Question 1

What was your sex registered at birth? (i.e your biological sex) *

Question 2

What is your height? *

Question 3

What is your current weight? (It's really important you give us an accurate up-to-date measurement. You may be asked to provide evidence of your current weight) *

Question 4

What is your ethnicity? (This will help our prescribers gain a better idea about your risk in relation to your weight) *

Question 5

Do you have any of the following conditions? *

Question 6

Do you have gallbladder or bile duct issues? *

Question 7

Do you have liver impairment? *

Question 8

Do you have diabetes? *

Question 9

People with weight-related medical conditions may be prescribed weight loss medicines at a lower BMI than other patients, if suitable. Please let us know if you have any of the following weight-related conditions: *

Question 10

Have you ever made yourself sick (vomit) to control your shape or to lose weight? *

Question 11

In the last year, have you taken laxative medication in order to lose weight? *

Question 12

Do you worry that you have lost control over how much you eat? (i.e. you have eaten an unusually large amount of food and have had a sense of loss of control at the time?) *

Question 13

Would you say that food or image dominates your life? *

Question 14

Do you ever eat in secret? *

2. Your Medical History

Question 16

Do you have any allergies? *

Question 17

Have you had any surgery in the past 3 months? *

Question 18

Have you ever been diagnosed with an eating disorder (such as anorexia, binge eating disorder or bulimia) by a healthcare professional? *

Question 19

How much exercise do you undertake each week? *

3. Your Treatment

Question 20

Are you CURRENTLY using any of the following (You have used a dose within the last 2 weeks) *

Question 27

Details of your current GP. To ensure the best level of care, you must provide these details before you can proceed. We will notify your GP if a supply is made. Your order may be delayed if you do not enter the correct GP name and address. *

Question 28

We need to visually assess your weight against your BMI and other medical history by capturing real-time photos of you.

Photos will only be used by our clinical team and will help our clinical team assess your order quickly.

Review our photo guide to understand what to wear and how best to stand.

Stand in front of a clear background, in full light and in focus, without any glare or obstructions.

Relax – a 5 second timer lets you get into position for both your front and side image. You’ll be able to review and confirm your photos and retake if you need it.

Not able to take photos right now? Select the ‘Take photos later’ option and add them later. But remember, we won’t be able to approve your order until you upload your photos.