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If weight loss pills are causing intolerable side effects, the NHS offers several evidence-based alternatives, including structured Tier 2 and Tier 3 weight management programmes, supervised very low calorie diet (VLCD) programmes, and bariatric surgery for those who meet NICE eligibility criteria (typically a BMI of 40 kg/m or above, or 35 kg/m or above with a significant obesity-related condition)

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This staircase pattern of increasing effectiveness is intentional and explains why the clinical trial results, averaging 15 to 17% total body weight loss, were measured at week 68 rather than week 4