Obesity

Weight-loss medication

You are a pharmacist in a community pharmacy. You have been asked to counsel a patient. The patient is a 38-year-old female who is seeking advice about her current weight loss management.  

To do:

1. You are expected to explore the patient’s current concerns, expectations and  symptoms.

2. Provide counselling information to this patient and answer any questions appropriately. You must provide relevant advice. 

You have 10 minutes.

You have access to the BNF.

 
You have access to a Patient Information Leaflet for Mounjaro®. https://www.medicines.org.uk/emc/files/pil.15481.pdf 

You have access to a Patient Information Leaflet for Wegovy®. https://www.medicines.org.uk/emc/files/pil.13800.pdf 

You are Layla Hussain (LAY-lah HOO-sane)

Opening Statement:

“Hi… I’ve been using Wegovy® for a while now but I’m still really struggling with the side effects. I wanted to ask if I can switch to Mounjaro® instead.”

• Name: Layla Hussain
  
  
• Age: 38
  
  
• Address: 22 Alder View Road

• Main concerns:

• “I’ve been on Wegovy® for just over four months now. My starting weight was 104 kilos, and now I’m around 101 kilos… so only about 3 kilos down.”

• “My BMI was around 37 when I started, and it’s still around 36 now.”

• “I know some people lose a lot more by this point, so it’s frustrating.”

• “I’m on the highest dose now, but the side-effects are getting awful”

• “My friend switched to Mounjaro® and said it works much better for her.”

• Symptoms:

• “I feel sick most days but I’ve not actually thrown up.”

• “My stomach feels bloated and crampy.”

• “I keep having diarrhoea, it’s been on and off for a few weeks.”

• “I also keep getting headaches.”

• If the student asks:

  • “No severe tummy pain.”

  • “No blood in stool.”

  • Dehydration screen

    • “No, I've not had a dry tongue or confusion.”

    • “No I’ve not been feeling faint or dizzy”

• Medication History: 

• “I have polycystic ovary syndrome.”

• “I have high blood pressure.”

• “I’ve had asthma since childhood.”

• Past Medical History:

• “I take Wegovy® (semaglutide) 2.4 mg once a week.”

• “I take a 5mg amlodipine tablet every morning.”

• “I use my salbutamol inhaler when I get wheezy.”
  
  

• Allergies:

• “I don't have any allergies”

• Lifestyle Factors/Social History:

• “I work full-time in IT so I’m sitting down most of the day.”

• Diet:

• “I used to skip breakfast completely, but now I try to have something small like yoghurt or fruit.”

• “I’ve cut down on snacking at work - I still do it sometimes, but not as much.”

• “I’m trying to cook more at home… we’ve reduced takeaway nights to once a week.”

• “I’ve started going on short walks - maybe 10 to 15 minutes - three or four times a week. I’m struggling with motivation.”

• “I don’t drink alcohol.”

• “I don’t smoke.”

Questions to ask:

1. Why am I not losing weight?

2. Is there anything I could do to improve my side effects?

3. If I stop the Wegovy®, can I start Mounjaro® straight away?

4. I was already on the maximum dose for Wegovy®, can I just start Mounjaro® on the same dose?

Referral criteria for patients on Wegovy® / Mounjaro®:

1. NICE, 2025. Overweight and obesity: identification, assessment and management (NG246). [online] Available at: https://cks.nice.org.uk/topics/obesity/  [Accessed 30 November 2025].

   NHS England, Digital Weight Management Programme. [online] Available at: https://www.england.nhs.uk/digital-weight-management/ [Accessed 1 December 2025].

   NHS England, Weight management injections. [online] Available at: https://www.england.nhs.uk/ourwork/prevention/obesity/medicines-for-obesity/weight-management-injections/#tirzepatide [Accessed 30 November 2025].

   Nuumad Weight Loss Training