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Lifestyle integration remains fundamental: Dietary modification : A balanced, calorie-controlled diet rich in whole foods, with adequate protein to preserve muscle mass during weight loss Physical activity : Combination of aerobic exercise (150 minutes moderate intensity weekly) and resistance training to maintain muscle mass and bone density—particularly important during perimenopause Behavioural support : Addressing emotional eating, stress management, and sleep hygiene Monitoring and follow-up : Review at 3–6 months to assess weight loss, tolerability, and comorbidity improvement Consider discontinuation if weight loss is less than 5% after 6 months on the maintenance dose Regular review of cardiovascular risk factors, bone health, and perimenopausal symptoms When to contact your GP : Severe, persistent abdominal pain (possible pancreatitis) Signs of gallbladder disease (right upper quadrant pain, jaundice) Symptoms of hypoglycaemia if taking concurrent antidiabetic medications Persistent vomiting or diarrhoea leading to dehydration Any concerns about side effects or treatment efficacy Integration with HRT : There is no contraindication to using Wegovy alongside hormone replacement therapy