The word medical should be doing some work.

An independent guide to what the word medical is actually buying in a weight programme, owned by the UNTIL group. Medical Weight Loss London runs no clinic, employs no clinician and names no medicine, brand or drug class anywhere, because advertising prescription-only medicines to the public is unlawful here. It arranges an assessment through UNTIL Health Concierge.

Weight that changes without an obvious explanation is a symptom before it is a problem of effort. An underactive thyroid, several common prescription medicines, fluid retention, disturbed sleep and raised cortisol all produce it, and each is separated by a different test. It is the presentation where a clinician has most to add.

An underactive thyroid can cause weight gain, usually a modest amount, and much of it is fluid rather than fat. It is checked with a blood test for thyroid stimulating hormone and free T4. Treatment restores normal thyroid function, and it is worth ruling out before assuming that the effort was the problem.

Partly because fat stored around the organs behaves differently from fat under the skin, and responds to sleep, alcohol, stress hormones and the fall in oestrogen at menopause as much as to what you eat. It is also the fat that shifts first when weight comes down. What does not work is targeting it, because no exercise empties one area.

A full history, blood pressure, and blood tests covering thyroid function, longer-term blood sugar control, a lipid profile, liver and kidney function and a full blood count. It should also ask about sleep, mood and every medicine you take. A consultation that moves straight to an offer has not assessed you.

A registered clinician taking responsibility for it: they take the history, order and interpret investigations, exclude other explanations for your weight, and put their name to the plan. It is a higher bar than a consultation delivered by somebody holding a certificate.

Ask four things before you pay anything. Which registered clinician is responsible for your care, and on which register. What investigations are done before any plan is proposed. How often you are reviewed and for how long the programme runs. And what is written to your GP. Medical Weight Loss London recommends no clinic and ranks none.

Around half a kilogram to one kilogram a week is the rate generally regarded as sustainable, and slower is not a failure. Faster loss costs more lean mass and is harder to hold. A five per cent loss that is maintained already improves blood pressure, blood sugar and lipids measurably.

It stops for almost everybody, usually between three and six months, and it is physiology rather than a lapse: a smaller body needs less energy and appetite signalling rises to defend the weight you were. What matters is that the programme expects it. A programme that ends at the plateau has ended where its work was about to begin.

When food occupies a large share of your thinking, when eating is followed by guilt or compensating behaviour, when your weight is already within a healthy range, or when the scale governs your day. Speak to your GP. Beat runs helplines for anyone affected by an eating disorder.

It is worth knowing what it offers. NHS weight management is organised in tiers, the specialist tier needs a referral and has its own access criteria, and your GP is the person who can tell you where you sit. Going privately does not close that route off.

Because advertising a prescription-only medicine to the public is unlawful in the United Kingdom, and this is a public page rather than a consultation. No medicine, brand or drug class is named anywhere on this site. That question belongs with a prescriber who has assessed you in person.