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Early animal and small human studies suggest it is generally well tolerated in the short term, but we do not yet have large, longterm trials

These include: Lifestyle interventions (dietary advice, physical activity programmes) Licensed pharmacotherapy such as orlistat, or GLP-1 receptor agonists including semaglutide 2.4 mg (Wegovy, NICE TA875) or tirzepatide (Zepbound) where clinically indicated and available Referral to tier 3 or tier 4 weight management services , including bariatric surgery assessment where appropriate Information on NHS weight management services and eligibility for licensed treatments is available via the NHS website and NICE guidance

(3) having a history of jejunoileal bypass surgery or gastroplasty

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