A medical condition with medical treatments — not a failure of willpower.
Assessed and treated by a GMC-registered GP
Prescriptions, sick notes and referral letters included
A written treatment plan after every appointment
Your NHS records in the room, with your consent
Care led personally by Dr Khan
Attentive, unhurried care that listens properly
Five-star Google reviews from the people we have looked after
Registered with the Care Quality Commission
Obesity is defined as excess body fat sufficient to affect health. It is measured most often by BMI, and BMI is a blunt instrument — more on that below.
The most important thing on this page is this: obesity is not a failure of willpower. Body weight is regulated by a powerful biological system involving appetite hormones, energy expenditure and signals between the gut and the brain. When you lose weight, that system responds by increasing hunger and reducing the calories you burn at rest — and it does so for years afterwards, not weeks. This is measurable physiology, and it is why the great majority of diets are followed by regain.
Understanding that changes what sensible treatment looks like. It explains why willpower alone fails so reliably, why medication that acts on appetite regulation works where advice did not, and why regain after stopping treatment is biology rather than a personal collapse.
A realistic and worthwhile goal is 5 to 10% of body weight. That amount measurably improves blood pressure, blood sugar, cholesterol, sleep apnoea and joint pain — long before anyone reaches a "target" weight. Aiming for something achievable and holding it is worth considerably more than a dramatic loss you cannot sustain.
Weight is defended by the body rather than freely chosen. Appetite hormones — leptin, ghrelin, GLP-1 — regulate hunger and fullness, and after weight loss they shift decisively towards regain: hunger rises, fullness signals weaken, and resting energy expenditure falls below what the new body size predicts. This adaptation persists for years.
Genetics accounts for a substantial share of the variation between people in the same environment. The environment supplies the calories; biology determines how hard they are to resist.
Several widely used drugs cause substantial weight gain, and people are rarely told at the point of prescribing:
Obesity is identified by measurement, but the useful assessment is not the number — it is what the excess weight is doing to you and what is driving it.
Our weight and metabolic panel covers this set, and it is required before starting any weight-loss medication.
Weight management is one of the better uses of a twenty-minute remote appointment. There is nothing to examine that a set of measurements and blood tests does not cover, and many people find this conversation easier without a waiting room.
Weight-loss medication is appropriate at a BMI of 30 or above, or 27.5 or above with a weight-related condition such as diabetes, hypertension or sleep apnoea — with lower thresholds for the ethnic groups noted above. It is not appropriate for cosmetic weight loss at a healthy BMI, and we will decline it in that situation.
Most weight is regained after GLP-1 medication is stopped — trial data suggest around two thirds of the loss returns within a year. That is not a criticism of the drug; it is the same appetite biology reasserting itself, exactly as it does after any diet.
It means these are best understood as long-term treatments for a long-term condition, in the way blood pressure medication is. Anyone starting one should decide that with open eyes, and the cost of continuing is part of that decision. We will say this before you start rather than after.
Baseline bloods are required. These drugs are not suitable in pregnancy or while trying to conceive, or with a personal or family history of medullary thyroid cancer or MEN2, or with previous pancreatitis. Nausea is common early and usually settles with slow dose increases. Gallstones are more likely with rapid weight loss. Severe persistent abdominal pain radiating to the back needs urgent assessment.
Bariatric surgery remains the most effective long-term option for severe obesity, and specialist services also offer structured psychological support. We refer where appropriate.
Call 999 for:
Seek same-day assessment for:
Book a routine consultation for:
Unintentional weight loss should always be assessed — see unexplained weight loss.
Aim for 5 to 10% of your current weight. For someone of 100kg that is 5 to 10kg — and at that point blood pressure, blood sugar, cholesterol, sleep apnoea and joint pain all measurably improve. Setting an unattainable target and treating anything less as failure is the commonest way people abandon progress that was working.
People with obesity encounter blame in healthcare more than in almost any other condition, and the evidence is clear that it leads to avoidance of care and worse outcomes. You will not be lectured here. If previous attempts have not worked, the useful question is which mechanism defeated them — not how hard you tried.
The NHS offers more for weight than most people realise, and it is free. Tier 2 weight management services take referrals or self-referrals in many areas, NHS tier 3 services provide multidisciplinary support — dietitian, psychology, exercise — which is what actually changes outcomes, and bariatric surgery remains the most effective long-term treatment for severe obesity.
Tirzepatide and semaglutide are both available on the NHS for weight management on criteria that have been widening. Ask your NHS GP whether you qualify before paying privately — that referral costs nothing, and the NHS route generally includes the behavioural support that private prescribing does not.
Where a private consultation is genuinely worth paying for is speed and a proper twenty minutes: a full assessment, baseline bloods, and an honest conversation about whether medication is appropriate for you — including saying no where BMI is below the licensed threshold.
The most valuable thing we do is often not prescribing. Reviewing what else you take matters enormously — several antidepressants, antipsychotics, older antihistamines, insulin, sulfonylureas and steroids all drive weight gain, and an alternative sometimes exists. So does treating an untreated cause: thyroid disease, sleep apnoea, PCOS, or binge eating disorder.
Where money is wasted: meal replacement subscriptions, fat burners, detox programmes, and any service prescribing weight-loss injections without a genuine assessment.
NICE CG189, Obesity: identification, assessment and management, and NICE NG246 set the framework — a tiered approach from lifestyle interventions through specialist weight management services to pharmacological and surgical options.
NICE TA875 covers semaglutide and TA1026 covers tirzepatide for weight management, specifying BMI thresholds and the requirement for delivery alongside a reduced-calorie diet and increased physical activity.
CG189 recommends bariatric surgery for people meeting defined BMI criteria, and notes it is the most clinically and cost-effective intervention for severe obesity.
NICE guidance recommends reviewing medicines that contribute to weight gain, and assessing for secondary causes including hypothyroidism and Cushing's syndrome.
CG189 also recommends screening for comorbidities — type 2 diabetes, hypertension, dyslipidaemia, sleep apnoea — which is why those are named above.
Correct. Weight is regulated by hormonal systems that respond to weight loss by increasing hunger and lowering the calories you burn at rest — and that response persists for years. This is measured physiology, not an excuse. It is precisely why treatments acting on appetite regulation succeed where advice repeatedly failed.
Most likely, yes — trial evidence suggests around two thirds of the loss returns within a year of stopping. This is the same biology that causes regain after any diet. It is the strongest argument for regarding these as long-term treatments rather than a course, and for factoring the ongoing cost into the decision before you start.
Only roughly. It cannot distinguish muscle from fat, and it under-estimates risk in people of South Asian, Chinese, Black African and Caribbean family origin, for whom lower thresholds apply. Waist-to-height ratio is more useful — aim to keep your waist under half your height.
Sometimes, and it is worth checking. Thyroid disease, PCOS and — rarely — Cushing's syndrome all contribute. Far more often the answer is a medication: several antipsychotics, antidepressants, diabetes drugs and steroids cause significant weight gain, and alternatives sometimes exist.
The one you can maintain. Head-to-head trials of low carb, low fat, Mediterranean and intermittent fasting show broadly similar results — adherence, not composition, predicts the outcome. Anyone insisting there is a single correct diet is overstating the evidence.
No, and this is the most encouraging fact here. Five to ten per cent produces meaningful improvements in blood pressure, blood sugar, cholesterol, sleep apnoea and joint pain. You do not need to reach an ideal weight to gain most of the health benefit.
Because exercise burns fewer calories than most people assume and appetite partly compensates. It is far more effective at maintaining a loss than producing one — and it improves blood pressure, blood sugar, mood and cardiovascular risk whether or not your weight changes. It is worth doing for those reasons alone.
No. These are licensed for a BMI of 30 or above, or 27.5 or above with a weight-related condition, with lower thresholds for some ethnic groups. Prescribing them for cosmetic weight loss at a healthy weight is not clinically appropriate and we will decline — whatever other providers may offer.
August 23, 2026
Ongoing
Time to be seen
Appointment length
Your NHS record in the room
Written treatment plan
Told when a test isn’t needed
Cost
Same day, usually
20 minutes
Yes, with your consent
Included
Yes, and told why
£40 for 20 minutes
Varies by practice
Typically 10 minutes
Yes, your full record
Not routinely
Usually
Free
Same day
Often 10 to 15 minutes
Usually not
Sometimes charged
Varies by provider
Often a subscription
Same-day access is usually available, from 6am to 10pm, seven days a week. You choose a time that suits you rather than waiting on hold at 8am.
Yes. Care is led personally by Dr Mohammad Khan, so you are not passed between clinicians. Continuity is the point of a small practice: someone who knows your history and is listening attentively rather than working through a checklist.
Yes, with your consent. We can access your Summary Care Record during the consultation, so your current medications, allergies and significant history are in the room. That means fewer questions you have already answered elsewhere, and safer prescribing.
No. We are not here to replace GPs, only to support them. Your NHS practice remains responsible for your ongoing care, and with your consent we write to them after the consultation. We are useful when you need to be seen sooner, or want more time than a standard appointment allows.
Twenty unhurried minutes and a comprehensive assessment. A written treatment plan is included, along with any prescription, sick note or referral letter arising from the consultation, at no extra charge.
£40 for 20 minutes, self-pay. Membership is optional and never required. Priced for fairness, because we are not here to charge extortionate amounts for access to a doctor.
It means the diagnosis can usually be made from your history and photographs, and that treatment can be arranged safely without examining you. Where a condition is not marked treatable online, it is because examination is the diagnosis — listening to a chest, feeling an abdomen, examining an ear or a joint — or because a procedure or device is needed.
Yes, where there is a genuine bacterial infection — cellulitis, impetigo, bacterial urine infections, confirmed strep throat. We will also frequently tell you that you do not need one. Most sore throats, coughs, colds and earaches are viral, and an antibiotic gives you the side effects with none of the benefit.
If your problem turns out to be genuinely outside what we can do remotely, the doctor will tell you straight away, point you to the right service, and refund your fee in full. We would rather do that than fill twenty minutes to justify the charge.
Call 999 or go to A&E — do not book an online appointment and do not wait for a reply to an email. For urgent problems that are not emergencies, NHS 111 is available 24 hours a day, online or by phone, and can direct you to the right service.
Patient reviews
