Metabolic health concerns how the body regulates weight, blood sugar, blood fats and energy. Many people who come to a metabolic specialist have already tried hard to manage their weight through diet and lifestyle, and are looking for answers as to why it has been difficult. If your weight has been hard to manage despite sustained lifestyle measures, if blood test results such as glucose or HbA1c are drifting toward the diabetic range, or if weight changes have coincided with a hormonal condition, an underlying endocrine or metabolic factor may be involved. A specialist assessment may help clarify what is happening and what options are available to you.

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Dr Mamta Joshi is a Consultant Endocrinologist with over a decade of clinical experience, practising at Spire St Anthony's Hospital in Cheam, Surrey. She sees patients from across Surrey and South London for private metabolic health consultations. Her approach is that of a medical weight management specialist: to assess and treat the endocrine and metabolic factors that can make weight difficult to manage, rather than to offer a diet or lifestyle programme.

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What does a metabolic consultation cover?

 

Metabolic medicine looks at how the body handles energy: how insulin and blood sugar are regulated, how hormones affect weight, appetite and fat storage, and how these interact with overall health. Weight concerns are one of the most common reasons patients seek this kind of specialist input, but the work covers the full picture of metabolic health.

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Dr Joshi's private metabolic consultations cover:

• Insulin resistance: a state in which the body's tissues respond less effectively to the hormone insulin, which can affect blood sugar control and is often associated with difficulty managing weight 

• Metabolic syndrome: a cluster of related factors, including raised blood pressure, raised blood sugar, abnormal blood fats and increased weight around the middle, occurring together and raising long-term health risk 

• Hormone-related weight gain: weight gain associated with thyroid conditions, PCOS, perimenopause or other endocrine disruption 

• Obesity with endocrine contributors: assessment of the underlying medical contributors to weight difficulty, rather than only its outward symptom

• Type 2 diabetes and pre-diabetes where endocrine input is relevant: specialist review of glucose control where other endocrine conditions are involved or suspected 

• PCOS-related metabolic concerns: the metabolic aspects of PCOS, which commonly include insulin resistance. [See our PCOS page for the full condition overview: /consultations/pcos-specialist-surrey, LIVE NOW]

• GLP-1 medication assessment and management: specialist assessment of whether prescription weight management medication may be clinically appropriate, with prescribing and ongoing monitoring where indicated. [Full section below]

 

Not every patient who comes for a metabolic consultation receives a diagnosis of a metabolic condition, and not every patient seeking weight management input needs medication. A specialist consultation provides the full clinical picture and a plan appropriate to your situation.

 

Why patients seek a private metabolic specialist

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Many patients seek a private metabolic consultation after finding that weight and metabolic concerns have been difficult to fully investigate through existing routes.

 

Common reasons include:

• Weight that has been difficult to manage despite sustained lifestyle measures

• Blood test results, such as HbA1c, glucose or cholesterol, sitting at or near the borderline, without a clear plan for what to do next 

• A diagnosed or suspected hormonal condition, such as a thyroid disorder or PCOS, alongside weight changes

• Wanting a more thorough investigation than has been offered so far

• Difficulty optimising treatment for an existing metabolic condition

• Wanting a second opinion on a diagnosis or treatment plan

• Considering GLP-1 medication and wanting a specialist medical assessment before deciding anything

 

A private consultation with Dr Joshi provides dedicated time, a full clinical assessment, and specialist-level discussion of your results and the options available to you.

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What to expect at your consultation?

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Your first consultation with Dr Joshi will typically involve:

• A detailed review of your symptoms, medical history, previous tests and current medication

• A discussion of your concerns and what you are hoping to understand or address

• Consideration of appropriate further investigations, which may include blood tests such as glucose, HbA1c, thyroid function and hormone levels

• A clear explanation of your results and what they mean in the context of your symptoms

• A discussion of the management options available, tailored to your individual situation

 

No treatment or medication is prescribed without a full assessment. Dr Joshi's approach is to give you the information and the time you need to make informed decisions about your care.

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GLP-1 medications: specialist assessment and management

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GLP-1 receptor agonist medications, such as semaglutide, and related medications, such as tirzepatide, have received significant public attention in recent years. They are prescription-only medicines. They require medical assessment before starting and ongoing medical supervision while taking them. They are not appropriate for everyone, and not everyone who asks about them will be advised to take them.

 

What specialist assessment and management within this practice involves:

• A full medical assessment, including your history, relevant investigations and any previous treatments

• Assessment of underlying endocrine or metabolic contributors that may be affecting your weight, before and alongside any medication decision 

• A discussion of whether this class of medication may be clinically appropriate for your individual circumstances, including the medical criteria that apply 

• Prescribing where clinically appropriate, as one part of an individualised treatment plan 

• Scheduled follow-up in the outpatient setting, including monitoring how you are getting on and reviewing the treatment plan as appropriate 

 

No medication is prescribed without a full assessment. If GLP-1 medication is not clinically appropriate in your situation, or you would prefer not to take it, Dr Joshi will discuss the other options available for investigating and managing your metabolic health. The consultation is about understanding your situation and reaching the right decision with you, not about a particular treatment.

 

It is not possible to predict an individual result in advance, and no specific outcome can be promised from any treatment. Responses vary between people, and treatment decisions are reviewed as part of ongoing care.

The care described on this page is outpatient care: consultation, investigation where indicated, treatment planning, prescribing where clinically appropriate, and scheduled monitoring and follow-up. It does not include surgical, inpatient or intensive interventions, which sit outside this practice. 

 

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Metabolic health and other conditions

 

Metabolic health does not sit in isolation from the rest of the endocrine system. Thyroid conditions can affect metabolic rate and weight, and PCOS is commonly associated with insulin resistance and related metabolic changes . As a Consultant Endocrinologist with specialist training across the full endocrine system, Dr Joshi is well placed to assess these interactions and to provide a joined-up view when that is clinically relevant.

 

If your concerns sit more directly in one of these areas, you may find these pages helpful:

• PCOS Specialist in Surrey (links to: https://www.managethyhormone.com/consultations/pcos-specialist-surrey — LIVE NOW)

• Thyroid Specialist in Surrey (links to: https://www.managethyhormone.com/consultations/thyroid-specialist-surrey — LIVE NOW)

• Private Endocrinologist in Surrey and South London (links to: https://www.managethyhormone.com/private-endocrinologist-surrey — LIVE NOW)

 

About Dr Mamta Joshi

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Dr Mamta Joshi is a Consultant Endocrinologist with over ten years of clinical experience in diagnosing and managing endocrine conditions. She completed specialist training at Guy's and St Thomas' Hospitals, London, and holds membership of the British Society for Endocrinology, the European Society of Endocrinology, the Endocrine Society, and the Royal College of Physicians.

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Her specialist interests include thyroid conditions, women's health, endocrine autoimmune conditions, and metabolic medicine. She has published in peer-reviewed journals and presented at national and international conferences.

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Dr Joshi practises at Spire St Anthony's Hospital in Cheam, Surrey, and sees patients from across Surrey and South London.

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Patient reviews are available on Dr Joshi's Doctify profile: https://www.doctify.com/uk/specialist/mamta-joshi