Medicines and a health-history notebook laid out for a specialist review
Medical Conditions

Complex Severe Obesity

You are not difficult to treat. Your health simply deserves to be understood in full.

When weight sits alongside rheumatoid arthritis, mental-health medication, hormonal illness, previous bariatric surgery or other treatments, ordinary weight-loss pathways may not be enough. We look at the connections, the risks and the person behind the history.

Weight loss treatments may be considered where appropriate, but never in isolation. Every recommendation begins with assessment and a plan shaped around your wider health.

Specialist metabolic medicine

Complexity changes the safest path forward

A decision that appears routine can affect blood sugar, mental health, inflammation, nutrition or the safety of another treatment. We take time to understand your history and review relevant test results before recommending care.

When it is complicated

Nothing is too complicated to bring here

Some of the people who come to us have been turned away elsewhere, or told nothing more can be done, because their situation is genuinely complicated. These are a few examples of what Dr Raj deals with — not a list of the only things he can help with.

  • Rheumatoid arthritis managed on biologic treatment
  • Serious mental illness, and the weight effects of antipsychotic medicines
  • Weight regain after bariatric surgery
  • Complex endocrine presentations
  • Medication combinations that make treatment unsafe without specialist review

If your situation isn't here, it doesn't mean it's beyond us. It usually means it needs a conversation.

Woman discussing her health with a specialist seen only from behind

What's actually happening

Pain, sleep, medicines, hormones and mental health can all change what is possible.

Complexity is coordinated, not carried alone. Your health deserves understanding, not blame.

The same woman taking a rest during a park walk

Why it's harder than it looks

If you have spent years trying to manage your weight while living with another condition, it can feel as though the usual advice was never written for you.

Medicines and a health-history notebook

What we look at

We look at what has been tried before, what helped, what did not, and how your health has changed. Relevant investigations answer specific questions rather than adding another unexplained list of results.

  • Your existing conditions and medicines
  • Appetite, sleep, mobility and emotional wellbeing
  • Previous surgery and nutritional needs
  • The clinicians already involved in your care
Blood samples with endocrine and heart models

What can change

Where treatment touches another condition, we coordinate with the clinician responsible for that care. Your psychiatrist, rheumatologist, own doctor or hospital team may need to be part of a decision.

The aim is a safe, realistic plan. It may involve changing a weight-related medicine with its prescriber, treating a hormonal condition, supporting nutrition or considering weight loss treatments where appropriate.

What happens next

The next step

Understanding what is driving your weight takes a proper assessment — your history, the other conditions you live with, the medicines you already take, and what has been tried before.

Where obesity is complex, Dr Raj may recommend the Specialist Weight Management Plan: our most intensive option, for the most complex cases. Not everyone needs it. For others, consultations and review alone are enough, and what you are offered depends on what is actually going on.

Care is delivered through our London and Chennai clinics.

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Complex Severe Obesity FAQs

It can be the interaction between weight, other illnesses, medicines, previous surgery and everyday life. Complexity does not mean you are difficult; it means your care needs a fuller assessment.

Do not stop prescribed medicines yourself. If a medicine contributes to weight or affects treatment choices, we discuss any change with the clinician responsible for it.

No. It is our most intensive option for the most complex cases. For others, consultations and review alone are enough. Dr Raj may recommend it after assessment when that level of support is appropriate.

Yes. Care is delivered through London and Chennai. Contact your chosen clinic to discuss an appointment and whether video or in-person assessment is appropriate.

Clinical guidance

Further reading

This information cannot replace a consultation. Your care depends on your symptoms, history, medicines and test results. We coordinate with your own doctor or relevant specialist when needed.