Weight loss treatment: online medical assessment

What you are buying on this page

This page sells one thing: a medical assessment of whether prescription weight management treatment is appropriate for you, either to start it or to continue it. It is not a supply of medicine, a diet programme, a coaching subscription or a body composition service, and there is no video call, phone appointment or live chat at any point.

You complete a written questionnaire. A doctor reads it in his own time and answers in writing. Because the assessment is asynchronous there is no appointment to book and nothing to fit around a clinic's opening hours, but there is also no conversation in real time, so the questionnaire has to carry everything a prescriber would otherwise ask you face to face. That is why it asks for more detail than a booking form.

The doctor is registered in Poland, not on the Irish Medical Council register, and the document that comes out of a positive assessment is a cross-border prescription written under EU rules rather than an Irish prescription form. Those two facts shape everything else on this page, including what a pharmacy will and will not do with it. They are stated here rather than in small print, because a patient who finds that out at the pharmacy counter has wasted both money and a trip.

Who is likely to qualify

Licensed weight management medicines are authorised for adults, broadly at a body mass index of 30 or more, or 27 or more where there is at least one weight-related health problem such as high blood pressure, prediabetes, type 2 diabetes, obstructive sleep apnoea or a lipid disorder. The precise wording differs between products, and the authoritative version for any given pen is its Summary of Product Characteristics, published by the European Medicines Agency and available through the HPRA.

Those figures are a threshold, not a decision. Treatment is licensed alongside a reduced-calorie diet and increased physical activity rather than instead of them, and the doctor is assessing whether the medicine is appropriate for you specifically, which is a different question from whether your numbers clear a line.

Some situations rule treatment out regardless of body mass index. These medicines are not for use in pregnancy or while trying to conceive. A history of pancreatitis, the thyroid and endocrine conditions named in the product information, active gallbladder disease, an eating disorder, or another medicine that interacts badly can all mean no. The assessment on this page is for adults, and it covers both starting treatment for the first time and continuing a medicine you are already established on.

What you need to hand before you start

Have your height and current weight to hand, measured rather than remembered, because the assessment turns on them. You will also be asked for your full list of current medicines including anything bought over the counter, your allergies, your medical history including conditions someone else is treating, and whether you have used weight management medication before, which one, at what dose and why you stopped. If you are continuing treatment you already take, add the medicine, your current dose and when you started it. The doctor may also ask for your waist measurement or recent results before deciding.

Recent blood results help, particularly HbA1c, kidney and liver function and a lipid profile, and if you have them from a GP or a health screen it is worth uploading them. They are not compulsory in order to submit the questionnaire, but a doctor who cannot see them may ask for them before deciding, and that pause is the most common reason an assessment runs longer than expected.

Answer accurately even where an honest answer is likely to produce a refusal. The doctor has nothing to go on except what you write, so an omission does not improve your chances, it moves the problem to the pharmacy counter or, worse, into a course of treatment that was not safe for you. If something does not fit the boxes, write it into the free text rather than leaving it out. Nothing you submit goes to your employer or to any insurer.

How the assessment runs, step by step

The form has four steps: Medication, Your details, Medical questionnaire and Summary. In the first you either name the medicine you are asking about or leave the choice to the doctor, and you set the pack size. In the second you enter your name, date of birth, address and contact details, which have to match the identification you will show at the pharmacy, because a name that does not match is a reason for a pharmacist to refuse.

The third step is the clinical part described above. The Summary step shows the fee before you pay, and payment happens there rather than at the start.

After payment the questionnaire goes into the doctor's queue. He reads it, and one of three things follows: he issues a prescription, he writes back asking for further information or documentation, or he declines and explains why. Where he asks for something, the request arrives by email and the assessment stays open until you answer it.

We put no time on any of this, and you should treat a service that does with suspicion, because a prescriber who guarantees a turnaround has committed to an outcome before reading the case. What we can say is that nothing has to be scheduled, so there is no appointment to be offered a date for.

What you receive and what a pharmacy does with it

A positive assessment produces a PDF prescription carrying the fields listed in the Annex to Directive 2012/52/EU: your name and date of birth, the date, the active substance rather than only a brand name, the strength, the form, the quantity, the dosage, and the prescriber's name, qualification, work address including the country, email and telephone with an international dialling code. It arrives by email. There is no code to enter, no national patient number, and no pharmacy that we send it to on your behalf.

You take it to a pharmacy of your choice with photo identification. Many pharmacists prefer a printed copy, so print it before you go. The pharmacist then checks it and decides. That decision is theirs: a pharmacist in Ireland keeps professional discretion over whether to dispense any prescription, and a cross-border one is checked in the same way as any other, sometimes with a phone call to the prescriber whose contact details are on the form. We do not guarantee that any particular pharmacy will dispense it, and nobody honestly can.

Supply is a separate obstacle. These products have had intermittent availability across Europe, and a valid prescription for a medicine the wholesaler cannot supply is still a wait. A phone call to your pharmacy about stock costs nothing.

When a doctor declines, and what happens to the fee

A refusal is a normal outcome of an assessment rather than a fault in the paperwork. The usual reasons are that you do not meet the licensed criteria, that something in your history is a contraindication, that a medicine you already take interacts, that the information given is not enough to decide safely, or that the doctor judges a physical examination or a blood test is needed first.

What happens to the fee is stated here, before you pay. The fee pays for the medical assessment, not for the issuing of a document. Where the doctor declines on medical or legal grounds, the fee is refunded. If the doctor asks you for documentation, you have at least 7 days to provide it and we will remind you before the deadline; if the consultation cannot be completed, we refund the full amount.

A request from the doctor is easy to miss, so watch for email from us after you submit, including in a spam folder. If a request arrives and you no longer want to go ahead, say so rather than going quiet. A refusal also comes with a reason written in plain language, which is usually the more useful thing to bring to a GP.

What it costs, and what it does not cover

The assessment is 29.90 euro. That is the whole of what we charge for it, there is no subscription, and nothing renews on its own.

The medicine is a separate cost, paid to whichever pharmacy dispenses it, at a price that pharmacy sets. Reported private costs in Ireland for these products run roughly from 180 to 350 euro a month, and the figure usually rises over the first months because the dose is stepped up rather than started at maintenance level. Budget for the maintenance dose rather than the starting one, and ask the pharmacy for its own price instead of relying on a figure from a comparison page.

Reimbursement is where expectations most often break. The Drugs Payment Scheme caps what a household pays each month for prescribed medicines that are reimbursable, but a product has to be covered before any cap can apply, and GLP-1 treatment prescribed for weight management is generally not reimbursed in Ireland. The same active substance prescribed for type 2 diabetes is handled differently, which is why two people comparing notes can get very different answers. Ask the dispensing pharmacy to check the status of your specific prescription before you commit to a course, because that answer, not ours, decides the real monthly cost.

Continuing treatment after the first prescription

Weight management medication is not a single course with an end date built into it. Doses are stepped up over the first months, and the withdrawal phases of the trials that supported authorisation showed that when treatment stops appetite returns and most people regain a substantial share of what they lost. Obesity behaves as a long-term condition, and these medicines treat it while they are being taken.

Practically, that means deciding early what continuing looks like and what it will cost every month, not only in the first one. Plan the exit as well: a maintenance dose, or a handover to eating and activity changes that have had long enough to become routine. Resistance training and adequate protein are worth attention, because some of the weight lost on these medicines is lean tissue rather than fat.

If you are continuing treatment you are already established on, including treatment started elsewhere, this same weight management assessment at 29.90 euro is the service for that. Continuation is not automatic in either direction: a doctor reviewing a repeat can still decline, and a new problem, a poor response or a side effect you have been putting up with are all reasons to raise it rather than to reorder quietly.

What we can do, what we cannot, and who is behind this service

What we can do: assess, from your written questionnaire, whether a licensed weight management medicine is appropriate for you, whether you are starting treatment for the first time or continuing one you are already established on; ask for your current weight, your waist measurement or test results where the doctor needs them; and, where treatment is appropriate, issue a cross-border prescription as a PDF. The doctor can also decline, or advise you to be seen in person first.

What we cannot do is worth knowing before you start. We cannot issue an Irish prescription form, register you with a GP, examine you, issue a certificate supporting an Illness Benefit claim, or supply medicines. A referral for blood tests is a separate service, Test Referral: the doctor decides from your written answers whether to issue one, the laboratory decides whether to accept it, and the test itself is paid for separately. We do not prescribe controlled substances, which are excluded from cross-border prescriptions under Article 11(6) of Directive 2011/24/EU, although that exclusion does not affect the medicines discussed on this page.

MEDINOW is operated by MEDINOW Sp. z o.o. The assessment described here is carried out by lek. Damian Wojno, a doctor registered in Poland, PWZ no. 3211301. He is not on the Irish Medical Council register, and this service does not replace a GP. Under Directive 2011/24/EU a doctor providing a service from another member state is regulated by the state he is registered in, which is why the prescription carries his registration details and an international contact.

Severe abdominal pain going through to the back, persistent vomiting, chest pain or signs of dehydration are urgent matters for a doctor who can see you, not for a questionnaire. This page was written by the MEDINOW editorial team and reviewed by lek. Damian Wojno. Corrections are welcome by email and are made to the page.