GLP1R and obesity due to melanocortin 4 receptor deficiency: The glucagon-like peptide 1 (GLP-1) receptor agonist semaglutide 2.4 mg (Wegovy) has been shown to induce a mean body weight loss of 16%, significantly more than the previously available GLP-1 analogue liraglutide 3.0 mg (Saxenda) and the lipase inhibitor Orlistat.10 The NICE guidance on the use of Saxenda limited its use to secondary care but the recent guidelines on the use of Wegovy enable increased flexibility, allowing it to be offered within specialist obesity service without dictating the clinical setting.