Dear Juniper Patients,

We have an important update on our current stock levels that we know may be disheartening:

- Our remaining avenue to secure 1mg pens has been abruptly shut down by the main supplier.
There is only one manufacturer of Ozempic, and they have not distributed enough to meet demand meaning further, sudden, restrictions.

- The immediate impact is to all patients currently on 1mg, 1.5mg, 2mg or going to 1mg in the next 30 days. Those impacted will not receive 1mg pens for their next order.

- The prescribing team have developed a contingency plan. Their advice is that the best available clinical option for impacted patients is to receive a 0.5mg strength pen for their next order.

- If you wish to discontinue your treatment of Ozempic, please head to the link below.

- If you currently have an order scheduled from the 18th of July to the 23rd of July you will have your order automatically delayed by 7 days, to ensure enough time to thoroughly review the updated prescriber recommendations and confirm a treatment plan.

- Our prescribing team have provided a set of recommendations for how to best manage your weight-loss during this time which are outlined below.

We believe Wegovy (which has the same active ingredient as Ozempic) will become available in the United Kingdom soon. We have an entire team dedicated to sourcing more supply across Europe and will always prioritise existing patients for any 1mg that becomes available. We are working around the clock to secure more supply amidst the shortage.

We recognise the hard work you have put in and we understand this is devastating news. During this period our goal is to provide the best continuation of your weight loss journey. The prescribing team has developed a contingency plan which is their recommendation of the best way to maintain weight loss during this time. They have issued the following letter (summarised below).

We encourage you to follow all or any combination of these recommendations:

Recommendation 1
Our prescribing team recommend moving to a 0.5mg weekly dose. There are a few reasons for this. Lower dosages will still help with weight management, and for those that plan on continuing to use medication to help, a prolonged pause in treatment (greater than 20 days) would mean restarting at 0.25mg under current clinical guidelines.

Moving down to 0.5mg ensures that you can go directly back up to 1mg (and higher after 4 weeks, where prescribed) without having to start again, as soon as more supply becomes available.

Recommendation 2
Our prescribing team recommend starting or continuing with a meal replacement regime under the supervision of the Juniper programme. What this looks like in practice is replacing one meal a day with a shake - if you have a preferred shake, please feel free to use this, or ask your health coach for their recommendations.

Juniper has a meal replacement shake available, which we have temporarily reduced in price to give you the best shot at continuing with the least disruption possible to your weight loss journey.

Recommendation 3
Finally, our prescribing team recommend engagement with your health coach to create an action plan to ensure you don’t lose all of your hard work, you can speak with a health coach. During this change we will continue to support the Juniper community with health coaching regardless of how you decide to proceed, you can access a health coach in the Juniper app.

We know this news is tough and you may have a lot of questions.

- We have put together an FAQ that we think covers the most important issues (see below).

- Our team is available for support and questions here.

- You can download our Juniper App to interact with our Health Coaches here.

- Should you wish to discontinue your treatment please follow this link.

We are devastated to be in this position. Our team is working day and night to give the entire Juniper community the best possible treatment amidst a national shortage.

FAQ

What do I need to do?

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If you’re on 0.25mg, 0.5mg or 1.0mg of semaglutide

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You don’t have to do anything — the updated price will be automatically applied to your next order.

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If you’re on 1.5mg or 2.0mg of semaglutide

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Your order is paused while you are in review with a pharmacist. Please speak to your prescriber to readjust your dose.

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If your order is due to refill on Wednesday 31st May, or Thursday 1st June, Friday 2nd June, Saturday 3rd June, Sunday 4th June 2023

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Your order is delayed until the Monday the 5th of June to give you time to adjust to the price changes. If you wish to refill your order sooner, you can do so in your dashboard.

Price and supply

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Why was the price increased by £30?

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The cost of Ozempic has more than doubled due to unprecedented global demand for the medication. We've absorbed these increasing costs so far, but in order to continue providing your treatment we've had to make this change.

Our team has worked around the clock to secure enough medication in light of the shortages. At the present time, the cost of the medication alone exceeds what we charge for the entire programme.

We're doing everything in our power to manage this situation responsibly. Our priority is for you to continue on a successful weight loss journey without interruptions. Increasing the price allows us to continue buying the medication for your treatment.

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Does this mean Juniper will be out of stock?

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We are proactively managing our resources and working diligently with our suppliers to avoid any disruption in the availability of the medication. Our priority is to ensure the continued treatment of our patients, and we are confident in our ability to source the necessary stock to maintain the high-quality care you deserve.

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Will there be further price increases?

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We do not anticipate further changes to price at this time. Our goal is to revisit pricing as soon as the situation with the shortage improves. We will continue to communicate any changes from our suppliers as they come through.

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How long do you anticipate the medication shortage to last?

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The duration of the medication shortage is difficult to predict, as it depends on patient demand and manufacturer supply, as well as market and prescribing regulations. We are actively monitoring the situation and working closely with our suppliers to secure medication, and will keep you informed of any changes to Juniper based on the shortage.

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Will Juniper notify patients if the medication shortage situation improves or prices return to normal?

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Yes, we are committed to keeping our patients informed about any changes in the medication shortage situation.

As soon as it becomes feasible to revert the changes in light of the evolving shortage, our goal is to do so and return to our structure.

We will promptly communicate any updates or improvements to ensure you stay well-informed throughout this process.

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Can I expect more frequent communication and updates about the medication shortage and its impact on the programme?

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Yes, we understand the importance of keeping you informed about the medication shortage and its impact on the programme. Our team will be providing regular updates and maintaining open lines of communication to ensure you stay informed about any changes and developments. We are committed to transparency and keeping you up to date as we navigate this situation together.

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Why is there a medication shortage?

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The success of GLP-1 agonists in the treatment of obesity has prompted high demand for the medication across the world. This places pressure on manufacturers to create higher volumes of medication, and creates sourcing limitations for suppliers. For Juniper, we have secured enough medication for our patients, but at an increased cost price, and while we have been able to absorb the cost, the most recent shortage forces us to pass this on to patients.

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How was the decision to increase price made, and who was involved in the process?

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When we began to experience rising costs in May 2023, we worked with our Medical Director in Australia, our clinical team in the UK, and suppliers in the UK and across Europe to develop a solution that would allow patients to continue accessing their treatment with support from health coaches and pharmacists.

In order to achieve this, we were forced to increase the price to match the rise of the medication cost (which has increased by over 200% since we launched Juniper only a year ago). While other providers have been forced to close their doors and turn away patients, we have strived to continue to service existing patients to the best of our ability by increasing the cost of the programme and pausing new patients from joining Juniper.

This decision did not come lightly, and we are working with suppliers and our clinical team to communicate any further changes that arise from this evolving supply issue. We welcome all feedback and suggestions, and appreciate your patience.

Medication and dosing

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Does Juniper offer alternative medications?

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We are exploring additional medication offerings to expand treatments and diversify medication supply, to mitigate shortage issues that may arise in future. We are working with manufacturers, medical experts, and suppliers to meet this, but in the meantime, our core medication offering remains the same. Whilst there are other medications on the market, we believe semaglutide to be one of the most clinically effective treatments for treating obesity. We aim to continue to provide best-in-market service through evidence-backed treatments alongside our health coaching and app offering.

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Will the price reduce if the situation improves?

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We will readjust the price when the medication costs reduce, but we cannot promise when this will occur.

We're prioritising keeping the cost as low as possible for existing patients. If we re-open the programme to new patients, their subscription price will be higher than £225 to help subsidise the increasing costs.

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If there’s extra fluid in my pen, can I get extra needles and use this?

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Each 0.25mg Ozempic pen is loaded by the manufacturer with up to 2 extra doses. This is to ensure that each dose is correctly delivered in full at all times and to account for any errors or maladministration.

As per manufacturing instructions, we cannot clinically recommend using this.

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Why are the dosages changing for 1.5mg and 2.0mg?

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Our team has worked around the clock to secure enough medication in light of the shortages. At the present time, the cost of the medication alone exceeds what we charge you for the entire programme.

We're doing everything in our power to manage this situation responsibly.

Unfortunately, due to the sharp increase in Ozempic costs, we can no longer offer dosages that require more than one pen at the regular price.

Our team has worked around the clock to secure enough medication in light of the shortages. At the present time, the cost of the medication alone exceeds what we charge you for the entire programme.

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Will Juniper offer extended dosing schedules?

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All patients will continue on a 7 day dosing schedule.

To ensure we achieve clinical efficacy during a shortage, we consulted the advice issued by the Department of Health & Social Care and the NHS Specialist Pharmacy Service, who suggest that it is appropriate to change the dose schedule due to the severe shortage of semaglutide. Semaglutide (Ozempic) is a long-acting medication, meaning that the steady-state of active medication remains in the circulation for up to 5 weeks after the last injection. Once a patient has been using the medication for 4-5 weeks, the medication will remain at an effective dose level beyond 7 days after the last injection. Due to the way that the medication is metabolised, at 10 days, the dose in circulation will remain at a slightly lower, but still very effective level. This will continue for many weeks to months at a regular dose interval of 10 days. While we have secured supply for our current patients, the dosing schedule will not extend beyond 7 days. We will communicate any updates to this as they occur.

Juniper programme

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Can I refill my order before the price change comes into effect?

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The price increase will affect future orders processed from and including Wednesday 31 May 2023. To ensure our patients continue to receive equal access to the medication as scheduled, we will not offer refills at the previous price.

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Can I cancel and rejoin later?

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During this shortage period, we are restricting new signups to maintain stock levels for existing patients. This will include patients who have cancelled their treatment and try to rejoin the programme. However, you can pause your treatment plan while the cost of the programme is increased and reactivate your plan later. If the price increase is inaccessible to you at this time, you can pause your treatment plan while the cost of the programme is increased and reactivate your plan later. Please note that this may affect your dose if you stop taking semaglutide, and you may have to retitrate up when you return.

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Will this impact my order if it is currently processing?

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If your order is currently processing and dispensed by the pharmacy, it will be shipped out as normal.

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How can I share my concerns or feedback about these changes with Juniper?

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If your question is not answered here, please submit a request here and one of our patient support specialists will respond to you as soon as we can. There is a high volume of requests during this period, so please bear with us as we respond to every enquiry.

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If I decide to pause or cancel my subscription, will I still have access to the health coaching and community support?

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Unfortunately not, the programme is inclusive of health coaching and community access.

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Will I still be able to refer friends and family to Juniper?

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We have made the decision to suspend the refer a friend programme during this time, to support existing patients on the programme. We will explore reactivating this offer once supply returns to normal.

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What else is Juniper offering during this period?

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We’ve invested a lot into Juniper’s programme. The new Juniper app has a steady supply of informative video content created by our in-house team of dietitians, pharmacists, and nutritionists, which covers everything from nutrition and sleep to movement and mental health. We highly recommend downloading the free, members-only app and exploring our content catalogue (which we will continue to contribute to).

We’d also invite you to reach out to our patient support team and health coaches

You can also find us in our Slack community, where you can ask questions, share stories with other Juniper members, and maybe even meet a new friend to share the journey with.

While our medication is the foundation of our programme, it’s this support and community that leads to better weight loss outcomes.

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Will this delay my order if it is currently processing?

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If your order is currently processing and at the dispensing stage by the pharmacy, it will be shipped out as normal unless otherwise advised. The price modification only applies to upcoming orders, which you will be reminded of prior to being debited.

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Is Juniper accepting new patients right now?

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Our focus right now is on you, our existing patients. We’re not accepting new members in order to limit impacts to supply, and we have paused Juniper’s referral codes. We encourage you to make the most of Juniper’s coaching tools including dietitian support, app, and pharmacist reviews. Whilst our medication is the foundation of our programme, it’s this support that leads to better weight loss outcomes than just using medication alone.

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Can new patients join a waitlist?

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We are exploring setting up an email waitlist for the programme and prescriber consultations, however this is currently not available.

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How can Juniper support me during this time?

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We’ve invested a lot into our support recently. The new Juniper app has a near-endless supply of informative video content created by our in-house team of dieticians, nurses, and nutritionists, from everything on nutrition and sleep to movement and mental health. We recommend downloading the free, members-only app and familiarising yourself with our content catalogue.

We’d also invite you to reach out to our team of health coaches and medical support specialists via in -app chat where you can talk directly to your health coach. Our team is experienced, friendly, and ready to support you in any way that you need.

While our medication is the foundation of our programme, it’s this support that leads to better weight loss outcomes. In fact,  a University of Copenhagen study also demonstrates that without a structured treatment plan, there is a high risk of gaining the weight back.

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Why are you still letting new patients into the programme?

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In May, we actively turned off new consultations to prevent new patients coming into the programme, and are prioritising our supply for existing patients. Our current patients are our top priority, and we are bringing on additional resources to support you through this period. Medication is just one part of our programme, our coaching tools, shakes offering, and ongoing medical and health coaching support has been shown to offer results too.

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Can I order two 0.50mg pens?

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To ensure we can offer as much medication to as many existing patients as possible, unfortunately we are unable to fulfil two pens at the same time

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Why are you giving me 0.5mg if my prescription states otherwise?

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Juniper is only able to fill scripts for medication that is available. Based on our updated prescriber recommendation, our pharmacy is able to dispense 0.5mg under emergency supply provisions to ensure continuity of treatment in lieu of 1mg or higher dosages.

We understand that this is a frustrating situation however given the current national and global shortage, this is the only option to continue your treatment plan.

If you would like to cancel and not receive a 0.5mg for your next order, please visit this link.

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When will I be updated next?

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The current shortage we are experiencing is an evolving situation. Refilling stocks and alleviating delays to our patients is our main focus, and any updates we receive will be shared with you quickly.

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Why is this happening?

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We know this is a frustrating position for our patients to be in. GLP-1 medications are playing a vital role in helping tackle obesity. We are working very closely with suppliers to enable patients to continue their weight loss journey, and we are responding as quickly as possible based on evolving information. Currently demand for these medications is causing disruptions nationwide because demand is greater than the available supply from the manufacturer.

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When will this end?

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Unfortunately we don’t know how long this issue will last, but we are committed to keeping you informed with regular updates when we have them. In the meantime, we are working hard to replenish our stocks and, to ensure our long-standing members are best supported.

We believe Wegovy (a new generation of the medication) will become available in the United Kingdom very soon. Staying on the medication continuously, even at lower dosage, means you don’t have to re-titrate up from 0.25mg once higher dosages become available or Wegovy is launched.

We also working hard to secure supply of more 1mg pens. We have an entire team dedicated to finding more supply across Europe and we will prioritise existing patients for any 1mg that comes available. We are working day, night and weekends to secure more supply amidst the shortage.

This means that remaining on 0.5mg will give Juniper patients the quickest path to titrating up when 1mg or Wegovy becomes available.

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Is only Juniper affected?

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We are not in a position to comment on other suppliers, however there is currently a national shortage. Juniper is in direct contact with global suppliers of our treatments and will update you as soon as we can to return to regular dosage schedules.

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How can I stay updated?

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Alleviating supply chain challenges to best support our patients on their weight loss journeys is our main focus, and any updates we receive will be shared with you as soon as possible.

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What happens to my appetite when I titrate down from a higher dose to 0.5mg?

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The medication can help you feel fuller for longer by slowing down the emptying of your stomach, even at lower doses. To manage your appetite, dietary changes can be very effective and can help you develop lifelong healthy eating habits. Here are some effective strategies to help you achieve this:

  • Aim for 3 main meals throughout the day
  • Include 1-2 light snacks each day
  • Ensure a fist-sized portion of protein with each meal
  • Add wholegrains to your diet
  • Strive for at least 5 fruit and veg portions throughout the day
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Are there any side effect considerations when decreasing from a higher dose to 0.5mg?

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No, we don’t expect patients to have any negative effects when reducing dosage. Side effects are most commonly experienced when increasing your dose and it is generally recommended that patients reduce their dosage to manage side effects.

If you have any concerns or need additional support, please do not hesitate to contact our medical support team.

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Can I get my treatment now?

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Your next order date will be updated automatically based on your order schedule and the new dosing recommendations. If your order has been delayed it's for you to acknowledge the updates about dosages. Go to your Account page to manage your order and check if you're allowed to refill, it depends on what dosage you're on. Unfortunately, we are currently unable to allow multiple pens at once.

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Can I delay my next order?

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If you need to delay your order please do so in your profile.

Please note a prolonged pause in your treatment (greater than 20 days) would mean under current clinical guidelines - restarting at the original 0.25mg dose.

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Do you offer alternative treatments?

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Based on the updated prescriber guidance, the recommendations we have outlined are the best available interventions we can offer and have been chosen following the guidelines for the management of overweight and obesity. Any of the recommendations made can be done either stand-alone or together

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How do I get in touch with health coaching?

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Our health coaches are experts in weight management and behavioural change. They can provide tailored advice to cater to your lifestyle and dietary requirements.

You can get in touch with a health coach by

  1. Chatting with them through the app
  2. Submit a request through this form and select Health Coaching

For further resources to help you stay on track of your goals, please visit the content section in our app.

It's important to keep in mind that weight loss plateaus or slight weight gain are a normal part of the weight loss journey, and they don't necessarily mean that you're doing anything wrong.

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What are some ways I can supplement my weight loss journey?

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Medication is only one piece of the puzzle. In fact, it’s the compounding effects of small behavioural changes that leads to lasting weight loss. In order to continue your great progress, our team of experts can help you make tweaks relating to diet, movement, sleep, stress, and more. And all of these have positive impacts to your weight loss journey.

You can read more about our weight loss shakes here.

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How can Juniper support me during this time?

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We’ve invested a lot into our support recently. The new Juniper app has a near-endless supply of informative video content created by our in-house team of dieticians, nurses, and nutritionists, from everything on nutrition and sleep to movement and mental health. We recommend downloading the members-only app and familiarising yourself with our content catalogue.

We’d also invite you to reach out to our team of health coaches, medical support specialists and prescribers. Our local team is experienced, friendly, and ready to support you in any way that you need.

You can also find us in the Juniper Weight Reset slack community, where you can ask a question, swap stories with other Juniper members, and maybe even meet a new friend to share the journey with.

While our medication is the foundation of our programme, it’s this support that leads to better weight loss outcomes.

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Will there be any changes to the cost of treatment?

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There will be no change to the treatment price. You still have full access to control your plan in your account.

The only exception is for patients on 1.5mg and 2mg who decide to switch to 0.5mg. In this case, the new price will be £225 per month for 0.5mg.

Still have a question?

We’d love to help. You can reach out to our friendly team here.