Lifestyle

Weight Loss Injections

Over the last couple of years there has been a huge increase in people using injectable medications for weight loss treatment. Because of the limited availability on the NHS for people who are not diabetic much of this is privately sourced. There are around half a million users in the UK.

The main medications available are Tirzepatide (the brand name is Mounjaro) and Semaglutide (the brand names are Ozempic and Wegovy).

All these medications are called GLP-1 injections and they work by mimicking a naturally occurring hormone, glucagon-like peptide-1 (GLP-1), to help regulate blood sugar and promote weight loss. They achieve this by causing lots of changes in the body including increasing insulin production, reducing glucose production in the liver, and slowing down food digestion, leading to a feeling of fullness and reduced appetite.

They are very effective weight loss mediations when you are taking them, but on stopping them over a few weeks the effects diminish, appetite returns and most people regain a substantial proportion of the weight lost over the following months unless they have simultaneously managed to make dietary and lifestyle changes.

On the whole the data we have at present indicates these are relatively safe medications. The main side effects are gastric with people feeling sick, vomiting, being constipated or having diarrhoea and experiencing abdominal discomfort and increased flatulence. Other common side effects are tiredness, dizziness and hair loss.

There are some people who should NOT take GLP-1 injections for example people with significant gastrointestinal diseases, anyone who has had pancreatitis before, or anyone who is pregnant and breastfeeding.

There is no little data about the safety of these medications in pregnancy and it is advised that if you are using these injections you should be using an effective form of contraception and continue this for up to 3 months after stopping them.

As a GP with a special interest in women’s health I’m aware there are 2 groups of people who may be using GLP-1 injections and could run into problems:

Women of childbearing age – Mounjaro (but it seems not ozemipic or wegovy) has a significant impact on how well the body can absorb the contraceptive pill – both the combined pill, and the progesterone only pill. This can decrease the effectiveness of the pill and put women at risk of unplanned pregnancy. If you are using pills for contraception you should be using extra precautions for a month after you start Mounjaro AND for a month after any dose increase. Contraceptives like implants or coils are not affected and are safe to use. If you are taking the pill and do not want to use barrier contraception perhaps consider changing to a more effective contraceptive method before starting the injections. This is a very good information leaflet that covers lots of issues to do with GLP-1 injections and contraceptive pills: https://www.fsrh.org/Common/Uploaded%20files/documents/Patient-information-GLP-1-agonists-and-contraception.pdf

Postmenopausal women on HRT – it’s thought that all GLP-1 injections, but likely especially Mounjaro, can impact the absorption of HRT taken by mouth. So for those taking oral oestrogen the injections could cause your menopausal symptoms to increase. More concerning is if you are using an oestrogen through the skin via a patch, spray or gel AND oral micronised progesterone (utrogestan) tablets. If you have the normal amount of oestrogen but too little progesterone the lining of the womb is not adequately protected and this can cause bleeding and increase the risk of endometrial cancer. If you are on HRT with oral progesterone, before you start the GLP-1 injections, please discuss with your GP the options of either increasing your oral progesterone or change to a progesterone mixed in to the patch or via a coil. If you do have increasing or unexpected bleeding on your HRT preparation please discuss with your GP.

Dr Jo Coldron (GP Partner)
Tavyside Heatlh Centre

Weight Loss Injections Read More »

We’re Proud to Be an Active Practice!

We’re Proud to Be an Active Practice!
As part of our commitment to promoting healthier lifestyles—for both patients and staff—we’re delighted to announce that we are now officially recognised as an Active Practice.
This means we’re making positive changes to encourage physical activity in everyday life. Here’s what we’re doing:
 
💼 For Our Staff:
  • Standing Desks: We’ve introduced adjustable sit-stand desks to allow our team to move more throughout the day.
  • Regular Breaks: Staff are encouraged to take short, active breaks—whether it’s a quick stretch or a walk to the water cooler.
  • Active Challenges: We run friendly competitions, like step challenges tracked on Strava, to keep each other motivated.
  • Commute Incentives: We support the Cycle to Work scheme and provide facilities like bike racks, showers, and changing rooms for those who cycle or run to work.
  • Discounted Gym Memberships: We’ve partnered with a local gym to offer staff reduced rates, supporting both mental and physical wellbeing.
  • E-Bike for Home Visits: Our GPs now use an electric bike for home visits—a greener, more active alternative that’s been very well received.
  • Walk and Talk: We actively encourage staff to step away from their desks and deliver messages in person when possible.
👩‍⚕️ For Our Patients:
  • Consultation Choice: When you visit us, you’ll be asked whether you’d prefer to sit or stand in the consultation room—it’s all about what makes you feel most comfortable.
  • Appointment Reminders: Our text reminders now include messages about the benefits of walking or cycling to your appointment where possible.
  • Cycle Rack Available: A bike rack is installed at the practice for your convenience.
  • Health Promotion: We proudly display information about Parkrun, which we’re linked with, and have posters in every clinical room promoting simple, effective ways to get moving—no matter how small the effort.
We believe that small changes can make a big difference. By becoming an Active Practice, we hope to inspire both our team and our community to move more and feel better—together.
 

We’re Proud to Be an Active Practice! Read More »

Group Clinics

Group Clinics: Together, patients are stronger 

What are group clinics? 

Group Clinics are still a clinical appointment. It’s a way for GP practices to consult with patients in a group. This allows patient to learn more about their condition whilst meeting others who can share their experiences and learnings.  

While a traditional clinician and patient appointment, such as an asthma or diabetes review, lasts around 20-30 minutes, our group clinics can run for 45-60 minutes and allow up to 6 participants to spend more time with their specialist clinician – and each other. This allows additional time to ask questions so you can better understand your condition and how to look after yourself.  

Group clinics continue to foster a sense of community between patients and staff, allowing everyone to learn from each other in a safe and secure setting, making a real difference to day-to-day life. 

We are now running our Type 2 annual diabetic review appointments as group clinics. 

For further information, please clinic here – Group Clinics

Group Clinics Read More »

Menopause Lifestyle

As one of the menopause leads in my practice I naturally have a lot of discussions about Hormone Replacement Therapy (HRT)  but there are many of us who are unable to take HRT or who’s symptoms aren’t fully controlled by it. Just as important as medication is looking at what symptoms can be reduced by lifestyle and environment changes. To be honest a lot of the lifestyle advice is the same as we discuss with our patients all the time – eat a healthy diet, do more exercise, don’t smoke and drink less. I worry that the repetition of this advice decreases it’s impact, but there are specific reasons in menopause why it’s so important to focus on this.  

Activity and Exercise  

For me the most important message I can communicate is how important activity and exercise is in perimenopause and post menopause life. Increasing physical activity, and for those who can, adding in moderate and vigorous activity like running, has a direct impact on menopause symptoms. It reduces hot flushes and temperature intolerance, probably because a lot of the physiological changes the body makes to cope with being hot and sweaty during exercise then help us to regulate temperature control at other times. Increasing activity, especially outdoors, decreases stress and improves cognitive function and brain fog. The link between exercise and the brain is becoming increasingly understood with increasing evidence all the time. All of these improvements can then add together to improve sleep, so important as one of the tortures of menopause is insomnia.  

As well as a direct impact on symptoms increasing activity has a huge effect on post menopausal health. It has a huge positive benefit to the risk of heart attack and strokes that increases markedly post menopause. It limits the loss of bone density and the change of developing osteoporosis. It helps maintain muscle mass allowing us to be active longer and prevent falls and musculoskeletal pain. It is a powerful tool to prevent weight gain and especially fat placement around the middle which is more dangerous for our health.  

Smoking and vaping 

Smoking and vaping makes hot flushes worse, make sleeping, anxiety and cognitive function  deteriorate and moods swings increase. We all know how damaging smoking is to the body generally, damaging our lungs and cardiovascular system and adding to thinning of the bones (vaping seems to be as bad for bones as cigarettes are), but quitting at any time of life can be positive.  

Alcohol and caffeine 

 Alcohol and caffeine make hot flushes worse at the time of drinking and for some hours after, again compounding a lot of the other symptoms of menopause. Alcohol and caffeine also have a direct impact on the brain increasing anxiety, mood swings and brain fog independent of the insomnia.  

Diet 

Eating large meals late, especially high sugar or spicy meals can have a huge impact on flushes and sleep during the night. Avoiding high sugar or ultra processed foods and eating more whole foods can decrease menopause symptoms, be a part of losing or controlling weight and improving our health as we age. Foods containing phytoestrogens, for example lentils and chick peas, can improve menopause symptoms.  

Environment 

I think any menopausal woman knows the importance of a cool environment, light clothing that can be altered quickly when hot flushes occur, and cool calming sleep environments. One area of life we have less control over is our working environment but menopausal women are entitled to work in a place that allows them to feel well and this is supported in law.  

Stress and mental wellbeing 

This is a more difficult thing to tackle. Menopause tends to hit just at the point of life where work can be stressful, family commitments can include caring for both children and elderly relatives, and the pressures of life at present are intense. Menopausal symptoms are compounded by stress, and feeling unwell then decreases wellbeing – a vicious circle. It’s important to prioritise wellbeing for yourself and not just care for others.  

Useful Links: 

https://www.cuh.nhs.uk/patient-information/menopause-a-healthy-lifestyle-guide/ 

https://www.talkworks.dpt.nhs.uk/workshops/talkworks-for-menopause 

https://www.menopausematters.co.uk/ 

https://rockmymenopause.com/resources/ 

https://www.acas.org.uk/menopause-at-work 

Menopause Lifestyle Read More »