posted 20th June 2025
Weight loss medications/injections
(tirzepatide/mounjaro; semaglutide/wegovy; exenatide/byetta)
Anti-obesity medicines – GLP-1/GIP agonists
June 2025
We are aware of the huge public interest in weight loss and particularly medications and injections that can facilitate this. We know an increasing number of our patients are sourcing weight loss medications privately. We thought it might be helpful to have some links to resources regarding weight loss medications for information. There are a couple of important areas to highlight too.
Pregnancy
• GLP-1 agonist/GIP – anti-obesity medications are NOT safe in pregnancy, and it is important to use effective contraception during use and for 4-12 weeks after use (washout period). Washout periods:
Tirzepatide 1 month, semaglutide 2 months, exenatide 12 weeks
Contraception
• Using mounjaro (tirzepatide) affects oral contraception:
Both the combined and progesterone oral contraceptive pill (mini pill).
If you are using tirzepatide you should use a barrier method of contraception (e.g. condoms) in addition to your pill for four weeks after starting the medication, and for four weeks after any increase in dose. Alternatively, you may wish to consider another (non-oral) method of contraception whilst using tirzepatide.
There is currently no evidence that semaglutide, exenatide, liraglutide, dulaglutide or lixisenatide reduce the effectiveness of oral contraception.
HRT
• Using mounjaro and on oral HRT medication:
Mounjaro affects absorption of progesterone component of HRT and therefore may affect ability of the progesterone to protect your womb lining.
British menopause society have suggested that women using oral progesterone as part of their HRT should have an increased dose for 4 weeks after starting and with dose increases. Or switch to full transdermal (patch) for their HRT.
Please contact the practice so we can ensure you are on the best option for HRT.
GPs are not allowed to prescribe weight loss medications. Our access will be through weight management specialist services - please see update re this below
NHS Lothian guidance (June 2025)
Please note the Weight Management Service is not able to accept referrals for anti-obesity medications at this time. We apologise this is taking so long but please be reassured NHS Lothian are working hard to bring these medicines to patients.
NHS Lothian have a short life working group currently developing the pathway and once agreed we can start a phased roll out.
Three medicines are approved for use in NHS Scotland for managing weight in the treatment of obesity:
Liraglutide (Saxenda®)
Semaglutide (Wegovy®)
Tirzepatide (Mounjaro®)
NHS Lothian patient leaflet – if taking these medications privately, with information about diet and how to manage side effects.
leaflet - Anti Obesity Medications
Please also remember other factors that can influence weight gain which include quality of food, aiming for whole food; management of stress; optimising sleep and promoting healthy physical activity. Many of our community resources can help with addressing these factors. Additionally, weight loss medications can contribute to malnutrition if we are not eating enough protein, vitamins and minerals. It is also really important to have adequate physical activity including strength training because weight loss medications cause loss of muscle mass as well as fat loss.
Community Resources