Your wraparound care
Stages of support
Personalised preparation, ongoing clinical and lifestyle support, and a plan for long-term maintenance. Our wraparound service connects what you need at each stage with the evidence behind it.
Before
Prepare
Set meaningful goals for your wider health
We agree goals that consider your health as well as your weight. A 5–10% weight reduction can improve blood pressure in people with hypertension and blood glucose control in people with type 2 diabetes, making these changes meaningful measures of progress.18
Understand your likely treatment timeline
We help you understand how progress can develop over months and when to review your goals. The 3–12-month period highlighted in our original guide should be discussed in the context of your medication, dose and individual response, rather than treated as a guaranteed results window.
Plan and set realistic expectations before treatment
We help you set achievable goals and understand that response varies. In SURMOUNT-1, approximately 1 in 10 participants taking tirzepatide 10 mg or 15 mg did not achieve 5% weight loss by 72 weeks.17 Your plan should reflect your individual response.
Establish a personalised protein plan
We help you build practical protein habits before appetite decreases. A range of 1.2–1.6 g/kg/day is discussed in weight-loss nutrition guidance, but the appropriate target and weight used for calculation need to reflect your health, body composition and clinical circumstances.14
Establish your health baseline before starting
We review your history, nutrition, activity and relevant health measurements, including blood tests where appropriate. A baseline assessment gives us a reference point for monitoring changes in your health and body composition throughout treatment.14
Understand treatment eligibility and your care options
We help you understand eligibility criteria and prepare questions for your prescriber. NICE’s tirzepatide recommendation includes BMI 35+ with at least one weight-related condition, with lower thresholds for some ethnic backgrounds.5 NHS access criteria and private prescribing criteria are not identical.
During
Support
Make muscle preservation part of your care
We help you prioritise nutrition and strength activity while losing weight. In the SURMOUNT-1 body-composition substudy, around 1 in every 4 kilograms lost was lean mass.27 Lean mass includes more than muscle, but the finding highlights why weight alone is not the whole picture.
Address side effects and barriers to continuing treatment
We help you manage common symptoms and discuss difficulties with your prescriber. A review of real-world studies reported that 20–50% of people discontinued GLP-1 treatment within the first year.21 Reasons vary, so support should address the individual barriers you face.
Combine protein guidance with strength activity
We bring protein and resistance training together in your lifestyle plan. Protein supports the building and maintenance of muscle, while resistance activity provides a stimulus to retain strength. Your plan should address both, with advice adapted to your needs.1415
Build a practical plan to maintain and improve strength
We help you make appropriate strength activity part of your routine. A research review reports that supervised resistance-training programmes lasting more than 10 weeks can produce gains of around 3 kg in lean mass and 25% in strength.15 These are research findings, not predicted results for every patient.
Track changes beyond the number on the scales
We review body composition alongside weight, strength and relevant health measures. Understanding changes in fat versus lean mass helps us assess progress more fully and identify where your nutrition or activity plan may need attention.14
Review your progress and adapt your plan
We review your rate of weight loss, nutrition, strength and symptoms, adapting your lifestyle support as needs change. A rate such as 1–2 kg per month needs individual context, rather than serving as a universal target. When weight plateaus, we help assess whether this reflects maintenance or a need to review your plan.18 Medication decisions remain with your prescriber.
After
Maintain
A maintenance plan for every patient
We develop a personalised plan for maintaining progress. In the STEP 1 extension study, participants regained around two-thirds—approximately 2/3—of their previous weight loss within one year after semaglutide and structured lifestyle support stopped.20
Plan follow-up and respond early to weight regain
We help you plan follow-up, recognise weight changes early and agree practical next steps. NICE recommends regular feedback and monitoring for at least 12 months after treatment ends.8 Weight regain can occur in a long-term, relapsing condition;18 we review possible contributors and support a prescriber review where further medical treatment may be appropriate.
Review maintenance options with your prescriber
We help you prepare for informed discussions about continuing or stopping treatment. In STEP 4, continued semaglutide produced a further 7.9% average weight loss, compared with 6.9% regain after switching to placebo, over the following 48 weeks.19 Medication decisions remain with your prescriber.
Prepare for returning appetite
We help you plan meals, recognise changes in hunger and maintain practical eating routines as medication changes or stops. Preparing for returning appetite gives you strategies to use and a clear route to further support if managing it becomes difficult.
Plan for health and maintenance over the long term
We help you consider long-term goals and ongoing care needs. Semaglutide studies have reported sustained weight loss over 2–4 years with continued treatment.3839 These findings support a long-term approach; they do not show that a short programme guarantees lasting results after stopping.
Keep strength and muscle health in your maintenance plan
We continue to prioritise adequate nutrition and appropriate resistance activity as part of maintenance planning. Preserving lean mass supports physical function, and researchers suggest it may also help limit regain after medication ends, although that benefit should not be guaranteed.15
Sources for this page are listed on our Sources page.