Indication assessments in the registry

Atherosclerotic obstruction of the lower-limb arteries producing exertional ischaemic symptoms, with objective confirmation by ankle–brachial index or imaging.

Interventions proposed to modify rate of biological ageing, assessed by composite biomarker clocks, functional measures, or mortality.

Pharmacological modification of innate or adaptive immune function, assessed by cell counts, functional assays and clinical infection or oncological endpoints.

A pattern of alcohol use characterised by impaired control, salience, and physiological features, meeting recognised diagnostic criteria.

Obesity arising from structural hypothalamic injury or a defined genetic syndrome affecting the melanocortin pathway or energy homeostasis.

Excess adiposity sufficient to impair health, operationalised in the pivotal incretin programmes as a body-mass index of 30 kg/m² or above, or 27 kg/m² or above with at…

Genetically determined impairment of oxidative phosphorylation producing myopathy, exercise intolerance or multisystem disease.

Adiposity above the 95th percentile for age and sex, or above the 120th percentile of the 95th percentile for severe obesity, in individuals under 18 years.

A reproductive-endocrine disorder defined by combinations of ovulatory dysfunction, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology.

Persistently reduced sexual desire or impaired erectile function causing distress, assessed by validated instruments.

Insufficient endogenous growth-hormone secretion, or the pharmacological stimulation of the growth-hormone axis, assessed here principally through provocative testing…

Loss of skeletal muscle mass and function, considered here principally as a consequence of rapid weight reduction under incretin therapy.

Established atherosclerotic disease of the coronary, cerebral or peripheral arterial beds, or a risk profile sufficient for enrolment in a cardiovascular outcome trial.

Domain-specific cognitive function or protection against cognitive decline, assessed by standardised neuropsychological batteries or clinical dementia rating.

Symptomatic heart failure with a left ventricular ejection fraction of 50 % or above, occurring with obesity as a dominant phenotypic driver.

Steatotic liver disease with histological evidence of hepatocyte ballooning and lobular inflammation occurring in the context of at least one cardiometabolic risk…

Restoration of epithelial and dermal integrity following injury, assessed by closure rate, area reduction and scar quality.

Persistent reduction in estimated glomerular filtration rate or persistent albuminuria in the context of type 2 diabetes, staged by eGFR and urine albumin-to-creatinine…

Abnormal regional fat distribution with excess visceral adipose tissue, in the setting of HIV infection and antiretroviral therapy.

Difficulty initiating or maintaining sleep with daytime consequences, assessed by polysomnography, actigraphy or validated questionnaires.

Acute or overuse injury of tendon, ligament or muscle, with healing assessed by imaging, function and return-to-activity endpoints.

Chronic immune-mediated inflammation of the intestinal tract, or disorders of intestinal permeability including coeliac disease.

A disorder of glucose regulation characterised by insulin resistance with relative insulin deficiency, diagnosed by glycated haemoglobin, fasting plasma glucose or oral…

Slowed gastric transit, considered here both as a pharmacodynamic mechanism and as an adverse-effect surface relevant to procedural and anaesthetic risk.

Use alongside insulin in autoimmune diabetes, where the therapeutic target is postprandial excursion, insulin dose or weight rather than endogenous insulin secretion.

Dependence on nicotine-containing products, characterised by craving, tolerance and withdrawal.

Recurrent upper-airway obstruction during sleep producing apnoeas and hypopnoeas, graded by the apnoea–hypopnoea index on polysomnography.

Sustained elevation of arterial pressure above accepted diagnostic thresholds, considered here as a weight-responsive outcome rather than a primary treatment indication.

An adverse lipoprotein profile, typically raised triglycerides with reduced HDL cholesterol and a raised apolipoprotein B to apolipoprotein A1 ratio.

Glucose regulation impaired beyond normal limits but below diagnostic thresholds for diabetes, including impaired fasting glucose, impaired glucose tolerance, and…

Degenerative joint disease of the knee with radiographic or symptomatic confirmation, occurring with obesity as a mechanical and inflammatory contributor.