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see the NHS orlistat page for eligibility and guidance), or GLP-1-based therapies such as semaglutide 2.4 mg (Wegovy), which has received MHRA approval and a NICE Technology Appraisal recommendation (NICE TA875) for use in adults with a BMI of 35 kg/m or above (or 3034.9 kg/m in certain circumstances) alongside at least one weight-related comorbidity, when used within a specialist weight management service Enquire about clinical trial eligibility , if you are interested in accessing investigational medicines through a regulated research pathway your GP or specialist can advise, and you can search for trials via the NIHR 'Be Part of Research' website or ClinicalTrials.gov Discuss realistic expectations , as even the most effective weight loss medicines work best alongside dietary changes, increased physical activity, and behavioural support Your GP can refer you to a specialist weight management service if appropriate

Michael Calore: Excellent

Elevated urinary tiglyglycine is associated with deficiency in the isoleucine catabolic enzyme, 2-methylacetoacetyl-CoA thiolase, and is also associated with propionic acidemia

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