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Medical Assessment for Weight Loss Management

Complete this short online consultation so our medical team can show you suitable treatments.

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Tell us about yourself
Are you aged 18 or over? (You must be at least 18 years old to complete this medical consultation and receive treatment)
Your Health Information
Are you currently pregnant, breastfeeding, or planning to become pregnant or breastfeed while using this medication?
Do you have a medical diagnosis of any of the conditions listed below?

A condition affecting the absorption of food, such as chronic malabsorption, diagnosed by a GP or healthcare professional

Any existing liver condition or impairment

Any existing kidney condition or impairment

A diagnosed thyroid disorder

Previous surgery to remove the gallbladder (gallbladder removal surgery)

Cholestasis or any condition that restricts the normal flow of bile from the liver

Any serious or unstable medical condition that may require urgent hospital treatment

 

 

Have you ever had an eating disorder, for example anorexia or bulimia, that was identified by a healthcare professional?
Your Current Medication
Do you take any current medication, including prescription treatments, over-the-counter products, or any recreational drugs?
Do you take any medicines for cholesterol, diabetes, or blood pressure?
Do you currently take the contraceptive pill?
Patient Declaration & Agreements
Do you agree to the following? Please read each statement carefully before confirming. This ensures you understand how your treatment will be supplied and used safely.

☑️ I will read the Patient Information Leaflet provided with my medication before use.

☑️ I will contact ifeelshy and inform my GP immediately if I experience any side effects, start a new medication, or if my medical conditions change during treatment.

☑️ I understand that the treatment is for my personal use only and will not be shared with anyone else.

☑️ I confirm that I have answered all questions accurately and truthfully to the best of my knowledge.

☑️ I understand that the prescriber relies on my answers in good faith, and that providing incorrect or incomplete information could affect my health.

☑️ I understand that while treatment decisions are made jointly between myself and the prescriber, the final decision to issue a prescription rests with the prescriber.
Are you aware that this treatment must be stopped once your BMI is under 28?
Are you aware that treatment may need to be stopped if you have not lost weight after three months of starting treatment?
Do you understand that you should take a multivitamin that contains vitamins D, E, and K and beta carotene? It should be taken once a day at least 2 hours before or after taking Orlistat (Xenical/Alli/Orlos) such as at bedtime.
Do you understand the treatment should be taken with a nutritionally balanced, calorie-controlled diet that contains approximately 30% of the calories from fat? It is recommended that your diet is rich in fruit and vegetables.