I simply will support you during the process of weight control. Nothing is aimed to be too drastic or rapid as that is not sustainable nor pleasant. It shouldn't be torture!
Whilst on medication you must drink plenty of water, you will feel like reducing your food intake, but you must still take healthy snacks e.g. cashew nuts or fruit during the day. I do not want you to start any 'extreme diets' - in patients with raised BMIs, there is a likelihood of non-alcoholic fatty liver disease and sudden excessive weight loss or dropping of carbohydrates ('carbs') from daily life can cause problems from liver inflammation to gallstones.
I do not want you to suddenly decide to augment the treatment by stopping all carbohydrates and just eating proteins. I do not want you to be inventive, all I want from you is smaller portions of food and if in doubt to get guidance from our dietician.
So in our clinic it's all about slow incremental changes in lifestyle.
You need to be aware of the most common side effects: headaches (drink water and use paracetamol occasionally), nausea (usually worse in the first month and it's often because you are hungry), stomach upset (loose stools or constipation) and heartburn (more so if you smoke, but you can use gaviscon or an acid suppression medication like Nexium from the shops).
If weight loss is too much initially then we will need to change the dose, or potentially stop the medication - hence the 4 week review.
Please get advice from Vic Kelly our personal trainer. Slow enjoyable increases in exercises at first. Otherwise you will be put off by failure, or injury which prevents further exercise. Don't set unreasonable goals or place excessive expectations on yourself like signing up for a marathon! What you could do is consider more achievable goals like "Couch to 5km"
If you choose running/jogging go to Graeme Le Maistre sports and ask for technical running shoes to be fitted using a treadmill gait analysis approach. Don't just choose shoes that you like the look of, you need shoes to choose you!
Given that we live on an island, swimming is an excellent non impact sport, as is cycling (where your weight is borne by the saddle, preventing impact injuries to the spine and lower limb joints).
Consider joining a class or don't join an exercise class. Its totally up to you. Don't be afriad to start on your own and when your confidence is higher then join a class.
Whatever you do it should be enjoyable and not torture to either the body or mind!
Finally walking is also a very good exercise for the mind and body - can you walk to work rather than drive?