News and updates from B@CastleQuay Weight management clinic

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Saxenda (aka Liraglutide) remains off the radar for the time being.

Wegovy (aka Semaglutide)- this is slowly becoming available, but exceptionally slowly and the supply chain is hit & miss at present.

Mounjaro (aka Tirzepatide) - this is a new medication by Eli-Lilly. It's a single molecule that works in two ways. The supply chain here is much better and is likely to be my default medication to offer.

Saxenda (aka Liraglutide) remains off the radar for the time being.

Wegovy (aka Semaglutide)- this is slowly becoming available, but exceptionally slowly and the supply chain is hit & miss at present. To the extent I am not even going to take people on to my waiting list that is already 5 months long.

Mounjaro (aka Tirzepatide) - this is a new medication by Eli-Lilly. The results look promising and is available, however (!), the company is still trying to clarify if it is legal to prescribe for weight loss in Jersey (not the UK). Officially it only has a license in the United Kingdom. I should get an answer after this weekend, at which point I will then contact my waiting list patients first. (I'm still awaiting patient information and patient training devices). Mounjaro currently is not NICE approved for weight loss, although its is licensed by the MHRA for such.

I cannot in all honesty deliver a safe clinic until my concerns have been addressed.

Alas it appears that for the time being Saxenda is not returning to the weight loss market. Wegovy is coming out but in exceptionally small amounts to independent clinics. In the UK the sole distributor and our only supplier is a merged company with Boots. Boots has their own weight loss patients and because of the arrangement between the two companies that is where the majority of the medication is going. 

I have been trying very hard to source medication to restart the clinic but unless the supply chain is strong and reliable then I won't formally reopen to weight loss bookings

Update 12th August 2023:

There is no available prescription medication. There is no Saxenda aka Liraglutide. There is no Victoza aka Liraglutide for anyone who isn't a Type 2 Diabetic. There is no Ozempic (aka Semaglutide) which doesn't actually have a license for weight loss, and is only available for people with Type 2 diabetes. WEGOVY (aka Semaglutide for weight loss) is not available yet and its wrong that this was placed in the public main stream media recently.

I will contact clients when medication supplies restart. I intend to review the situation in Mid September 2023, and will email all clients.

Quite simply, this is completely out of my hands. There has been a global demand for Saxenda/Ozempic/Weygovy and the manufacturer simply can't keep up. I spoke this afternoon (Tuesday 4th July) with NovoNordisk Private Clinic managers and to be fair they didn't seem to have much information either other than to say supply will be very intermittent for the next 18 months.

Our pharmacy at Castle Quay stocks the largest amount of Saxenda on island and was struggling last week but was just about maintaining levels but with rationing of prescriptions. However what has developed is a picture of global shortage triggered by social media and mainstream media news regarding weight loss during May 2023 and this has depleted all stocks.

Is there a risk to your health if you suddenly stop Saxenda? No. Clients have been stopping all the time during the clinic course, thats the beauty of Saxenda, you can stop at anytime.

My advice would be to limit yourself to 1.8mg rather than the target dose of 3mg.

All existing patients will be supported. The clinic is just closed to new patients for the time being.

Will I gain weight if I stop Saxenda?  To be honest, yes, if you just depend on Saxenda. What I do recommend is to engage with our Dietician and Personal Trainer. I will be working with our pharmacist and with the NovoNordisk team to try and keep some semblance of supply going.

Is this only effecting Castle Quay Weight Loss clinic? No, this is a global issue and it's likely that the UK Government will embargo this medication for only diabetics until the supply chain can be strengthened. NovoNordisk are building new facilities but they won't be online until the end of the year apparently. However if you go online now, most online pharmacies now just state "out of stock:".

There is nothing more that can be done for now.

Dr Robert Greig, 1815hrs 4th July 2023

Patients on treatment for weight management

For those taking Saxenda or Ozempic for weight loss rather than diabetes there is no alternative prescription. These patients should be advised to continue with their dietary and lifestyle measures to maintain weight loss achieved but will need to discontinue treatment until supplies resume. NB Ozempic is not licensed for weight loss outside of the context of diabetes but is widely used. For some patients, Orlistat (which reduces fat absorption) may help maintain weight loss but if offered patients should be counselled on potential GI side effects as detailed in the patient information. Orlistat is available on prescription and as an over-the-counter medication - (addendum by Dr Greig: Orlistat is in limited supply according to medication supply companies)

Dr David Hopkins   Dr Elias Chacko

I have spent the past few weeks in meetings with various people at NovoNordisk the only manufacturers of Saxenda. No one at NovoNordisk was able to tell me when a stable supply will be available. Its likely to be 2024. Saxenda is only made in Copenhagen, in one facility. Then it is given to a single distributor in the UK called Alliance. Alliance are over subscribed and as soon as they get a delivery, they are out of stock.

The problem started in early May 2023 when global news outlets and social media started talking about Saxenda/Ozempic as the 'magical weight loss injection' - this drove up global demand beyond any supply capability of the company. Hence zero availability.

The pharmacists on Jersey cannot reliably source Saxenda and therefore clients cannot continue to use Saxenda at present to lose weight. 

My clinic is not just about Saxenda, there are my colleagues that you can approach to help manage your weight, have a look at the 'working with others' section of the website.

In the meantime, it is perfectly safe to abruptly stop Saxenda or you can start to slowly wean down your remaining doses.

To conclude: I am so very sorry this has happened but it is completely out of my hands. I will revisit this situation in Mid September 2023 and email all clients then. Then are no available alternatives.