For GLP-1 prescribing services, clinics and GPs
The psychological half of this treatment
A course for your patients, written by a chartered clinical psychologist. It does not touch dosing, prescribing, or medical management — and it addresses the part you have nowhere to refer to.
The problem you already have
Your patients do well, and then some of them do not.
The ones who lose weight and cannot say out loud that something feels wrong. The ones whose loss slows and who read it as a personal failure. The ones who stop — by choice, by cost, by supply — and regain, and do not tell you it is going badly until months in.
And the ones quietly eating less than they need in order to get ahead of the regain, which looks like success from outside and is the most common route from this treatment into disordered eating.
None of that is a prescribing problem. All of it determines whether your patients keep what they gained.
What the course does
It works on what the medication does not: what eating was doing for the person, what fills that gap, and what holds when appetite returns.
It follows the whole arc rather than the first months — the quiet, the work, the narrowing, the decision about whether to continue, what comes back if they stop, and maintenance afterwards. Patients are asked where they are when they arrive and taken to the part that matches, so it works for someone in their first month and someone two years past stopping.
Three things in it are worth knowing about specifically.
Continuing is treated as a decision, not a delay. There is a lesson dedicated to staying on deliberately. Nothing in the course advocates discontinuation.
Restarting is named as a legitimate clinical option. There is a lesson on going back on, framed as treatment resumed rather than relapse. In my experience the shame attached to that decision costs patients months.
Stopping is slowed down. The part on the decision is built to separate a considered choice from a flight from cost, side effects or shame — and to send the patient to you with better questions.
Scope
Stated in the course, repeatedly and plainly:
Nothing about dose, titration, side effects, brands, or whether to be on the treatment. Those belong to the patient and their prescriber.
Physical symptoms — persistent nausea, early fullness, inadequate intake, unintended rapid loss — are routed to the prescriber or GP by name, early rather than late, with the explicit instruction not to wait it out to be polite.
Safeguarding
Screening before payment. Seven questions covering risk to self, compensatory behaviours, inadequate intake, unprescribed supply, eating disorder history, and restriction to prevent regain. Answers are not stored. Risk to self is a hard stop with crisis routing and a refund — the patient cannot buy their way past it.
Re-screening. Anyone returning to the course at the decision or after stopping is re-screened if their last screening was more than three months ago, because their situation has changed since purchase.
Crisis routing on every page. NHS 24, Samaritans, Breathing Space, SHOUT, and 999, with the stated position that the course is not monitored and cannot respond to urgent contact.
Escalation to you, not to me. The course does not create a therapeutic relationship and says so. Where something needs a person, it names a GP or prescriber rather than offering itself.
Who wrote it
Dr Rachel Megahy, Chartered Clinical Psychologist. HCPC PYL17840, BPS Chartered. DClinPsych, University of Edinburgh. NHS since 2006, including several years leading an NHS weight management service.
Prism Psychology Ltd (SC707886). Professionally insured for digital products.
How services use it
Referral. A link and a code for your patients. They buy it themselves at a reduced rate. No cost to you, nothing to administer.
Seat licences. You buy access in blocks at a reduced rate and give it to patients at no cost to them. This is the arrangement I would recommend for any service that wants the psychological half to be part of what it offers rather than an upsell — and it removes the question of whether a patient can afford it on top of the prescription.
No commission, deliberately. I do not pay referral fees to prescribers and would not want to. A financial interest in a referral is a problem for you rather than for me, and the arrangement is cleaner without it.
Both are arranged directly with me at present. Email, and I will set it up.
For your team
Most services prescribing these medications are staffed by people with no training in eating behaviour, body image, or the psychology of weight regain — and who are nonetheless the ones patients tell.
I offer consultation and short training sessions for prescribing teams: what to listen for, what to say when a patient reports the loss has slowed, how to have the conversation about stopping, and when to refer on.
That is a separate arrangement from the course. Ask if it is useful.
What this is not
It is not therapy and does not claim to be. It is not a substitute for psychological assessment where that is indicated, and it says so to the patient.
It does not make outcome claims. There is no trial data behind it, and the honest position is that almost all published data on these medications describes medication alone or medication plus brief lifestyle advice — very little describes people who did the psychological work during the quiet period. I am not going to claim my course changes those figures.
It does not advocate for or against the treatment.
Get in touch
If you want to look at the course before recommending it — which you should — I will give you full access. No obligation and no follow-up sequence.