Body & weight
Medical weight management
A physician-supervised programme for weight reduction with a modern, GLP-1-based injection therapy – following a careful suitability assessment, with an individual treatment plan and regular follow-up checks.
Treatable areas
- Medical weight reduction
Obesity is a recognised chronic disease in which hormonal regulatory loops, metabolism and appetite regulation play an essential role – many of those affected know the yo-yo effect after numerous diets. Medical weight management combines a modern medication-based therapy with continuous medical supervision and an adjustment of diet and lifestyle.
At its heart is an injection therapy based on GLP-1 receptor agonists. GLP-1 (glucagon-like peptide 1) is a gut hormone produced by the body itself that enhances the feeling of satiety, curbs the appetite and slows gastric emptying. The active substances used mimic this hormone and – in combination with an adjusted diet and more exercise – can support weight reduction. These are prescription-only medicines whose use requires a careful medical assessment; for legal reasons we deliberately do not name any preparations.
All information is provided for general guidance and does not replace personal medical advice. Treatment results can vary from one individual to another.
Indications
Who it is suitable for
Whether a treatment makes medical sense in your case is something we determine together in a personal consultation. Typical concerns include:
- Adults with obesity (as a rule from a BMI of 30 kg/m²)
- Adults with excess weight (BMI from approx. 27 kg/m²) and weight-related concomitant conditions, e.g. high blood pressure, lipid metabolism disorders or prediabetes
- Patients in whom dietary change and exercise alone have not so far led to a lasting weight reduction – for example with a recurring yo-yo effect
- People who wish for a structured, medically supervised therapy rather than untested self-medication and are willing to actively support it through dietary change and exercise
Step by step
How the treatment works
This is how the treatment usually proceeds with us – from the first consultation through to aftercare.
Detailed consultation and suitability assessment
At the first appointment we record BMI, previous dieting attempts, pre-existing conditions, your current medication and possible contraindications; where needed, we arrange additional investigations such as laboratory values. Only on this basis do we decide together whether a prescription is a medical option.
Information about mode of action, side effects and alternatives
We explain in understandable terms how GLP-1-based active substances work, which results are realistic and which side effects may occur. We also openly address treatment alternatives and the limits of the therapy, so that you can make an informed decision.
Individual treatment plan and start of therapy
If the therapy is an option for you, we draw up an individual treatment plan with a gradually increasing dosage adjusted to your tolerability. After precise instructions, you carry out the usually once-weekly injection into the subcutaneous fatty tissue yourself at home.
Regular medical follow-up checks
At fixed intervals we monitor the weight course, tolerability and – where sensible – relevant laboratory values; the dosage is adjusted if needed, side effects are discussed and treated.
Evaluation and long-term strategy
Together we assess the success of the therapy at regular intervals and discuss the further course of action – from continuation through dose adjustment to a structured tapering-off. The aim is a strategy with which you can maintain your weight even beyond the treatment.
Transparency
Prices
- Dosisstufe 1 (Einstieg)
- 100 €
- Dosisstufe 2
- 115 €
- Dosisstufe 3
- 140 €
- Dosisstufe 4
- 150 €
Die passende Dosisstufe legen wir gemeinsam im Rahmen der ärztlichen Verlaufskontrollen fest.
All prices are guide values for initial orientation. Medical services are billed according to the German scale of fees for physicians (GOÄ); the final amount depends on the individual effort involved and is discussed transparently with you before treatment. For treatments without a listed price, we are happy to give you a guide value during your consultation.
Patient information
Safety & patient information
Responsible treatment includes open information about possible risks and side effects – even when they occur only rarely.
Nausea and a feeling of fullness
The most common side effect, especially at the start of therapy and after dose increases; it is an expression of the slowed gastric emptying and usually improves over the course. Smaller meals and avoiding very fatty foods can ease the complaints.
Further gastrointestinal complaints
Constipation, diarrhoea, vomiting, bloating or belching also occur commonly, are mostly temporary and well manageable; in the case of persistent or strong complaints, we adjust the dose or pause the therapy.
Heartburn and reflux complaints
Owing to the delayed gastric emptying, heartburn or acid belching may occur; adjusted eating habits usually help, and if needed an accompanying treatment.
Reactions at the injection site
Redness, slight swelling or itching at the injection site are possible and usually subside on their own; a regular change of the injection site prevents skin irritation.
Tiredness, headaches, dizziness
Particularly in the initial phase, some patients report fatigue, headaches or dizziness – in part as a consequence of the reduced food and fluid intake; drinking sufficiently is therefore important.
Loss of muscle mass
As with any larger weight loss, part of the lost weight is attributable to muscle; a protein-rich diet and strength training can counteract this effect.
Hypoglycaemia (low blood sugar)
With use on its own, the risk is low. In combination with certain blood-sugar-lowering medications, however, episodes of low blood sugar may occur – your overall medication is therefore carefully checked before and during the therapy.
Gallstones and biliary tract diseases
A rapid weight loss generally increases the risk of gallstones; biliary tract diseases have also been described under GLP-1-based therapies. Sudden, colicky pain in the right upper abdomen should be clarified medically promptly.
Inflammation of the pancreas (pancreatitis)
Rarely, inflammation of the pancreas has been observed under the therapy. Warning signs are persistent, severe upper abdominal pain that can radiate into the back, often with nausea – in this case the therapy is to be stopped and medical help sought immediately.
Note from animal studies on the thyroid
In studies on rodents, tumours of the thyroid C cells (medullary thyroid carcinoma) were observed under GLP-1 receptor agonists; whether this finding is transferable to humans is not clarified. In accordance with the prescribing information, the therapy is not used in the case of a personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2.
When we do not treat
In certain situations we do not carry out a treatment, or only at a later time – for your safety.
- Pregnancy, breastfeeding and a currently planned pregnancy – before a planned pregnancy the therapy must be ended in good time
- Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 (MEN 2)
- Previous or existing inflammation of the pancreas (pancreatitis)
- Severe gastrointestinal diseases, in particular a strongly delayed gastric emptying (gastroparesis) or chronic inflammatory bowel diseases in an active phase
- Known hypersensitivity to the active substance or one of the other ingredients
- Active diseases of the biliary tract – start only after clarification and individual benefit-risk assessment
- Severe liver or kidney function disorders – only after individual medical assessment
- Existing or past eating disorders (e.g. anorexia, bulimia) as well as underweight or normal weight without medical indication – a purely cosmetic wish to lose weight is not a basis for treatment
- Age under 18 years – we treat exclusively adults
This information does not replace a personal medical consultation. Before every treatment we inform you individually about the procedure, risks and alternatives.
In depth
Medical details & background
How it works & the evidence
According to today's medical understanding, obesity is a chronic disease – recognised as such, for example, in the S3 guideline on obesity of the AWMF guideline register. Body weight is not steered by willpower alone, but by an interplay of hormones, the nervous system and metabolism. After diets, the body often responds with counter-regulation: energy expenditure falls, hunger-promoting hormones rise, satiating signals diminish – which explains why purely will-based strategies often reach their limits.
A central role in appetite regulation is played by the incretin system: gut hormones such as GLP-1 signal satiety to the brain, slow gastric emptying and support the need-based release of insulin. GLP-1 receptor agonists mimic this hormone but act considerably longer: they curb the feeling of hunger in the appetite centres of the brain and prolong satiety after meals. This makes it easier for many patients to actually implement a calorie-reduced diet – the active substances do not, however, “burn” any fat but support the behavioural change at a physiological level.
The injection therapy is therefore not a substitute but a building block of a multimodal treatment consisting of dietary change, exercise, behavioural change and, where appropriate, medication support, as also provided for in the S3 guideline on obesity. The medical supervision encompasses the gradually increasing dose escalation, the monitoring of weight course and laboratory values as well as strategies for maintaining muscle mass.
The active-substance class of GLP-1 receptor agonists is among the best-studied therapies in modern obesity medicine. Large randomised, placebo-controlled study programmes show that the therapy, in combination with a lifestyle intervention, can lead to clinically meaningful weight reductions – considerably beyond lifestyle measures alone; favourable effects on blood sugar and blood pressure values have also been described. We deliberately refrain from naming individual studies and specific percentage figures: results vary greatly from person to person and cannot be transferred to the individual case.
Just as honestly, the limits of the evidence belong here too: after stopping the therapy, weight often rises again if the accompanying lifestyle changes are not maintained – the yo-yo risk thus exists with this form of therapy as well. Obesity is a chronic disease; the treatment is to be understood more as a longer-term concept than as a short-term cure, and long-term data over many years are available only to a limited extent so far. Decisive for our treatment decisions are the respectively current prescribing information of the approved medicines, the assessments of the European Medicines Agency (EMA) and the recommendations of the S3 guideline on obesity.
Preparing for your treatment
A few simple measures before your appointment help you contribute to the best possible result with as few complications as possible.
- Bring a complete list of your current medications to the consultation – including blood-sugar-lowering and anticoagulant preparations as well as dietary supplements; adjustments are made exclusively after medical consultation
- Existing prior findings, current laboratory values or doctors' letters (e.g. on the thyroid, pancreas, metabolism) facilitate the suitability assessment
- Inform us about previous diets, earlier attempts to lose weight and your weight development – this helps to design the treatment plan realistically
- Be sure to tell us about an existing wish to have children or a possible pregnancy before the start of therapy
- Under no circumstances start beforehand with preparations from untested sources (e.g. internet orders without a prescription) – this can be a health risk and distort the suitability assessment
Aftercare
The right care after treatment supports healing and the result. You will receive individual recommendations from us – as a rule:
- Store the medicine according to instructions (as a rule in the refrigerator) and regularly alternate the injection sites between abdomen, thigh and upper arm
- Adhere to the agreed dosage plan with a gradually increasing escalation – never increase the dose on your own initiative and do not double a missed dose
- Pay attention to a protein-rich, balanced diet and sufficient fluid intake (guide value approx. 1.5–2 litres daily), in order to prevent muscle loss and circulatory complaints
- Where possible, complement the therapy with regular exercise, ideally with strength training to maintain the musculature
- In the case of warning signs – persistent vomiting, severe upper abdominal pain or pain radiating into the back, colicky pain in the right upper abdomen – seek medical help promptly
- Attend the agreed follow-up checks – they serve to adjust the dose and to monitor tolerability and, where applicable, the laboratory values
- Do not stop the therapy abruptly and not without consultation – the tapering-off and the stabilisation phase we plan together
- Report new medications, relevant new diagnoses or a pregnancy that has occurred or is planned to us immediately
FAQ
Frequently asked questions
Answers to questions we are asked particularly often about “Medical weight management”.
Sources & guidelines
- S3 guideline “Prevention and therapy of obesity” – AWMF guideline register (lead: German Obesity Society, DAG)
- Current prescribing information of the GLP-1 receptor agonists approved in the EU for weight regulation
- European Medicines Agency (EMA) – public assessment reports on medicines for weight management
- German Obesity Society (DAG) – patient information on obesity as a chronic disease
Personal consultation
Arrange a personal consultation
In a confidential conversation on our practice floor at the Albertus Zentrum in Mönchengladbach, we take time for your questions and assess whether the treatment may be suitable for you.
More treatments
You might also be interested in
The basis of every weight reduction remains the multimodal lifestyle therapy of dietary change, exercise and behavioural change; in the case of higher-grade obesity, bariatric surgery at specialised centres can also be an established option. For people of normal weight with individual, circumscribed fat deposits, injection lipolysis is more suitable than a systemic therapy; after a larger weight reduction, skin-tightening procedures such as the fractional CO₂ laser or hyaluronic acid fillers can complement the result.
