Please either call me, message me or book a free 5 minute consultation slot. 

If you call or message me, I shall contact you within normally a few hours but at the latest within one working day to agree a plan.  

This may include an appointment date, time and duration at the clinical rooms at Elcot Lane - there is parking directly outside the clinical rooms.

NHS care:

• Is free at the point of contact.

• Has good links to many types of specialist and support.

Private healthcare:

• Is paid for directly at the point of contact by you or your insurer.

• Offers access to a wider variety of specialists.

• You are seen much sooner.

• You can control when appointments are and you are normally seen punctually.

• The environment is often less utilitarian.

• You can choose to see the same clinician without delay.

• Booking systems are simpler to use and often over the phone.

No, I operate a confidential service - but will share information with your GP with your permission.

You can be referred privately to specialists. You can also be referred to an NHS specialist - in a similar way that your NHS GP could.

• We all passionately want you to have good health.

• The quality of websites, influencers and news articles is varied and often commercially biased.

• All websites will cover themselves legally by including significant diagnoses that are unlikely but possible based upon the symptoms entered. So searching may leave you with information that is either dangerous of leaves you feeling unnecessarily worried.
  

• Websites offer generalised information. Individual consultation provide greater accuracy and tailored advice.
  

• The following websites are better than most.
  
  1. www.patient.co.uk ("patient info" articles contain less jargon than "professional" articles). It is written verified and edited by doctors and is linked.
  
  2. www.nhs.uk is managed by the Department of Health and Social Care and NHS England.
  
  3. https://library.hee.nhs.uk/ is a department of health website that lists reputable websites.
  
  

• Having said that Doctors generally want to support you and encourage you to lead managing your health. Some judicious reading can be very helpful.
  

• If you have found something on a search that has led you to worry about your health, telling us directly is hugely helpful.

The world has changed with injectable weight loss drugs. From late summer 2026 Wegovy / Semaglutide arrived in tablet form. Many new weight loss drugs are coming. Should you be considering medication?

Yes, no and maybe….

Why yes

• If you have a BMI (see appendix at the end about BMI) over 40 you have roughly a 5% chance of achieving weight loss without targeted professional weight loss advice. Losing weight will likely confer phenomenal benefits to your physical health (diabetes risk, heart health, joint pain, gallstones and MANY more) and how you feel about yourself. However please don’t use this method alone despite a worrying number of providers advocating for this.

Why no

• If your weight is below this threshold – there may be very sustainable ways of making changes that will encourage gradual sustainable weight loss without significant costs. Additionally the drugs can cause significant harms – most notably your weight loss will be 60% fat but 40% bone and muscle loss – precisely what you want to avoid for a healthy middle and late part of your life. See the following https://www.medicines.org.uk/emc/product/15484/pil

Why maybe

• If you have really struggled to lose weight this may be an excellent tool but only ONE part of the toolkit. Please read on to know more. With all elements of your health not just weight management, I tend to bring in medicines last. I work around the diagram below starting with Socialising working anticlockwise. Why is this?

The British Society of Lifestyle Medicine has found that addressing issues in this order results in greater likelihood of persistence with a behaviour change and therefore success. For example – if depressed, making changes to exercise or diet is unlikely sustainable.

1. Socialising – Quality of relationships with family, friends and colleagues.

2. Temperament - mood and mental health.

3. Activity – work and hobbies

4. Nutrition – food, fluids, snacking, timings.

5. Damages – e.g. alcohol, drugs, gambling

6. Sleep – quality and duration

7. Medications – Tablets Wegovy / Semaglutide injections (Wegovy / Semaglutide or Mounjaro /Tirzapetide.

How do each of these sections work in practice?

• Socialising – Quality of relationships with family, friends and colleagues.

• How do your relationships with your family, friends and work colleagues impact your mood, Temperament - mood and mental health.

• How does your mood affect your decision making and readiness to make change. What psychological barriers are currently in place. What psychological impact has previously weight loss attempts had upon you. Would some specialist psychological support be helpful here?

Activity – work and hobbies

• How do the time, stress and physical demands of your work impact.

• How may your hobbies be helping / counteracting your efforts. What exercise types will give you the best outcome for weight loss. What exercise should you be considering with expected muscle loss during menopause or if using GLP1 medicines or both?

Nutrition – food, fluids, snacking, timings

There is no golden bullet diet. Your food choices have to match your biochemical needs within the goalposts of daily life. Specialist dietician collaboration (I can arrange) in some cases can be vital – particularly with repeated failed diet plans, cancer, using GLP1 medicines or peri/ menopause.

Damages – e.g. alcohol, drugs, gambling

• Alcohol and recreational drugs may affect inhibitions, metabolic processing of food, food choices and quantities.

Sleep – quality and duration

• Sleeping 7 hours versus 8 hours increasing your risk of obesity by 25%. How can we reduce this risk, intiate and maintain sleep better and work around sleeping patterns.

Medications

• We will discuss medicines that may increase your appetite, interrupt your sleep or make you gain weight in other weights.

• Are there blood tests that may precede medicines for weight loss – kidney and thyroid function

• What are the pros and cons of weight loss medicines like GLP 1 injectables, Fat absorbtion blocking medicines.

A note about BMI:

This is calculated by dividing your weight by height – try it here:

https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-adults

What is it for: It is supposed to be used to establish how at risk you are of health problems based on your weight. It is very useful for estimating the health of populations.

However not as much for individuals as it doesn’t consider individual features of muscle mass or breast size.

Much more useful is a height to abdominal waist circumference ratio:

https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/measuring-your-waist

Despite the above eligibility for weight loss drugs is currently based on BMI.

It seems odd that doctors do this - Surely you went to ask their opinion? Some can find this irritating, condescending or even that the doctor is asking the patient to do their work. Others feel this shows the doctor values their patient’s opinion.

Why:

It sounds obvious – but consultations tend to be most effective when the patient and doctor are both clear about 3 key bits of information.

1. What the patient ideas are about what the problem is.

2. What the patient is really concerned about – worst case scenarios.

3. How they are expecting the issue to be addressed.

So doctors are trained to gather this information using the model “ICE” Asking about Ideas, Concerns and Expectations.

This can seem clumsy if someone asks –“What are your ideas/ concerns / expectations?” This information is often gathered by generally listening but occasionally doctors may ask directly if the agenda is unclear.

Often the ICE elements are obvious:

• E.g I have an infected cut after falling off a horse. I would like treatment.

Sometime less so:

• E.g. I have a cough. 1. I would like treatment / 2. Am I safe to visit my relative having chemotherapy? 3. Can I safely fly and compete in a skiing race this weekend?

I would always recommend that you consider your “ICE” before you visit a doctor to ensure your agenda is clear. Hopefully it might help to know why they may ask you these rather odd sounding questions!

What is Lifestyle Medicine:

• Treating an illness with a multitude of approaches that will may or may not include medicines but will usually not be medicines alone.

• An approach using the 6 pillars of the British Society of Lifestyle Medicine: Social, Temperament, Activity (work and non work), Nutrition, Damaging factors and Sleep

• An evidence based and honest approach about how a behavioural change will impact upon or prevent an illness.

• Support to help you make behaviour change – as this will require adaptation.

PLEASE beware.

1. Lifestyle medicine isn’t a whimsical promise that a supplement or single food group will magically address an issue rapidly. Lifestyle change takes time to embed and progress often takes weeks or months to show

2. Unfortunately .the term “Lifestyle” has been adopted by many practitioners and influencers who are non regulated. Many practitioners in this sphere may provide useful information but unless a practitioner use a protected term like Doctor, Physiotherapist, Dietician, Nurse or Osteopath – this person is not regulated and may little or no training.

3. The following link may be helpful to check https://www.gov.uk/government/publications/professions-regulated-by-law-in-the-uk-and-their-regulators/uk-regulated-professions-and-their-regulators

• Treating an illness with a multitude of approaches that will may or may not include medicines but will usually not be medicines alone.

• An approach using the 6 pillars of the British Society of Lifestyle Medicine: Social, Temperament, Activity (work and non work), Nutrition, Damaging factors and Sleep

• An evidence based and honest approach about how a behavioural change will impact upon or prevent an illness.

• Support to help you make behaviour change – as this will require adaptation.

PLEASE beware.

1. Lifestyle medicine isn’t a whimsical promise that a supplement or single food group will magically address an issue rapidly. Lifestyle change is an evidence based treatment requiring time and effort to embed and progress. Results often takes weeks or months to show benefits.

2. Unfortunately, the term “Lifestyle” has been adopted by many practitioners and influencers who are non-regulated. An example of a protected term is: Doctor, Physiotherapist, Dietician, Nurse or Osteopath. Please apply caution to those without these titles. The following link may be helpful to check https://www.gov.uk/government/publications/professions-regulated-by-law-in-the-uk-and-their-regulators/uk-regulated-professions-and-their-regulators

3. Please also apply caution to those who are acting outside of their areas of expertise. E.g. a Chiropractor who is providing dietary advice.

4. Please also be wary of those who are on a platform with a large audience like a popular podcast or have lots of followers on social media. Please always look at what their training is before you take advice from them.

Please visit our dedicated Complaints page for more information.