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NICE guideline CG189 ( Obesity: identification, assessment and management ) and NICE public health guidance PH53 ( Weight management: lifestyle services for overweight or obese adults ) outline a stepped-care approach, which may include: Tier 2 community-based lifestyle and behavioural interventions Tier 3 specialist multidisciplinary weight management services Pharmacotherapy , where clinically appropriate — for example, orlistat (subject to BNF/MHRA prescribing criteria and available via GP or specialist services) or semaglutide 2.4 mg (Wegovy®), which is approved by NICE technology appraisal TA875 for use within specialist NHS weight management services for adults meeting defined BMI and comorbidity thresholds Bariatric surgery in selected cases, as outlined in NICE CG189 Pharmacotherapy for weight management should only be initiated and monitored in accordance with NICE, BNF, and MHRA guidance, and within appropriate clinical services
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It has not been reviewed by the FDA for safety, effectiveness, or manufacturing quality and may only be prescribed when a licensed provider believes a compounded version is appropriate for a specific patient
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