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NICE-approved weight management interventions include: Dietary and lifestyle modification first-line approach for all patients Orlistat licensed medication for obesity (BMI 30 or 28 with comorbidities) GLP-1 receptor agonists including semaglutide (Wegovy) per NICE TA875 and liraglutide (Saxenda) with restrictions per NICE TA664, for specific patient groups Bariatric surgery for severe obesity meeting strict criteria The NHS emphasises that sustainable weight loss requires behavioural change, nutritional education, and increased physical activity

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Research indicates that high doses of B12particularly from supplements or injectionsmay alter skin bacteria behaviour and inflammatory responses in some people

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Probiotics Since tirzepatide affects gut motility and GLP-1 pathways, it may also influence your microbiome