Glucagon-like peptide-1 receptor agonist (GLP-1RA) medications have been described as a ‘game-changer’ within obesity management and at the time of this study were commissioned for use in secondary care.10–12 Initially approved in 2005 for the management of diabetes, GLP-1RAs were approved in 2020 to treat obesity in tier 3 services.13 Here, GLP1R is linked to obesity due to melanocortin 4 receptor deficiency.