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Weight Loss Consultation

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Your details

Name(Required)
Question 1(Required)
How old are you?
Question 2(Required)
Are you male or female?
Question 3(Required)
Your Height
Question 4(Required)
Your Weight
Question 5(Required)
Your ethnicity
! Please specify
Question 6(Required)
How much time do you spend exercising per week?
It is recommended that patients prescribed weight loss treatment incorporate a comprehensive approach to manage their health, which includes maintaining a balanced diet, engaging in regular physical activity, and adopting a healthy lifestyle. To optimise the therapeutic benefits of weight loss treatment, we advise patients to undertake at least 150 minutes of moderate-intensity exercise per week.
Question 7(Required)
What do you think about your diet? Here are some options:
Acknowledging dietary challenges is crucial for your health improvement. To complement your treatment with medications, adopting a balanced diet and reducing calorie intake are essential steps. We suggest starting with manageable changes: increase fruits and vegetables, opt for whole grains, include lean proteins, and importantly, reduce processed foods and sugary snacks. Cutting down on portion sizes and avoiding high-calorie meals can significantly contribute to your overall calorie reduction. Our team is prepared to offer further guidance and connect you with a health professional for personalised advice.
Question 8(Required)
Have you ever been diagnosed with any of the following?
  • Liver disease
  • Pancreatitis
  • Diabetes type 1
  • Diabetes type 2
  • Diabetic retinopathy/diabetic eye disease
  • Heart Failure
  • Kidney Problems
  • Thyroid cancer or family history of thyroid cancer
  • Gallstones
  • Weight related surgery
  • Fast heart rate (Tachycardia)
  • Multiple endocrine neoplasia 2 (MEN2)
  • Suicidal thoughts
  • Eating disorders
  • Cholestasis
  • Chronic malabsorption syndrome
Please provide further details
Question 9(Required)
Do you have any of the following weight-related conditions?
  • Hypertension (high blood pressure)
  • Dyslipidaemia (high cholesterol)
  • Cardiovascular disease
  • Pre-diabetes
  • Knee or hiposteoarthritis
  • Obstructive sleep apnoea
  • Asthma/chronic obstructive pulmonary disease (COPD)
  • Liver disease (non-alcoholic fatty liver disease
  • (NAFLD) or non-alcoholic steatohepatitis (NASH) and polycystic ovary syndrome (PCOS)
  • Erectile dysfunction
Please provide further details
Question 10(Required)
Have you previously or are you currently using any other weight loss treatment?
Could you please share with us when you first started taking this medication, how long you've been using it, and the last time you took it? It helps us understand your treatment history better. Please specify:
Question 11(Required)
Do you have any allergies?
Please provide further details.
Question 12(Required)
Are you taking any other medication (on prescription or over the counter)?
Please provide further details.
Question 13(Required)
I understand that the medication has specific storage and usage requirements and I will check this information in the leaflet provided.
Question 14(Required)
You can find a copy of our terms and conditions here.
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T: +44 28 4133 0477

E: pharmacy@meditrue.co.uk

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15D Lurganconary Road,
Kilkeel, Co Down,
United Kingdom,
BT34 4LL

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  • Weight Loss

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