• The rise in popularity of injectable weight loss medications has brought significant media attention. If you are considering weight loss medication, it is important that this is prescribed by an Irish Medical Council (IMC) registered Doctor who will issue you with a prescription to be dispensed by a legitimate and regulated pharmacy operation. 

• Everwell’s doctors are regulated by, and registered with, the IMC. Our doctors adhere to the Guide to Professional Conduct and Ethics for Registered Medical Practitioners and maintain their IMC registration through continuous professional development.

• ePharm NI is registered with the Pharmaceutical Society of Northern Ireland under registration number 584. The Pharmacy’s Superintendent Pharmacist is Jason Murphy (PSNI Reg. No. 4659). 

• The Everwell business is owned by Saxonvale Limited (in the process of changing its name to Everwell Digital Healthcare Group Limited), a company registered in Ireland with company registration number 778251. Our registered office is 20 Harcourt Street, Dublin 2, D02 H364.

• If you have any concerns regarding the legitimacy of our service, please contact us and a member of the team will give you a call. You can contact us by email at hello@joineverwell.ie, by telephone at +353 1 233 7359, or via WhatsApp Chat on +353 83 132 3105 (message only).

• All of Everwell’s doctors are regulated by, and registered with, the Irish Medical Council (IMC). Our doctors adhere to the Guide to Professional Conduct and Ethics for Registered Medical Practitioners and maintain their IMC registration through continuous professional development.

• As part of the Weight Loss Programme, our Doctors may prescribe you weight loss medication if you are eligible after a face-to-face video consultation. Whenever you sign-up for the monthly Programme, you have the option to consent and direct us to share that prescription to be fulfilled by ePharm NI. 

• ePharm NI is registered with the Pharmaceutical Society of Northern Ireland under registration number 584. The Pharmacy’s Superintendent Pharmacist is Jason Murphy (PSNI Reg. No. 4659). The Pharmacy is an independent third party to Everwell and there is no contractual business relationship between them. Everwell is not a pharmacy and does supply, sell, hold or dispense medication of any kind.

• Everwell takes the protection of your data extremely seriously. That's why we've invested heavily in purchasing a best-in-class clinical management platform called Semble to hold this data safely. 

• Semble has top-of-the-line security infrastructure, is GDPR compliant and has attained ISO 27001:2013 (Information security management systems) status. The controls Semble has implemented to protect your data are in addition to Everwell's own data protection policies and internal procedures. 

• Everwell will only ever ask you for data that is relevant to considering your eligibility for treatment, or data such as identity, payment and address data that is essential for us to provide you with a prescription and communicate with you about your subscription.

• For further information about the data we collect, and how it is used and stored, please see our Privacy Policy.

Whenever you sign up to Everwell’s Weight Loss Programme, you’ll be required to:

• Answer some questions about your medical history and why you’d like to join Everwell’s Weight Loss Programme 
• Share some current photos of yourself to share with our doctors through a secure online portal
• Verify your identity through a secure online portal

Once these steps are completed, one of our doctors will reach out to arrange a video consultation at a time convenient to you. They will:

• Confirm that you are the Everwell account holder
• Discuss your questionnaire responses with you
• Make a decision on whether you are eligible for treatment

If our doctor confirms that you are eligible for treatment, they will create a prescription for you, that will be sent to a pharmacy with your consent and at your direction, and you’ll be sent a secure link to pay for your medication from that pharmacy.

Every month, you will be asked to submit your current weight, height and new photos of yourself. You will also be asked certain questions with regard to the treatment.

Unless you cancel your subscription, you will be charged every 30 days after your first payment date using the card you originally paid with.

• It’s important to note that not all patients will lose weight when they take these medications.
• A healthy diet and rigorous exercise program is essential, however even still some patients may not lose weight.
• According to clinical trials, patients on Wegovy could expect to lose approx. 15% of their body weight at 68 weeks after commencing treatment.
• According to clinical trials, patients on Mounjaro could expect to lose >15% of their body weight in a similar timeframe (72 weeks).
• Patients on Alli could expect to lose on average 7% of their bodyweight in 6 months, after this it should be discontinued.
• Further information is available on the European Medicines agency website.

We will not provide a treatment plan to people who:

• are planning to conceive in the next 3 months, actively trying to conceive, who are pregnant, or who are breastfeeding
• have Type 1 diabetes
• are on anticoagulant medications (blood thinners)
• have a history of advanced liver or kidney disease  
• are under 18 years old
• are resident outside of Ireland
• do not meet the Everwell criteria for weight loss management

• When you sign up to Everwell’s Weight Loss Programme, and we’ve confirmed your consent for us to send your prescription to ePharm NI each month, you’ll then be able to choose whether you collect your medication from the pharmacy site, or have it couriered to your home address. 

• All medication costs are payable directly to the Pharmacy and are not included in your subscription to Everwell. The pharmacy will send you a separate link through which to pay for your medication each month, as long as the doctor approves your prescription. You can find out more about this here.

• If you do not wish to use ePharm NI to provide your medication, you can opt-out of this at any time by emailing us, hello@joineverwell.ie.

Mounjaro and Wegovy are both administered at home by the patient from a pre-filled pen:

• You will inject the medication, once weekly in the stomach (abdomen) into the sub-cutaneous tissue close to the surface of the skin.
• You can also use other areas such as the upper arm / thigh area, but most people use the abdomen, it is important to rotate injection sites.

There are detailed instructions in the Patient Information Leaflets for each of Mounjaro and Wegovy.

Alli is an oral medication taken in tablet form at mealtimes. Further information can be found in the Patient Information Leaflet enclosed with the medication.

• It’s essential that your GP is aware that you are taking weight loss medication. This is so that they can take into consideration the treatment you are being prescribed by Everwell when discussing any other medication you may require in the future. 

• As part of our normal processes, when you are prescribed medication by an Everwell doctor, we will notify your GP, but we would recommend that you discuss this with them at your next appointment too.

• If you are travelling abroad with your medication, you should check the entry regulations of each country you are travelling to. It’s likely that you will be required to take a copy of a valid prescription along with your medication. You can request a copy of your prescription by emailing hello@joineverwell.ie.

• The Patient Information Leaflet contained in the medication box provides further information on how medication should be stored.

The cost of your Everwell subscription includes:

• The cost of providing you with a new prescription every 30 days
• Consultations with an Everwell doctor
• Access to our 1:1 health coaching service

However, it does not include the cost of the medication itself. As Everwell is not a pharmacy, it does not supply, sell, hold or dispense medication of any kind. Therefore, you will have a separate agreement with a pharmacy that will fulfill your prescription for you.

• You will be asked to fill out a questionnaire and submit your current weight, height and new (clothed) pictures of yourself. This information will be reviewed by our Doctors to determine your eligibility for treatment and if eligible a prescription will be issued. We’ll also arrange a video consultation with one of our doctors. This will be at a time convenient to you and can be in the evening or early morning if required.

• If you are approved for treatment, we will complete these steps each month to confirm your ongoing eligibility, prior to providing a new prescription.

• For further support with your weight loss journey, your subscription with Everwell also gives you access to a health coach.

• Your subscription with Everwell includes access to a health coach, who can support you on your weight loss journey through providing advice on diet, nutrition, exercise and how to keep yourself motivated.

• All conversations with our health coaches take place over Whatsapp. Further details will be provided after your eligibility for treatment is validated by our Doctors.

• As our services are medical in nature, we must maintain accurate patient records and ensure that you are of an appropriate age to receive treatment. In order to do this we conduct an identity check through our partner, ID-Pal.

• Once you have completed the online questionnaire, you will receive a text message from ID-Pal. Please follow the instructions provided in the text message to complete the identity check.

• As this is a secure portal, you will also be asked to upload some current (clothed) pictures of yourself which the Doctor will review and take into account during the final stages of the Doctor Consultation in terms of determining your suitability for treatment. If you are approved for treatment, you’ll be redirected to this portal each month to upload further photos of yourself for ongoing assessment.

• Everwell’s services are only available to people aged 18 years or over, who have capacity to make decisions on their own behalf, and are resident in Ireland.  

• You will not be accepted for treatment if you don’t consent to Everwell notifying your GP that you are taking weight loss medication. This means you will also not be accepted for treatment if you are not registered with a GP. 

• If you are deemed to be ineligible for treatment, your monthly treatment plan will be cancelled and you will be charged a fixed fee of €99.99 and refunded the difference within 5-7 working days.

• If you need any further information on this, please reach out to us at hello@joineverwell.ie.

If you are eligible for treatment, a monthly subscription will be created on your behalf which includes the cost of your consultations, prescription and access to our health coaching service.

Your payment details will be stored securely and you’ll be charged each month, unless you cancel your subscription. You can manage your subscription at any time by following the link to your order in your most recent order confirmation email.

In order for our doctors to confirm your continued eligibility for treatment, they will ask you to  submit your current weight, height and new photos of yourself each month for them to review, to confirm whether you are still eligible for treatment.

These photos are held in our secure portal, and are only accessed by Everwell’s doctors to confirm your eligibility for treatment.

• Wegovy is available as pre-filled pens containing a solution for injection. It is injected once a week under the skin in the belly, thigh or upper arm.

• To reduce the risk of symptoms affecting the gut, the weekly dose is gradually increased over 16 weeks.

• Patients administer the medicine themselves.

• The medicine can only be obtained with a prescription.

• For more information about using Wegovy, see the Patient Information Leaflet or contact the Everwell Medical Team or your pharmacist.

• The active substance in Wegovy, semaglutide, is a ‘GLP-1 receptor agonist’.

• It acts in the same way as GLP-1 (a natural hormone in the body) and, among other things, appears to regulate appetite by increasing a person’s feelings of fullness, while reducing their food intake, hunger and cravings.

• Further information on Wegovy is available in the in the Summary of Product Characteristics from the European Medicines Agency which is available here:https://www.ema.europa.eu/en/documents/product-information/wegovy-epar-product-information_en.pdf

• Studies have shown that Wegovy is effective in helping people lose weight, with a significant proportion of them achieving at least a 5% weight reduction.

• Three of the studies involved adults who had tried unsuccessfully to lose weight in the past and had a BMI of >30 kg/m2 or a BMI of >27 kg/m2 plus a weight-related health problem.

• In the first of these, involving 1,961 people, people treated with Wegovy were able to lose on average 15% of their body weight after 68 weeks compared with a 2% loss of weight in people who had placebo (a dummy treatment). In addition, 84% of people in the Wegovy group were able to lose at least 5% of their weight compared with 31% of people in the placebo group.

• In the second study, involving 611 people, those treated with Wegovy lost on average 16% of their body weight after 68 weeks compared with a 6% loss of weight in people who had placebo. Around 85% of people in the Wegovy group lost at least 5% of their weight compared with 48% of people in the placebo group. All participants in this study also received counselling to help them lose weight.

• The third study, involving 902 people, looked at how the effects of Wegovy were maintained over the first 20 weeks. In this study, all participants had Wegovy for 20 weeks, after which some were stopped having Wegovy and were given placebo instead. After 48 more weeks, those who continued on Wegovy lost a further 8% of their body weight while those on placebo regained 7% of theirs, indicating that people need to continue taking Wegovy in order not to regain weight. 

• A fourth study involved 1,210 adults with type 2 diabetes with a BMI of >27 kg/m2 and who had also tried unsuccessfully to lose weight in the past. After 68 weeks, those treated with Wegovy were able on average to lose 10% of their weight compared with a 3% loss in people who had placebo. In addition, 67% of people in the Wegovy group were able to lose at least 5% of their weight compared with 30% of people in the placebo group.

• The most common side effects with Wegovy (which may affect more than 1 in 10 people) are headache, nausea (feeling sick), vomiting, diarrhea, constipation, and abdominal (belly) pain.

• For the full list of side effects and restrictions of Wegovy, see the Patient Information Leaflet if you are prescribed Wegovy. 

Potential side effects are generally mild and tend to diminish as the body adjusts to the medication:

• Up to 44% of patients experience nausea, vomiting, diarrhea, constipation and abdominal pain. Less commonly reported side effects are headache, fatigue, dizziness, indigestion. Hair loss occurs in some patients. In some instances patients are unable to tolerate the medication. 

There are however some potential serious side effects you need to be aware of (if you have any concerns or questions regarding these, it is essential that you contact the Everwell Medical Team before you start your treatment):

• Pancreatitis (inflammation of the pancreas): Symptoms include severe abdominal pain, nausea, and vomiting. Incidence is low but significant. This can be life threatening.

• Gallbladder Issues: Such as gallstones, potentially leading to cholecystitis. Symptoms include severe abdominal pain, nausea, and yellowing of the skin or eyes.

• Thyroid Tumours: Animal studies indicated a risk of medullary thyroid carcinoma (MTC), although this hasn’t been observed in humans. Monitor for neck lumps or difficulty swallowing. Any change to your voice.

• Hypoglycemia: Especially when combined with diabetes medications called sulphonylureas or insulin, occurring in ~6% of users with diabetes.

• Kidney Injury: Due to dehydration from severe vomiting or diarrhea.

• Diabetic Retinopathy Complications: Worsened vision in patients with pre-existing conditions.

• Allergic Reactions: Rare but potentially life-threatening, including symptoms like swelling of the face or throat, difficulty breathing, or severe rash.

• Tachycardia (Increased Heart Rate): Rare but possible, with heart rate increases of 1–4 beats per minute observed.

Incidence of Serious Side Effects

• In clinical trials, approximately 9.8% of patients reported serious side effects compared to 6.4% on placebo.

• Many of these resolved without requiring discontinuation of the drug, but regular monitoring is essential.

• Obesity can lead to severe health problems and many people with obesity experience difficulty trying to lose weight. Wegovy is effective at reducing weight in adults with obesity or who are overweight with a weight-related health problem.

• The European Medicines Agency therefore decided that Wegovy’s benefits are greater than its risks and it can be authorised for use in the EU which includes Ireland.

• Mounjaro is available as a solution for injection in prefilled pens and can only be obtained with a prescription. It is injected once a week, under the skin of the abdomen (belly), upper arm or thigh. Mounjaro should be injected on the same day each week.

• For more information about using Mounjaro, see the Patient Information Leaflet or contact the Everwell Medical Team or your pharmacist.

• The active substance in Mounjaro, tirzepatide, acts in the same way as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

• These hormones are produced in the gut and bind to specific receptors (targets) in the body, such as, among others, the pancreas and brain. This increases the amount of insulin that the pancreas releases in response to food and helps lower blood glucose levels in people with type 2 diabetes.

• Targeting these receptors also reduces appetite and helps people manage their weight.

• Further information on Mounjaro is available in the in the Summary of Product Characteristics from the European Medicines Agency which is available here: https://www.ema.europa.eu/en/documents/product-information/mounjaro-epar-product-information_en.pdf

• Mounjaro was effective at helping people lose weight in a study involving more than 2,500 adults who had obesity (BMI over 30kg/m2) or who were overweight (BMI between 27 and 30 kg/m2) and had at least one weight-related health problem.

• In this study, people who used Mounjaro in combination with diet and physical activity for 72 weeks reduced their weight by at least 15% on average, depending on the dose they were given.

• This compares with 3% in people who were given a placebo. Over 85% of people taking Mounjaro were able to reduce their weight by at least 5%, compared with 35% of people given placebo.

• For the full list of side effects and restrictions of Mounjaro, see the Patient Information Leaflet.

• The most common side effects with Mounjaro (which may affect more than 1 in 10 people) include problems with the digestive system, such as nausea (feeling sick) and diarrhoea.

• Constipation and vomiting were seen in up to 1 in 10 people. Side effects linked to the digestive system were generally mild or moderate in severity and occurred more often when the dose of Mounjaro was changed.

The common side effects of Mounjaro are generally self-limiting as the body gets used to the medication. The most common are as follows:

• Gastrointestinal Issues: Such as nausea, diarrhea, vomiting, abdominal pain and indigestion & flatulence, constipation, reflux, bloating. Up to 20% of patients may experience these side effects but generally this are self-limiting.

>1 in 10 patients experience the following:

• Allergic reaction (hypersensitivity) (e.g., rash, itching, and eczema).
• Dizziness reported in patients treated for weight management.
• Low blood pressure reported in patients treated for weight
  management.
• Feeling less hungry (decreased appetite) reported in patients treated for type 2 diabetes.
• Stomach (abdominal) pain reported in patients treated for
  type 2 diabetes.
• Being sick (vomiting) reported in patients treated for type 2 diabetes - this usually decreases over time.
• Indigestion (dyspepsia).
• Fatigue.
• Hair loss.
• Fast pulse.

Serious Side Effects could include (if you have any concerns or requestions regarding these, it is essential that you contact the Everwell Medical Team before you start your treatment if prescribed):

• Pancreatitis (inflammation of the pancreas): Symptoms include severe abdominal pain, nausea, and vomiting. Incidence is low
  but significant. This can be life threatening, and you should seek urgent medical attention (<1%).
• Allergic Reactions: Rare but potentially life-threatening, including
  symptoms like swelling of the face or throat, difficulty breathing, or severe
  rash.
• Hypoglycemia: Especially when combined with diabetes medications called sulphonylureas, metformin or insulin. This is common when prescribed with other diabetic medications.
• Gallbladder Issues: Such as gallstones, potentially leading to
  cholecystitis. Symptoms include severe abdominal pain, nausea, and yellowing of the skin or eyes.
• Diabetic Retinopathy Complications: Worsened vision in patients with pre-existing conditions.

• In patients who have obesity or are overweight with weight-related complications, treatment with Mounjaro resulted in weight loss which was mainly due to loss of fat mass. Further, Mounjaro improved other measures such as blood pressure levels and the amount of fat in the blood.

• The side effects of Mounjaro are manageable and its safety will continue to be monitored. The European Medicines Agency therefore decided that Mounjaro’s benefits are greater than its risks and it can be authorised for use in the EU which includes Ireland.

• One Alli capsule or chewable tablet is taken just before, during, or up to one hour after each main meal, three times a day. If a meal is missed or contains no fat, Alli should not be taken. The patient should be on a diet in which about 30% of the calories come from fat. The food in the diet should be spread over three main meals. Alli should not be taken for more than six months.

• Patients taking Alli should start a diet and exercise regime before beginning treatment. If patients taking Alli have been unable to lose weight after 12 weeks, you should speak to an Everwell clinician. It may be necessary to stop treatment.

• The active substance in Alli, orlistat, is an anti-obesity medicine, which does not affect appetite.

• Orlistat blocks gastrointestinal lipases (enzymes that digest fat). When these enzymes are blocked, they cannot digest some fats in the diet, and this allows about a quarter of the fat eaten in the meal to be passed out in the stools undigested.

• The body does not absorb this fat and this helps the patient reduce their weight.

• Because Alli is based on another medicine containing the same active substance already authorised in the European Union (Xenical 120 mg capsules), some of the studies involved patients who took Xenical.

• Alli capsules have been studied in three main studies. Two of the studies involving a total of 1,353 overweight or obese patients with a BMI of 28 kg/m2 or more and lasted from one to two years, comparing Alli given at different doses with placebo (a dummy treatment), in combination with dieting. Neither the patients nor the doctors knew which treatment each patient was taking until the end of the study. The third study compared Alli with placebo in 391 overweight patients with a BMI between 25 and 28 kg/m2. The study lasted four months.

• In all of the studies, the main measure of effectiveness was the change in weight.

• The company also carried out studies to show that Alli 27 mg chewable tablets have the same effect on fat absorption as Alli 60 mg capsules.

• Most of the side effects with Alli affect the digestive system and are less likely to occur with a low fat diet. In general, they are mild, and occur at the beginning of treatment, going away after some time.

• The most common side effects with Alli (seen in more than 1 patient in 10) are oily spotting, flatus (gas) with discharge, faecal urgency (urgent need to open the bowels), fatty oily stool, oily evacuation (bowel movements of just oil, without stool), flatulence (gas) and soft stools. For the full list of all side effects reported with Alli, see the package leaflet.

• Alli must not be used in people who are hypersensitive (allergic) to orlistat or any of the other ingredients. It must not be used in people who are being treated with ciclosporin (used to prevent organ rejection in transplant patients) or with medicines used to prevent blood clots such as warfarin. It must also not be used in people with chronic malabsorption syndrome (a long-term disease where nutrients from food are not easily absorbed during digestion) or cholestasis (a liver disorder), or in women who are pregnant or breast-feeding.

• The European Medical Agency decided that the benefits of Alli are greater than its risks and recommended that it be given marketing authorisation.