not known

Diagnosis:

Overweight (BMI 28 kg/m²) with central adiposity (waist circumference 102 cm).
Clinical history and assessment:
Patient reviewed for ongoing weight-management treatment. Patient has previously used Mounjaro (tirzepatide) and reports that it was effective for weight loss/weight management. However, patient has been intermittently stopping and restarting the medication. Discussed the importance of consistent treatment and adherence to the prescribed dosing schedule to optimise efficacy and minimise tolerability issues associated with repeated interruptions and re-initiation.

Current medication: citalopram. No other regular medications reported. No known allergies. No contraindications to treatment identified from the information provided.

Treatment discussion:
Discussed restarting tirzepatide (Mounjaro), including its mechanism of action as a dual GIP and GLP-1 receptor agonist. Explained that it promotes glucose-dependent insulin secretion, reduces glucagon secretion, slows gastric emptying and increases satiety, thereby supporting reduced food intake and weight loss.

Potential adverse effects discussed, particularly gastrointestinal symptoms including nausea, vomiting, diarrhoea, constipation, abdominal discomfort and reduced appetite. Patient advised regarding adequate hydration and to seek medical advice if significant or persistent adverse symptoms occur. Importance of adherence and appropriate dose escalation was discussed.

Plan:

Restart Mounjaro (tirzepatide) 2.5 mg once weekly.
Prescription for Mounjaro 2.5 mg issued.
Continue citalopram as prescribed.
Patient advised to avoid stopping and restarting treatment without clinical advice.
Monitor weight, waist circumference, tolerability and response to treatment.
Review at follow-up and titrate dose according to clinical response and tolerability.