Liraglutide 3 mg (Saxenda) , also a GLP-1 receptor agonist, is recommended by NICE (TA664) for adults with a BMI of 35 kg/m or above (or 32.5 kg/m in certain ethnic groups) and prediabetes, within a specialist weight management service
The medication works by reducing appetite
If patients do not tolerate the 2.4 mg dose, the dose can be decreased to 1.7 mg weekly
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Monitoring schedule Healthcare providers who specialize in GLP-1 therapy typically recommend this monitoring cadence: Baseline: Full B12 panel before starting semaglutide 3 months: Repeat serum B12 and MMA 6 months: Full panel reassessment Annually: Once stable, annual monitoring is usually sufficient For high-risk patients (metformin users, vegans, those over 60, post-bariatric surgery), the 3-month check is particularly important