedation (because of the aspiration risk highlighted by the MHRA), or are prescribed something that interacts.

Some services will not prescribe without GP consent. Others assess each case. If you do not want your GP informed, discuss why with the prescriber, but understand that it may affect whether treatment is offered.

Step 9: The prescriber's review

Once the information is gathered and verified, a prescriber reviews it. The prescriber is professionally accountable for the decision. They may:

• Approve treatment, usually starting at the lowest dose (2.5mg for Mounjaro, 0.25mg for Wegovy) with gradual increases
• Ask for more information, or a video or phone call
• Ask for evidence such as a GP summary, recent blood test results or a pharmacy-recorded weight
• Decline treatment and explain why
• Recommend you see your GP or a specialist in person

Why prescribers sometimes say no

Refusals are not a failure of customer service. Common reasons include a BMI below the licensed threshold, a safety concern from the screening questions, information that could not be verified, or a feeling that face-to-face care would be safer. A responsible service will explain its reasons and suggest alternatives.

Step 10: Ongoing reviews

The consultation is not a one-off. Responsible services review you before each dose increase and at regular intervals, asking about:

• Side effects, such as nausea, vomiting, constipation or diarrhoea
• Your current weight, which may need re-verifying
• Any new conditions, medicines, pregnancy or planned surgery
• Your progress and whether the current dose is still appropriate

NICE guidance on GLP-1 medicines expects treatment to be reviewed and stopped if weight loss is not sufficient after a set period. For example, NICE TA1026 advises considering stopping tirzepatide if less than 5% of initial weight has been lost after six months on the highest tolerated dose. Private services may apply similar principles. See our guide to GLP-1 non-responders.

How consultation models differ

Services vary in how they structure the process. The table below describes common models in general terms. It is not a ranking, and the details for any individual service will differ.

Whichever model a service uses, it should be clear about who the prescriber is, how your information is verified, and how to get clinical advice if you have problems. Our guide to how to choose an online pharmacy for weight loss treatment has a full checklist, and our providers page compares services on consultation process and safety features.

Preparing for your consultation

A little preparation makes the process faster and safer:

• Weigh yourself accurately, ideally on a reliable scale, in light clothing, and be ready for that weight to be verified.
• Have a list of all your medicines, including doses, and any supplements.
• Know your medical history, including dates of any pancreatitis, gallbladder problems, surgery or eating disorder treatment.
• Have your GP practice details to hand.
• If you have taken a GLP-1 before, note which medicine, the dose, and the date of your last injection.
• Think about contraception and pregnancy plans if relevant.
• Have photo ID available if the service asks for it.

Red flags in an online consultation

Be cautious if a service:

• Lets you choose your medicine and dose before any assessment, or skips straight to payment
• Does not ask about your medical history, medicines or pregnancy
• Makes no attempt to verify your weight
• Offers to start you on a high dose without a clear reason
• Has no named, registered prescriber and no registered pharmacy details
• Uses pressure tactics, countdown timers or "limited time" offers
• Offers medicines outside the licensed range, or products described as "research" or "compounded" versions

You can check registration on the GPhC, GMC, NMC and CQC registers. Our guide to getting weight loss injections online safely explains how.

Cost and the consultation

Some services include the consultation within the overall price of treatment, while others charge separately. Costs also vary with the medicine, dose, delivery and ongoing reviews. We don't quote prices in our guides, because they change often. You can compare current service costs on our prices page.

When to speak to a professional

If you are unsure whether a GLP-1 medicine is right for you, speak to your GP or a pharmacist before starting an online consultation, particularly if you have diabetes, a history of pancreatitis, gallbladder disease, an eating disorder, kidney or liver disease, or take several regular medicines. The decision to prescribe always rests with a qualified prescriber.

If you are already on treatment:

• Call 999 or go to A&E for severe, persistent abdominal pain (possibly spreading to your back, with or without vomiting), signs of a serious allergic reaction such as swelling of the face or throat or difficulty breathing, or collapse.
• Contact NHS 111 or your GP urgently for persistent vomiting or diarrhoea with signs of dehydration, pain under the right ribs with fever or yellowing of the skin or eyes, or symptoms of low blood sugar if you have diabetes.
• Contact your prescriber if you become pregnant, are planning surgery or sedation, start a new medicine, or notice changes in your mood. If you have thoughts of self-harm, call 999 or Samaritans on 116 123.

You can report suspected side effects to the MHRA through the Yellow Card scheme.