How to set up a GP-led weight loss clinic: a playbook for private GPs

How to set up a weight loss clinic: the short answer

To set up a GP-led weight loss clinic, you need a written prescribing protocol built on the Wegovy and Mounjaro licences and NICE guidance, a verified baseline weight and BMI for every patient, scheduled reviews, wraparound diet and behaviour support, and a route to share information with each patient’s NHS GP. In England, check whether your CQC registration needs the "services in slimming clinics" regulated activity (for a physical clinic) or already covers remote treatment. Never advertise the medicine: promote the consultation and the programme. Plan to compete on clinical quality and continuity, not on the price of the pen.

This playbook walks through each step, from eligibility and remote prescribing rules to pricing, advertising and a launch checklist.

Demand and service models for a private weight loss clinic

Demand is large and the NHS cannot meet it quickly. NHS England’s interim commissioning guidance for tirzepatide (TA1026) targets an identified cohort of 220,000 people over the first 3 years, with the full eligible population having access within a maximum of 12 years. In Wales, BMA Cymru Wales advised in September 2025 that GLP-1 medicines for weight loss are not commissioned in general practice and are prescribed only through specialist weight management services. Most people who want treatment now will look privately.

Much private supply has gone through online pharmacies, and regulators have found problems. The General Pharmaceutical Council (GPhC) received 1,307 concerns about weight management medicines and services in 2024 and 2025, most of them in 2025. The main themes were prescribing practice, customer service and advertising. A GP-led service can offer what a questionnaire cannot: a real history, a verified weight, a named clinician and joined-up care.

Common service models are:

• In person. Assessment and reviews in clinic. Simplest for verifying weight, blood pressure and history, and the best fit if you already have premises.
• Hybrid. First assessment in person (or by verified video), then video reviews with periodic in-person or verified weight checks. This suits most GP-led services.
• Remote. Video throughout, with independent verification of weight and BMI. This carries the most regulatory scrutiny and changes your registration position in England (see below).

Commercially, you can charge per consultation, sell a fixed-length programme (for example 6 months, matching NICE’s review point), or run a rolling monthly membership. A programme or membership works best because the clinical model is built around regular reviews.

Regulation: CQC, HIW, HIS and RQIA

England (CQC). "Services in slimming clinics" is its own regulated activity. It covers advice or treatment that includes prescribing medicines for weight reduction, provided by or under the supervision of a doctor, in a clinic that is a physical location. Where a doctor treats obesity other than in a clinic, for example through an online service, the CQC says "treatment of disease, disorder or injury" applies instead. A clinic that gives diet plans but does not prescribe for weight loss does not need the slimming clinics activity.

If you are already registered, check your scope before you launch. Adding slimming clinics means applying to vary your registration and updating your statement of purpose. The exception for doctors in independent practice will not cover a remote service: the CQC says it does not apply to treatment provided by telephone, video or email. See CQC registration by service.

Wales (HIW). Healthcare Inspectorate Wales registers independent clinics (premises in Wales where private medical services are provided regularly by doctors) and independent medical agencies (services with no fixed establishment, such as remote or online services). Submit HIW’s registration enquiry form to confirm which applies.

Scotland (HIS). Healthcare Improvement Scotland regulates independent clinics, and since 2024 has also brought independent medical agencies, including services operating entirely online, into regulation. Check with HIS before launching a remote service from Scotland.

Northern Ireland (RQIA). RQIA registers independent clinics and independent medical agencies. Confirm with RQIA which category your weight service falls into.

Pharmacies in Great Britain are regulated by the GPhC. Its guidance shapes what any pharmacy partner will expect from you as the prescriber.

Clinical governance: eligibility, checks and monitoring

Start with a written protocol that every prescriber follows and that you audit. Decide whether you prescribe to the licence or to NICE criteria, write down why, and apply it consistently.

Licences and NICE criteria

Source	Who it covers (summary)	Review and stopping
Wegovy (semaglutide) SmPC	Adults with a BMI of 30 or more, or 27 to under 30 with at least one weight-related comorbidity, alongside a reduced-calorie diet and increased physical activity. Also licensed for adolescents aged 12 and over with obesity and body weight above 60 kg.	Follow the SmPC.
Mounjaro (tirzepatide) SmPC	Adults with a BMI of 30 or more, or 27 to under 30 with at least one weight-related comorbidity, alongside diet and activity.	Follow the SmPC.
NICE TA875 (semaglutide)	At least one weight-related comorbidity and a BMI of 35 or more, or 30 to 34.9 if the person meets criteria for specialist referral. Within a specialist weight management service, for up to 2 years.	Consider stopping if less than 5% of initial weight is lost after 6 months.
NICE TA1026 (tirzepatide)	A BMI of at least 35 and at least one weight-related comorbidity. Primary care or specialist services.	If less than 5% is lost after 6 months on the highest tolerated dose, decide whether to continue.

NICE lowers BMI thresholds, usually by 2.5 kg/m², for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds. NICE guideline NG246 (overweight and obesity management, last updated January 2026) says all weight management medicines should be used alongside a reduced-calorie diet and increased physical activity, that the decision to start should follow a discussion with the person, and that support should be offered to maintain weight loss when medicines are stopped.

Private prescribing within the licence is lawful, but NICE is the benchmark an inspector or indemnifier will compare you with. If you prescribe below NICE thresholds, record your reasoning for each patient.

Required checks before the first prescription

• Identity. Confirm who the patient is, especially for remote consultations. The GPhC expects robust identity checks for higher-risk medicines supplied online.
• Verified weight, height and BMI. Weigh and measure the patient yourself, or verify by video, from clinical records or by contacting their GP. The GPhC says a phone call is not appropriate for this. Its April 2026 review reported concerns about self-declared BMI and photographs that could be easily manipulated, and also about inappropriate requests such as photos in tight-fitting clothes. Choose a method that is reliable and respectful, and make reasonable adjustments (for example, accept a hoist-scale weight for a wheelchair user).
• History and medicines. The GMC expects an adequate history, including adverse reactions, all current medicines (including those bought online), and other conditions. Ask directly whether the patient already gets a weight-loss medicine elsewhere.
• Contraindications and cautions. Screen against each SmPC. Include pregnancy, breastfeeding and plans to conceive; previous pancreatitis; diabetes treatment that may need adjusting; and planned surgery or sedation.
• Eating disorders and vulnerability. Screen for current or past eating disorders and do not prescribe to people with a BMI below the licensed range. The GPhC’s review lists supply to people with a history of eating disorders, people who were pregnant and under-18s among the concerns it received.
• Consent to share with the NHS GP. See the NHS interface section below.

Safety information to give every patient

• Pregnancy and contraception. The MHRA says GLP-1 medicines should not be taken in pregnancy. Stop semaglutide at least 2 months, and tirzepatide at least 1 month, before trying to conceive. Tirzepatide may reduce the effect of oral contraceptives: advise switching to a non-oral method, or adding a barrier method for 4 weeks after starting and after each dose increase.
• Pancreatitis. Acute pancreatitis has been reported, including rare fatal cases. Patients should seek urgent help for severe, persistent abdominal pain that may radiate to the back. If pancreatitis is confirmed, semaglutide should not be restarted.
• Anaesthesia and sedation. These medicines slow stomach emptying, so patients must tell an anaesthetist they are taking one.
• Genuine supply. The MHRA warns that the only way to be sure of a genuine medicine is a prescription dispensed by a legitimate pharmacy.
• Side effects. Explain how to contact you, and report suspected adverse reactions through the Yellow Card scheme.

Monitoring, follow-up and audit

Set review points in the protocol: before each dose increase, at 3 months, and at 6 months for the NICE response check. At each review record weight (verified), side effects, adherence, mood and eating behaviour, and diabetes control where relevant. The GPhC found complaints about doses being titrated automatically without review and treatment stopped abruptly without explanation, so make every dose change a clinical decision and plan how treatment ends.

Audit quarterly: the proportion of patients with a verified baseline BMI, 6-month weight change, discontinuation reasons, adverse events and Yellow Card reports, and the proportion with a letter sent to the NHS GP. These are the outcome measures an inspector will ask about.

Prescribing: in-house, or a prescribing or pharmacy partner

There are three common routes:

• You prescribe, a pharmacy dispenses. You issue a private prescription and a GPhC-registered pharmacy dispenses and delivers. You keep clinical control; the pharmacy carries dispensing and cold-chain responsibility.
• You assess, a partner prescribes. Some GPs use an online pharmacy’s prescribing service. This is simpler but you lose control of dose decisions, and the GPhC now expects pharmacies to carry out due diligence on third-party prescribers.
• You buy stock and supply. Holding refrigerated stock adds storage, cold-chain and wholesale questions. Most GP-led services avoid it.

Whoever prescribes, the GPhC’s 2025 distance-selling guidance puts weight management medicines in a higher-risk group. Before these medicines are supplied online, the prescriber must not rely on a questionnaire alone, must independently verify the person’s weight, height or BMI, should have the GP’s contact details and consent to share, and must work within national prescribing guidance. The GMC’s prescribing guidance says much the same: a face-to-face consultation may be more appropriate when you are not the patient’s usual doctor and they will not let you share information with their GP, particularly when treatment needs monitoring.

Private e-prescribing makes the pharmacy route much smoother. A good example is Jump, a newer record system on the market, which integrates with several pharmacies (SignatureRx, Roseway, Chemist4U, Healistic and CloudRx), so you and your patients keep a choice of partner rather than being tied to one. Its prescribing is checked against dm+d. Alternatives include Semble or Hero Health, or using a pharmacy’s own prescribing portal. See private prescribing governance.

Supply problems and price changes

Plan for disruption. Particular strengths can be hard to obtain, and list prices can change sharply: Mounjaro’s reimbursement prices rose from September 2025 to between £133 and £330 a pack depending on strength, from £92 to £122 before. The GPhC said most price-related concerns it received came in August and September 2025. It also recorded many complaints about cold-chain failures in delivery.

Protect patients from this by agreeing what happens if a strength is unavailable (hold, switch, or pause with review), keeping pharmacy choice open, not quoting medicine prices in your own fees, and checking delivery and cold-chain arrangements with any pharmacy you work with.

The wraparound: diet, activity and behaviour support

Medicines alone are not a weight management service. NICE NG246 says medicines should be used alongside a reduced-calorie diet and increased physical activity, with information, support and counselling on diet, activity and behavioural strategies when they are prescribed. NHS England’s tirzepatide guidance makes wraparound care mandatory in primary care: nutritional and dietetic advice as a minimum, plus access to behavioural change components, for at least 9 months from the start of treatment.

A practical wraparound for a small private service:

• a dietitian-led first session and group or video follow-ups (contract an HCPC-registered dietitian sessionally)
• a personalised nutrition plan set by the dietitian and revisited as the dose changes
• an activity plan, with strength work, agreed at each review
• behavioural support: goal setting, eating patterns, and a plan for maintaining weight after stopping
• a clear exit: what happens at the end of the programme, and how patients are supported if they stop

Safeguarding against misuse

• Do not prescribe outside the licensed BMI range, and never for cosmetic weight loss in people of healthy weight.
• Treat repeat requests to change BMI evidence, refusals to be weighed, or a history of eating disorders as triggers for a fuller assessment.
• Check for medicines from other sources, and record that you asked.
• Most GP-led services treat adults only. Under-18s with obesity are better served by specialist paediatric services.
• Watch for coercion. The GMC lists concern that a patient is not deciding freely, or lacks a safe place to consult remotely, as reasons a face-to-face consultation may be more appropriate.
• Record refusals and the reasons, and direct people you decline to an appropriate service. The GPhC expects prescribers to document refusals and reasons for discontinuation.

Systems: records, prescribing, booking and letters

You need a clinical record that can code the diagnosis, measurements and medicines; an e-prescribing route; online booking and payment for a recurring programme; video consultations; a way to collect pre-consultation questionnaires (as a starting point for a conversation, never a substitute); and a reliable route for letters to the NHS GP. Set recalls for each review point so no patient drifts onto unreviewed repeats. See sending notes to the NHS GP.

Staff, training and indemnity

• Prescribing GP. Owns the protocol, assessments and dose decisions. Keep up to date with the SmPCs, MHRA safety communications and NICE guidance.
• Dietitian. Sessional; delivers the nutrition element and contributes to reviews.
• Nurse or healthcare assistant. Can take verified measurements and teach injection technique, under a clear scope and supervision.
• Reception and admin. Trained not to promise a prescription, and to route clinical queries quickly. Slow responses to clinical questions were a theme in the GPhC’s review.

Tell your medical defence organisation or indemnity provider before you launch, describe the service (including any remote element), and get written confirmation that it is covered. See indemnity for private GPs.

Premises and equipment

• calibrated medical-grade scales with a suitable weight capacity, a wall-mounted stadiometer, and a tape for waist measurement
• a blood pressure monitor with a range of cuff sizes
• suitable seating and an accessible room
• a sharps disposal route if patients are taught injection technique in clinic
• if you ever hold stock: a pharmaceutical fridge with temperature monitoring and records

Pricing and unit economics

Keep your fee separate from the medicine. Patients pay the pharmacy for the medicine on your private prescription; you charge for assessment, reviews and the wraparound. This protects you from list price changes and keeps your advertising compliant.

Illustrative example only (not a benchmark):

Line	Illustrative figure
Initial assessment (40 minutes, in person)	£150 one-off
Monthly programme (GP review, dietitian group session, messaging)	£95 a month
Medicine, paid to the pharmacy	Separate; set by the pharmacy
GP time per patient per month (about 15 minutes)	about £30 cost
Dietitian time share, systems, payment fees, admin	about £25 cost
Contribution per patient per month	about £40

On these illustrative numbers, 60 active patients would contribute about £2,400 a month before fixed costs such as rent, registration, indemnity and marketing. What drives margin is retention (patients who stay through the 6-month review), how efficiently reviews run, and the dietitian model (group sessions cost less per patient than one-to-one). Show the full price, including any compulsory reviews, before the patient commits. See private GP pricing and break-even.

Marketing a weight loss clinic: advertising rules

You cannot advertise a prescription-only medicine to the public. The Human Medicines Regulations 2012 ban it, and rule 12.12 of the CAP Code says the same. In September 2025 the MHRA, ASA and GPhC updated their joint enforcement notice. It warns against terms such as "weight-loss injection", "obesity treatment jab" or "GLP-1", against imagery consumers would read as a prescription medicine (such as pens or vials), and against general weight-loss ads that send people to landing pages promoting the medicines. The MHRA said it had taken action against more than 25 businesses in 2025.

ASA rulings in July 2025 found against ads using "weight loss injections", "skinny jab", "weight loss pen", "GLP-1", pen and vial images, and prices per pen. What you can do: advertise a weight management consultation or programme, as long as it does not imply a prescription is the outcome. Talk about assessment, a named doctor, dietitian support and follow-up. Keep drug names off your homepage, ads, social posts and paid search terms. See advertising rules for private GPs.

The NHS interface

Ask for consent to share with the patient’s NHS GP before you prescribe. The GMC says that if you are not the patient’s regular doctor you should seek consent to contact their GP for information and to share information after the episode of care. If the patient refuses, explain the risks and record the discussion; if not sharing would make prescribing unsafe, explain that you cannot prescribe and signpost alternatives.

Send a proper letter: the medicine, dose and titration plan, the planned duration, the monitoring you will do, and who to contact. The GPhC’s review recorded NHS GP practices receiving notifications that left out the dose or regimen, and practices objecting to online prescribers asking them to confirm a patient’s suitability before prescribing, which shifts clinical responsibility onto the NHS GP. Do your own assessment; ask the GP for specific information, not sign-off.

Do not assume the NHS will take over prescribing or monitoring. NICE NG246 says weight medicines may be continued in primary care, for example with a shared-care protocol, only if local circumstances or licensing allow. In Wales, BMA Cymru Wales advises practices they may decline to prescribe or monitor these medicines unless commissioned. In England, NHS tirzepatide prescribing in primary care began on 23 June 2025 for a priority cohort (initially a BMI of 40 or more with at least 4 of: high blood pressure, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease and type 2 diabetes), widening in phases. Some of your patients may become eligible on the NHS; tell them, and make the handover safe.

Launch checklist for a GP-led weight loss clinic

1. Choose your model: in person, hybrid or remote, and programme length.
2. Check registration: CQC scope (slimming clinics or treatment of disease, disorder or injury), or HIW, HIS or RQIA. Apply for any variation and update your statement of purpose.
3. Write the prescribing protocol: licence or NICE thresholds, ethnicity adjustments, exclusions, verification method, review schedule, stopping rules.
4. Write the safeguarding procedure: eating disorders, under-18s, coercion, supply from other sources, refusals.
5. Choose your prescribing route and pharmacy partner(s); check their GPhC registration, delivery and cold-chain arrangements.
6. Set up systems: coded templates, e-prescribing, recalls, booking and payment, video, and NHS GP letters.
7. Contract a dietitian and design the wraparound programme.
8. Confirm indemnity in writing for the service, including remote work.
9. Buy and calibrate equipment.
10. Prepare patient information: safety advice, contraception, side effects, Yellow Card, how to contact you, and what happens at the end of treatment.
11. Set prices with the medicine separate, and publish the full cost.
12. Check all marketing against the CAP Code and the MHRA enforcement notice before it goes live.
13. Run a test patient journey end to end, then book your first audit date.