Manage your weight

An information sheet below outlines the considerations to make when choosing the most appropriate remission programme for your patient, details of eligibility criteria and how to make a referral. Please ensure patients meet all eligibility criteria and have no known medical exclusions.

NHSGGC Type 2 Diabetes Remission Programme Information Sheet

Eligible patients are screened for suitability and once enrolled, are supported throughout the 12-month programme by local specialist diabetes dietitians to help them achieve remission.

The NHSGGC Remission Team will align them to a local specialist diabetes dietitian who will support them throughout their weight loss journey, helping them achieve remission. 

The dietitians from the NHSGGC Remission Team are happy to discuss and advise on individual cases.  
 
Contact Details

• Call Type 2 Diabetes Hub: 0141 531 8901
• ggc.type2diabetes.remission@nhs.scot 

Pre-Programme

• Confirm eligibility, including up-to-date HbA1c and blood pressure
• Review and advise on medication changes, where necessary, prior to starting the programme (patient to book this appointment). Please refer to Medication Adjustment and Guidance for advice
• Prescribe a 3-month supply of fibre supplement, if clinically appropriate
• Provide a blood glucose monitor and box of strips. Only for patients previously on hypoglycaemic medication

During the Programme

• Liaise with dietitians regarding medical or medication-related queries, as required
• Review and adjust medications if indicated (e.g. in response to changes in blood glucose or blood pressure)
• Support patients in arranging HbA1c testing at approximately 3 and 6 months
• Receive written updates on patient progress, including notification of withdrawal where applicable

Post-Programme

• Support HbA1c testing at 12 months
• Continue routine annual diabetes care
• Receive a summary of patient progress and outcomes at 12 months

Ongoing Communication and Monitoring 

• Raise any clinical concerns with the dietitian as appropriate
• Patients are responsible for self-monitoring (blood glucose, blood pressure, weight) and for reporting concerns to the dietitian and/or GP practice
• Dietitians will contact the GP where medication review is indicated; prescribing decisions remain the responsibility of the GP
• GP practices will be kept informed of patient progress throughout the programme

Additional Information

• Dietitians can provide weighing scales and blood pressure monitors if required
• The programme will be evaluated in line with the Scottish Government framework, with quarterly reporting

Please explain to your patient that they will receive a programme information leaflet and a letter inviting them to book an appointment in the programme.

Following your patient booking an appointment with the NHSGGC Remission Team they will be screened to ensure they are suitable for the programme.

The referrer will also receive a notification on the outcome of the referral via letter.

If your patient is suitable, they will be fully supported by the NHSGGC Remission Team in preparation to commence the programme detailed below. 

Stage 1 – Total Diet Replacement (12 weeks)

• All meals are replaced with nutritionally balanced soups and shakes (providing around 850 calories per day)

Stage 2 – Food Reintroduction (12 weeks)

• Gradual return to everyday foods and support with healthy eating and lifestyle habits.

Stage 3 – Weight Maintenance (6 months)

• Ongoing support to help with building sustainable lifestyle habits and maintaining weight loss.

Patients have the option of a mixture of in person, video or telephone calls.

There are clinics located across the Board.

Please note the guidance is the same for both the national and local programmes.

Medication and Adjustments for the Type 2 Remission Programme

You may be suitable if:

• You are aged between 18 – 65 years old
• You have been diagnosed with type 2 diabetes within the last 6 years
• You are above a healthy weight, with a BMI between 27-45kg/m² for individuals from white ethnic groups or 25-45kg/m² for individuals from Black, Asian and other ethnic groups  
• Your HbA1c (average blood glucose) is above
  • 48mmol/mol if you are not taking diabetes medication
  • 43mmol/mol if you are taking diabetes medication
• You feel ready and motivated to make changes to your diet and lifestyle
• You feel ready to commit to a 12-month programme, including attending regular appointments with the dietitian

Please note if you are on insulin, you are not suitable for the programme and other exclusion criteria may apply.

Appointments are flexible and can be a mixture of in person, video or telephone calls.

If you would like to explore whether you are eligible for this programme:

Please speak to your GP or diabetes care team and they can arrange a referral if appropriate.

Community Weight Management offers a free 12-week membership to either Slimming World or Weight Watchers to help you lose weight in a safe, sustainable and realistic way.

This gives you access to a blend of in-person and online support which includes:

• Weekly face to face or online sessions
• A timetable of virtual sessions
• Free access to an app offering food planners, activity and weight loss trackers
• Online, quick, simple and healthy recipes
• Equipment-free, easy workouts
• 24/7 access to a social community

Patients who have used this service say it’s been life-changing, guiding them on a journey to learn new habits that make losing weight safe, simple, and sustainable.

The Specialist Weight Management Service is delivered by a team of dieticians, psychologists and physiotherapists.

Psychological approaches and physical activity guidance are provided alongside dietary advice, tailored to your needs.

This approach will help you identify ways to overcome barriers to weight loss.

Weight loss medication and surgery may be considered as part of the programme where appropriate.

If you’d like to learn more about the Specialist Weight Management Service visit:

Health professional referral

You can access the service by speaking to your GP, Practice Nurse, or other Health Professional (dietitian, physiotherapist) about a referral to the service.

If you are a health professional looking to refer your patient:

Self-referral

You can self-refer to the service if you have a BMI over 25 (22.5 for patients with South Asian, Chinese, Middle Eastern ethnicity) and are living with diabetes, heart disease, or have experienced a stroke. To get started, simply complete the self-referral form below and our staff will be in touch to guide you through the next steps.

These medications are prescription-only and must be prescribed by a registered healthcare professional. They should only be used by the person named on the prescription and under medical supervision.

Using someone else’s medication is unsafe and illegal.

When used correctly and for the right reasons, these treatments are safe. However, using them without proper medical oversight, especially in people with a healthy or low BMI, is associated with clinical risk, as the side effects and effectiveness in these groups are unknown.

If you choose to get weight management medication from a private provider, it’s important to make sure:

• The provider is legally registered, and the medication is licensed.
• You do not buy from unlicensed sources like beauty salons or social media.
• You speak to a healthcare professional before starting treatment.

Private providers do not have access to your full medical history, so they must carry out a full risk assessment before prescribing. The safest way to make sure your medication is legal and safe is to have it dispensed by a registered pharmacy.

If you are using weight management medication from a private source, please tell your GP practice. It is the responsibility of the private provider to assess whether these are safe for you to use, your GP practice does not have capacity to double check this assessment. The practice will usually add these on to your medicines record. This helps keep your medical records up to date and ensures any other treatments you receive are safe and appropriate—especially if your weight changes or you’re prescribed other medications.

There are also reports of counterfeit versions of these medicines. These are illegal and may not contain the correct ingredients or doses. Using counterfeit medicines can be dangerous, as there is no quality control or guarantee of safety.

There have been several recent reports of counterfeit weight loss pens being sold via social media and online. The growth in popularity of GPL-1 medicines such as semgaglutide or Mounjaro has led to a surge to a huge rise in scam websites or social media posts which offer them illegally without a prescription.

See more information from Trading Standards Scotland: Trading Standards Scotland Bulletin 10 September

These treatments are being considered for people with a BMI of 38 or higher with at least one obesity-related condition (as per Scottish Government Phase 1 rollout guidance). NHSGGC are working to establish pathways for patients who will meet this criteria.

They are not suitable for weight management for people with:

• A history of pancreatitis
• Severe kidney or liver disease
• Frailty or advanced age
• Severe mental health conditions
• Diabetic eye disease which requires treatment.
• T2 diabetes on insulin unless under the supervision of a diabetes specialist team.
• T1 diabetes.

These medications should not be used during pregnancy, while trying to conceive, or when breastfeeding.

Using these medications without proper medical supervision can worsen existing health problems and lead to serious side effects.

Some medications can interact with weight management medicines, so it is important patients are aware of the risks. As private providers must carry out a full health assessment before prescribing, this will check for any risks or interactions with other medications. Some GP practices have reported that patients were not informed about important interactions, such as with contraception.

Contraception

• Tirzepatide (Mounjaro®) may reduce the effectiveness of oral contraceptives.
• Women are advised to use a non-oral contraceptive (e.g. patch, implant, IUD) for 4 weeks after starting or increasing the dose.
• Women of childbearing age should use effective contraception during treatment and for a few months after stopping.

Hormone Replacement Therapy (HRT)

• These medicines may affect how well oral HRT works.
• Patches or vaginal products are preferred for oestrogen, as they bypass the stomach.
• It’s unclear if progesterone in HRT is affected.

Other Medications

Because these medicines slow down how quickly the stomach empties, they can affect how other medicines are absorbed. This includes:

• Warfarin (blood thinner)
• Digoxin (used for heart conditions)

These medicines may need closer monitoring to ensure the dose remains safe. Please speak to your pharmacist for advice.

Like most medicines, weight loss medicines can cause side effects. The most common ones include:

• Nausea
• Vomiting
• Constipation or diarrhoea
• Headache

These side effects are usually mild and go away on their own. If they don’t improve or get worse, patients should get medical advice, ideally from the healthcare professional who prescribed the medication.

Serious Side Effects

A rare but serious side effect is pancreatitis. If you experience severe stomach pain that spreads to your back and doesn’t go away, get urgent medical help.

Tips for Safe Use

To reduce side effects and support your health while on treatment:

• Stay well hydrated
• Eat small, regular meals
• Include protein in each meal
• Stay active to maintain muscle
• Eat a varied diet to avoid nutrient deficiencies

Drug Safety Updates (DSU) – Medicines and Healthcare Products
Regulatory Agency

29 January 2026

24 October 2024

You can find more information via the following resouces: