A weight programme run by a doctor is not a diet sheet with a prescription stapled to it. It starts by working out why the weight is there — because several of the common reasons are treatable, frequently missed, and change what will actually work for you.
Most weight programmes start at the same place regardless of who walks in. A medical one starts with the question of cause, because the answer changes the plan.
Weight that has climbed steadily since a pregnancy, weight that appeared in eighteen months around the menopause, weight that arrived after starting a new medication, and weight that has been lifelong are four different situations. They respond to different things. Treating them identically is why a lot of people conclude that nothing works for them.
The other thing supervision changes is what happens when something goes wrong — side effects, a plateau, a result that does not match the effort. Those are clinical questions, and having someone to take them to is most of the value.
Thyroid underactivity is common in women, easily tested, and easily treated. Polycystic ovary syndrome affects how the body handles insulin and makes weight harder to shift; it also often explains irregular periods, acne and unwanted hair, so the weight is rarely the only clue.
Perimenopause shifts where fat is stored towards the abdomen even when the number on the scale barely moves, which is why waist measurement matters more than weight alone in the forties and fifties.
Obstructive sleep apnoea both results from and worsens weight gain, and wrecks the sleep that appetite regulation depends on. Some prescribed medicines — certain antidepressants, steroids, some contraceptives and diabetes drugs — cause weight gain, and there is often an alternative.
None of these are exotic. All are checkable in a single visit, and finding one changes everything that follows.
A history: what your weight has done over time and what was happening in your life when it changed, previous attempts and what actually went wrong with them, how you eat and sleep, what you take, and what matters to you about this.
Measurements: weight, height, waist circumference and blood pressure. Waist is recorded because abdominal fat carries the metabolic risk, and two women at the same weight can sit in quite different places on that.
Blood tests where indicated — blood sugar and HbA1c, lipids, thyroid function, liver function, and iron or vitamin D if the history points there.
Then a conversation about options, with the reasoning shown, including what each realistically achieves. Nothing is decided in the room if you would rather go away and think.
Consultation ฿1,500–3,000 depending on complexity, plus the ฿300 clinic service fee. Any treatment is quoted separately before you agree to it.
Nutrition and activity remain the base of every plan. Not a generic deficit: one built around what you actually eat, what your day looks like, and what you can sustain past the third week.
Treating the contributor — the thyroid, the sleep apnoea, the insulin resistance, the medicine that is working against you — sometimes does more than any weight-specific intervention, and it is the step most often skipped.
Prescription treatment is available where it is clinically appropriate, and is discussed with you in consultation. We deliberately do not name prescription medicines on a public page: Thai regulations restrict advertising prescription-only medicines to the general public, and a medicine that suits one person can be unsuitable or unsafe for the next. Whether any is right for you depends on your measurements, your medical history, your family history and what else you take — all of which are checked before anything is prescribed, and monitored afterwards.
What is worth knowing in advance: prescription treatment is an adjunct to the rest, not a replacement for it; it is not suitable in pregnancy or while trying to conceive; and weight commonly returns when treatment stops unless the surrounding changes have taken hold. Anyone presenting it as a one-off fix is not describing it accurately.
This is where a urogynecology clinic has something specific to add. Body weight raises pressure inside the abdomen, and that pressure is carried by the pelvic floor. It is one of the mechanisms behind stress incontinence — leaking when you cough, sneeze, laugh or lift — and it contributes to prolapse symptoms too.
Weight reduction is one of the few interventions with genuinely good evidence for reducing leaking episodes in women who are carrying excess weight, and the improvement often shows up earlier than people expect, well before a target weight is reached.
It works best alongside correctly taught pelvic floor training rather than instead of it. If you are dealing with both, they are worth assessing together in one visit rather than as two separate problems in two separate clinics.
No residency, referral or Thai insurance is needed. The assessment is a single appointment and fits inside a stay.
A programme involving ongoing prescription treatment does need follow-up, so if you are here briefly it is worth saying so at the start — what can sensibly be started on a short visit is a fair question and we would rather answer it honestly than begin something that cannot be continued.
You will see a female specialist. Consultations are conducted in English or Thai.
One assessment covers the treatable causes, your measurements and the realistic options — including how weight is affecting your pelvic floor. Message us on LINE to arrange a time.
This page is general information, not a diagnosis or a treatment recommendation. Suitability for any treatment is decided individually after assessment, and results vary between individuals. Consultations are conducted in English or Thai. THE FIT CLINIC — 8th Floor, EM Tower, EMSPHERE, BTS Phrom Phong, Bangkok. Open daily 10:00–19:00.