Medical Weight Loss Options in the UK: options, safety and realistic results
If you’ve tried diet after diet and the weight keeps coming back, you’re not alone. In the UK, around 26% of adults are living with obesity and a further 38% are overweight.
That’s one reason you’ll see more people searching for “medical weight loss”, “weight loss treatment near me” and “weight management clinics”—they’re looking for structured, doctor-led support, not just another short-term diet.
In this guide, we’ll break down the main weight loss options available in the UK, how they work, who they’re usually for, and what kind of realistic results you can expect. We’ll also show where digital medical programmes like Piko fit into the picture.
What is “medical weight loss”?
“Medical weight loss” usually means a structured programme where your weight is managed with clinical support, not just self-help or generic diet plans. It can include:
Lifestyle programmes (nutrition, movement, behaviour change) with medical oversight
Weight-management medicines (only when appropriate and prescribed by a doctor or prescriber)
Bariatric surgery (for people with severe obesity and/or obesity-related health problems)
Non-surgical procedures and body-contouring treatments
The goal isn’t just to move the number on the scale. It’s to improve health markers, reduce obesity-related risks, and help you maintain weight loss safely over the long term.
Option 1 – Lifestyle-only approaches
This is where most people start: food, movement and habits.
What it usually includes
Personalised nutrition advice (sometimes with a dietitian or nutritionist)
Gradual increases in activity and resistance training
Sleep, stress and emotional-eating support
Self-monitoring: weight, measurements, food tracking, step counts, etc.
Who it’s typically for
People with overweight or obesity who prefer not to use medication
Those who are not eligible for medical or surgical interventions
Anyone wanting to improve health and relationship with food, even before considering other options
Pros
No medication side effects or surgical risk
Improves overall health (blood pressure, blood sugar, fitness, sleep, mood)
Skills you keep for life – not just while you’re “on a programme”
Often the foundation that other options are built on
Cons
Can be slow and frustrating if appetite and biology are pushing hard in the opposite direction
Hard to maintain without support and accountability
Some people with significant obesity may find lifestyle changes alone don’t lead to enough weight loss
Realistic results
With a good lifestyle programme and ongoing support, many people can achieve 5–10% of body weight lost over 6–12 months, sometimes more. Maintaining that loss is just as important as getting there.
Option 2 – Prescription weight-management medicines
Some people benefit from certain prescription weight-management medicines when lifestyle changes alone aren’t enough. These medicines are used alongside diet, activity and behaviour support – not instead of them.
How they’re used
A doctor or prescriber will usually assess:
Your BMI and waist circumference
Any obesity-related conditions (e.g. type 2 diabetes, high blood pressure, sleep apnoea)
Your past attempts at weight loss and eating patterns
Other medicines you take and your overall health
If you’re eligible, they may prescribe a weight-management medicine and monitor you regularly.
Who it’s typically for
Exact criteria depend on the medicine and local guidelines, but they commonly include:
Adults with obesity (for example, BMI in or above the obesity range), or
Adults with overweight plus weight-related health problems
These decisions are always individual and need a medical assessment, not just a BMI number.
Pros
Can reduce appetite, cravings or portion sizes, making lifestyle change more achievable
Often leads to greater average weight loss than lifestyle alone
May improve conditions like blood sugar and blood pressure when combined with lifestyle change
Cons and risks
Possible side effects (e.g. digestive symptoms), which can range from mild to significant, depending on the medicine and the person
Regular monitoring and follow-up are essential
Not suitable for everyone – certain medical conditions or other medicines can make some treatments unsafe
Stopping treatment suddenly without a plan can make weight regain more likely
Realistic results
When combined with lifestyle changes and medical monitoring, prescription weight-management medicines can help some people reach 10–15% or more of their body weight lost over time. Results vary widely: some people respond strongly, others more modestly.
Where a digital programme like Piko fits
A digital medical programme can bring together:
Doctor video appointments to assess eligibility and prescribe if appropriate
Structured lifestyle coaching (nutrition, movement, behaviour)
Regular follow-ups and progress tracking through an app
Monitoring of side effects and safety
It’s still a medical treatment – just delivered in a more accessible, digital format rather than only in a traditional clinic.
Option 3 – Bariatric (weight-loss) surgery
Bariatric surgery is the most intensive form of medical weight loss and includes procedures that change the anatomy of the digestive system.
Common procedures
Stomach-reducing surgeries (for example, procedures that reduce stomach volume)
Other operations that may alter how much food you can eat and/or how your body absorbs it
These operations are major procedures and require a full pre-operative assessment, plus long-term follow-up.
Who it’s typically for
Criteria vary between NHS and private providers, but surgery is usually reserved for:
People with severe obesity
People with obesity-related health problems where surgery is expected to improve outcomes
Those who have tried non-surgical options without sufficient long-term success
Pros
Among all options, surgery can lead to the largest and most durable average weight loss
Can significantly improve or even put into remission certain obesity-related conditions in some patients
Long-term improvements in quality of life are possible for many people
Cons and risks
Major surgery with short- and long-term risks
Requires lifelong nutrition monitoring, vitamin/mineral supplementation, and follow-up
Some procedures are not reversible
Changes to eating patterns and lifestyle are still essential – surgery is not a “quick fix”
Realistic results
Many patients may lose 20–30% or more of their starting body weight in the first 1–2 years after surgery, with good maintenance in people who stick to follow-up and lifestyle guidance. Results are individual and depend on the procedure and long-term habits.
Option 4 – Endoscopic and device-based procedures
Between medicines and surgery, there are non-surgical or minimally invasive procedures that act on the stomach or digestive system without open surgery.
Examples
Stomach balloons placed endoscopically and kept for a limited time
Other evolving endoscopic weight-management procedures and devices
These are specialised treatments offered by certain clinics and hospitals.
Who they’re typically for
People who don’t meet criteria for surgery or prefer not to have it
Those who need a temporary tool to help with a period of weight loss
Patients who can access specialist centres with expertise in these procedures
Pros
Usually less invasive than bariatric surgery
Procedures can often be reversed or removed
Can enhance results when combined with structured lifestyle support
Cons and risks
Still carry procedure-related risks
Weight regain is possible after the device is removed if habits don’t change
Not available everywhere and can be expensive
Long-term data for some devices is still emerging
Realistic results
Average weight loss is often less than with bariatric surgery but more than lifestyle alone, especially during the time the device is in place. Long-term success depends heavily on behaviour change.
Option 5 – Body contouring and “fat freezing”
This is where a lot of confusion comes in. Treatments like fat freezing, laser lipolysis or other body-contouring methods are aimed at local fat pockets, not overall body weight.
What they do
Target specific areas such as the abdomen, thighs or flanks
Aim to reshape or contour rather than tackle the underlying drivers of weight
Who they’re typically for
People close to their desired weight but unhappy with localised stubborn fat
Those prioritising cosmetic appearance rather than health-related weight loss
Pros
Local, targeted treatment
Can be an option for people wanting contouring rather than overall weight loss
Cons and risks
Not a treatment for obesity or overall excess weight
Results are usually modest and local
Can be costly, and multiple sessions are often required
Does not address appetite, metabolic health, emotional eating or lifestyle
Realistic results
Think of these as shape-tweaking, not as weight-loss treatments. The number on the scale may change very little, even if the treated area looks different.
How to choose the right path for you
There’s no single “best” weight loss solution. The most appropriate option depends on:
Your current BMI and health conditions
Your medical history and other medicines
What you’ve tried before, and for how long
Your preferences, values and level of risk you are comfortable with
How much support and structure you want day to day
In many cases, the foundation is the same:
A realistic nutrition plan, more movement, better sleep and stress management – with a programme and team that help you stick with it.
On top of that, you and a healthcare professional might decide to add:
A prescription weight-management medicine, if it’s safe and appropriate
A referral to a specialist service if you might benefit from surgery or an endoscopic procedure
A digital programme like Piko fits into the “medications + lifestyle” space: offering remote medical assessments, potential access to appropriate treatments, and continuous coaching and tracking through an app.
Safety first: red flags and myths
Whichever route you’re considering, safety comes first.
Be cautious of:
Unregulated “diet pills” or injections bought online without a prescription
Extreme crash diets with very low calories and no medical supervision
Social media trends promising huge losses in a few weeks
“Natural” products claiming drug-like effects without scientific backing
If something sounds too good to be true, it usually is.
What results can you realistically expect?
Very broadly (and remembering that individuals vary):
Lifestyle programmes: ~5–10% of starting weight lost over 6–12 months, with strong focus on long-term maintenance
Lifestyle + prescription medicine: often more weight loss on average than lifestyle alone (for some people, 10–15% or more over time) when combined with proper support
Bariatric surgery: often 20–30% or more weight loss over 1–2 years, with long-term maintenance in many patients who adhere to follow-up and lifestyle changes
Devices / endoscopic options: often between lifestyle and surgery, especially while the device is in place
Body contouring: visible local changes, but minimal effect on overall weight
The best result is one you can safely reach and maintain, that improves your health, energy and quality of life – not just the number on the scale.
Next step: check if you’re eligible for a medical weight-management programme
If you’re curious whether a medical weight-management programme (with or without prescription treatment) could be right for you, the next step is simple:
Take a short eligibility quiz or book an initial medical assessment.
In a few minutes, you can:
Share your current weight, height and health history
Flag any medicines or conditions that might affect your options
See whether a digital programme like Piko could be appropriate for you
Get guidance on which path to explore next – lifestyle-only, medical, surgical or other
You don’t have to guess alone. A properly structured, medical approach can help you move away from yo-yo dieting and towards something safer, more realistic and more sustainable.
→ Check if you’re eligible for a medical weight-management programme (quiz).
