Obesity treatment Radom

The International Classification of Diseases lists obesity under code E66, and the Polish Society for the Treatment of Obesity calls it a chronic disease in its 2024 guidelines: one that lasts for years, requires ongoing treatment and usually causes weight to return when treatment stops. A patient who lost over ten kilograms three times in ten years now weighs more than before the first diet. After losing fat tissue, the body starts using less energy than would be expected for its new weight, releases more ghrelin, the hunger hormone, and has lower leptin levels, the hormone fat tissue uses to tell the brain about its reserves. The same dinner then keeps the person full for less time than a year earlier.

Not everything depends on food. Oral steroids and some psychiatric medicines, untreated hypothyroidism, emotional eating and quitting smoking, after which the vast majority of people gain weight, all encourage obesity. Breathlessness creates a separate vicious circle. Someone who becomes breathless after one flight of stairs walks less. Less activity means faster weight gain, and a heavier body makes breathing even harder on the next stairs. Fat tissue also releases substances that sustain chronic inflammation and reduces tissues' sensitivity to insulin. This explains the links between obesity and type 2 diabetes, high blood pressure, fatty liver, and more severe asthma and chronic obstructive pulmonary disease.

Because the disease is chronic, we treat it continuously, as with high blood pressure or diabetes. The doctor makes the diagnosis, chooses a medicine, assesses tolerance and the rate of weight loss, then decides after a few months whether to continue or try another. The dietitian builds a meal plan around the patient's working hours, while the specialist in the psychology of eating addresses emotional eating. We plan this over years and explain from the outset that some weeks will bring no weight loss.

The first appointment starts with weighing, measuring waist circumference and discussing weight history. We calculate BMI by dividing weight in kilograms by height in metres squared. A woman who is 165 cm tall and weighs 92 kg has a BMI of 33.8. The World Health Organization thresholds, also adopted by the Polish Society for the Treatment of Obesity, are the same for women and men: overweight from 25, class I obesity from 30, class II from 35 and class III from 40. However, this index does not distinguish muscle from fat or tell us where fat is stored.

We therefore measure waist circumference halfway between the lowest rib and the iliac crest after a normal breath out. The International Diabetes Federation defines abdominal obesity from 80 cm in women and 94 cm in men; these thresholds apply to European populations regardless of BMI. Fat around abdominal organs reduces tissues' sensitivity to insulin, prompting the pancreas to release more, and promotes inflammation more strongly than fat on the thighs. The third part of the appointment is weight history. We ask about weight at school, when it began to rise, every treatment tried and how much of the lost weight stayed off. We also ask about breathing: how many flights of stairs cause breathlessness, whether the patient coughs in the morning, whether they smoke or used to, and since when.

At what BMI we prescribe medication and when we treat without it

From a BMI of 30, the index alone is enough for a prescription. At a BMI of 27 to 29.9, a weight-related condition listed in the summary of product characteristics, the official medicine information, is also required. It lists prediabetes and type 2 diabetes, high blood pressure, lipid disorders, obstructive sleep apnoea and cardiovascular disease. Asthma is not on that list. A patient with a BMI of 28 and asthma therefore does not qualify on that basis, although obesity worsens asthma control. We then look for metabolic complications in blood tests; if none are present, the options are a meal plan and activity matched to fitness. Below a BMI of 27, we offer medication to no one. Age does not rule out treatment, but affects medicine selection: we do not use liraglutide from age 75, and evidence for the other medicines in this age group is limited.

Patients are treated by internal medicine physicians certified by the Polish Society for the Treatment of Obesity. The first consultation costs PLN 250, takes around an hour and is held at Mireckiego 10 or by video call. The doctor reviews medicines and supplements, weighs the patient, measures waist and blood pressure, reviews results and orders missing tests. We ask separately about inhaled medicines, because uncontrolled asthma changes exercise planning. Patients with complete results who meet the criteria receive an e-prescription for the starting dose and a dietitian appointment. We teach injection pen use at the same appointment, in person or on camera.

With semaglutide, reaching the target dose takes 16 weeks: we start with the lowest of five doses and increase it four times, every 4 weeks. We meet by video before each change. The patient reports weight and blood pressure measured at home and describes tolerance; the doctor sets the dose and sends the next prescription code. Resistance exercises, using bands, dumbbells or body weight, are included from the first week, because weight falls fastest initially and muscle is then most easily lost instead of fat. We repeat blood tests in the fourth month.

We assess effectiveness after three months on the full dose, around treatment month seven. The Polish Society for the Treatment of Obesity considers a medicine effective when weight has fallen by at least 5 percent. Below that threshold, we change the medicine, for example to tirzepatide or an oral medicine. The second six months continue at a fixed dose, with video reviews every 4 to 8 weeks and one in-person appointment per quarter. After a year, we decide together whether medication continues or we start tapering it.

What we do not do in obesity treatment at Nasz Gabinet Radom

• We do not diagnose asthma or chronic obstructive pulmonary disease or change inhaled treatment. A respiratory specialist makes the diagnosis using spirometry, while we address body weight, which affects these diseases.
• We do not treat nicotine dependence or prescribe medicines to help stop smoking. We do address what smokers fear most: the kilograms gained after quitting.
• We do not recommend intense exercise to someone who becomes breathless after one flight of stairs until its cause is known. We start with walking on level ground and investigating breathing.

The basic panel includes a full blood count, fasting glucose or glycated haemoglobin, a lipid profile, liver tests, creatinine to assess kidney function and thyroid-stimulating hormone, or TSH. We ask for results older than six months to be repeated. A GP can order the whole panel under NFZ, Poland's National Health Fund, and we accept results in any form, including a phone photograph. Glucose and the lipid profile most often determine eligibility at a BMI between 27 and 30, liver tests detect fatty liver, and creatinine shows how the kidneys work. Normal TSH rules out hypothyroidism as the cause of weight gain, which patients ask about most often.

Which tests we add for a patient with breathlessness

For someone breathless with minor exertion, we add two tests. The first is a differential blood count with eosinophils, blood cells that increase in allergic diseases; we ask for it alongside the full blood count. The second is iron and ferritin, because anaemia itself causes breathlessness on exertion and can be overlooked in women. Spirometry with a bronchodilator reversibility test, measuring breathing before and after a bronchodilator, is ordered by a GP or respiratory specialist, and we send a letter describing the symptoms. For long-term smokers, we add a question about chronic obstructive pulmonary disease. Spirometry results in someone with obesity are interpreted differently from those in a lean person, so we leave reporting to the specialist.

Breathlessness on exertion is one of the commonest reasons someone with obesity sees a doctor, yet its cause is easily misattributed. Patients usually blame poor fitness, while a doctor may immediately diagnose asthma. In some people with obesity, both mechanisms overlap and each requires a different approach. We therefore ask every patient about breathing, including those who do not mention it themselves.

What causes breathlessness in someone with healthy lungs

Fat on the abdomen and chest acts like a tight corset. It raises the diaphragm, reduces the air remaining in the lungs after a normal breath out and increases the work the breathing muscles perform with every breath. A study of 373 people with normal airway patency measured how much lung volumes fall. At a BMI of 30, the air remaining after a normal breath out was 75 percent, and the additional air that could still be breathed out just 47 percent, of the values at a BMI of 20. The largest changes already occurred with overweight and class I obesity. Vital capacity remained within normal limits, so spirometry can be normal even in someone breathless on the first flight of stairs. In a meta-analysis of seven studies involving over 333,000 adults, excess body weight increased the risk of developing asthma by half in both sexes, and obesity itself nearly doubled it.

How we distinguish breathlessness due to the airways from breathlessness due to weight

The comparison below organises the questions we ask at an appointment. Spirometry with a bronchodilator reversibility test performed by a specialist settles the issue; the table helps decide whether that test is needed.

We remind patients diagnosed with asthma about a Canadian study involving 496 adults. In this study of 496 adults previously diagnosed with asthma by a doctor, the diagnosis was confirmed in around two thirds. Ultimately, asthma was not found in 31.8 percent of those with obesity and 28.7 percent of those without obesity, and almost two thirds of these people needed neither medication nor visits for breathlessness during the next six months of follow-up. Obesity did not increase the risk of misdiagnosis, as percentages were similar in both groups. Asthma once diagnosed without spirometry should therefore be confirmed before a patient accepts breathlessness as inevitable.

What weight loss changes for a person with asthma

There is only one randomised trial on this question, from Finland, involving 38 people with asthma and a BMI of 30 to 42, divided into two groups. The weight-loss group followed a supervised very low-calorie diet that produced faster loss than we propose to our patients. Over eight weeks they lost 14.5 percent of their weight, compared with 0.3 percent in the comparison group. After a year, the first group weighed 11.3 percent less than at baseline and the second 2.2 percent more. Forced expiratory volume in one second, the air breathed out in the first second and a basic measure of airway patency, was higher in the weight-loss group by 7.2 percentage points of the predicted value after eight weeks and 7.6 points after a year; vital capacity was higher by 8.6 percentage points after eight weeks. Separately, data from 3073 adults with moderate asthma in four trials of controller medicines were analysed. The higher the BMI, the weaker the response to an inhaled glucocorticoid, while response to montelukast remained similar regardless of weight. This observation came from reanalysing data collected for another purpose, so we do not change asthma treatment on that basis.

Surgical treatment data point in the same direction, although they are entirely observational. A review of 33 studies involving 3731 asthma patients after bariatric surgery found that 47 percent stopped asthma medicines, symptoms resolved in 58 percent, and forced expiratory volume in one second and vital capacity improved by 8 to 9 percentage points. GLP-1 analogues show a similar pattern: observational studies found fewer asthma exacerbations among users, but randomised trials in asthma patients without diabetes are still ongoing. Patients must not change inhaler doses themselves: the doctor treating their asthma decides on reduction after reassessing disease control.

How much weight is gained after quitting smoking and what we do about it

The typical weight gain after quitting is reasonably well known, so we include it in the plan at the first appointment. A review of 62 studies found that people who quit without medication support weighed an average of 1.1 kg more after a month, 2.9 kg after three months, 4.2 kg after six months and 4.7 kg after a year. Variation was large: after a year, 16 percent weighed less than on the day they quit, 37 percent had gained under 5 kg, 34 percent between 5 and 10 kg, and 13 percent over 10 kg. Patients then ask whether quitting is worthwhile at all. In a study of over three thousand people followed for an average of a quarter-century, those who had quit within the previous four years gained around three kilograms during that time but still had fewer cardiovascular events than continuing smokers. Weight gain does not cancel out the benefits of quitting.

In practice we treat these patients like everyone else, but with a different goal for the first months. For someone who quit in recent weeks, the initial aim is to prevent further gain. We explain this at the first appointment so that a lack of weight loss is not seen as failure. The dietitian plans meals every three to four hours and helps manage sweets used instead of cigarettes. Someone who quit over six months ago and has already gained weight enters the usual obesity treatment plan.

GLP-1 is a hormone released by the gut after a meal. It suppresses appetite, slows stomach emptying and stimulates insulin release from the pancreas; blood enzymes break it down after a minute or two. The molecules used in treatment were designed to be broken down much more slowly, so they work for several days. Patients describe two changes: fullness after smaller portions and feeling at ease between meals, as thoughts about food return less often. Tirzepatide is not an analogue of GLP-1 alone: it also acts on the receptor for a second gut hormone, GIP, and reduces weight more strongly than semaglutide. Semaglutide and tirzepatide are injected into the skin of the abdomen, thigh or upper arm weekly, and liraglutide daily. We increase semaglutide and tirzepatide doses every 4 weeks, and liraglutide weekly, to let the digestive tract adjust.

How many kilograms a person weighing 92 kg loses on medication

Study results are given as percentages of body weight, while patients think in kilograms, so we convert them at the appointment. Someone weighing 92 kg loses around 14 kg on semaglutide over 68 weeks, or around 19 kg on tirzepatide over 72 weeks; part of this comes from dietary change alone. The first figure is based on STEP 1, where weight fell by 14.9 percent versus 2.4 percent on placebo, a medicine advantage of 12.5 percentage points. The second comes from SURMOUNT-1, where tirzepatide 15 mg produced 20.9 percent versus 3.1 percent on placebo. Liraglutide performs less strongly: in SCALE, loss after 56 weeks was 8.4 kg versus 2.8 kg on placebo, approximately 8 percent of body weight. These averages conceal very different individual results, and a patient's outcome cannot be predicted in advance. Hence the 5 percent threshold after three months on the full dose, and the medicine changes that are a normal part of treatment.

Why we taper medication over months

After STEP 1 ended, participants stopped medication and support ended. A year later they had regained two thirds of the lost kilograms, and blood glucose and blood pressure returned to pretreatment levels. We therefore lower the dose gradually and continue support beyond the final injection, although some weight returns even with this approach. We begin dose reduction when weight has been stable for several months, eating follows a repeatable pattern and resistance exercise takes place on fixed weekdays. We monitor patients for another six months after their final injection and restart medication if they regain more than 5 percent of the weight reached during treatment.

Five substances are registered in Poland for obesity treatment, most commonly under the names Wegovy, Mounjaro, Saxenda, Mysimba and Xenical; cheaper equivalents are available alongside originator products. Patients usually arrive knowing other names. Ozempic and Rybelsus contain semaglutide, and Victoza liraglutide, the same substances as Wegovy and Saxenda, but are authorised only for type 2 diabetes. Whether a medicine can be prescribed for obesity therefore depends on the indication in its summary of product characteristics, even if the ingredient is the same.

Why we do not prescribe a diabetes medicine for obesity

Dose and indication determine this. Wegovy was studied in people with obesity in the STEP programme and contains semaglutide in doses up to 2.4 mg, whereas Ozempic goes up to 2 mg. Rybelsus is semaglutide in a tablet, also for diabetes. Saxenda with liraglutide 3 mg treats obesity, while Victoza at up to 1.8 mg treats diabetes. Only Mounjaro with tirzepatide is authorised for both diseases. A patient without diabetes taking Ozempic is therefore on a dose not studied as a target dose in obesity, and NFZ may require a doctor who prescribed it at a reimbursed price to repay the reimbursement. We therefore start obesity treatment with Wegovy or Mounjaro, use the other products when injections are contraindicated, and agree the product with the diabetes specialist if type 2 diabetes is also present.

Monthly prices for the five medicines

Prices from September 2026 are as follows: Wegovy PLN 550 to 890 per month, Mounjaro PLN 800 to 1900, Saxenda PLN 500 to 1250, Mysimba PLN 370 to 600, and Xenical and equivalent orlistat products PLN 160 to 350. For injectable medicines, the first figure is the starting dose and the second the target dose. As the target is reached over several months, we suggest budgeting for the second figure. For oral medicines, the range reflects differences between pharmacies and manufacturers. The same dose can differ by several dozen zlotys between pharmacies, so we ask patients to compare prices before the first purchase and then stay with one pharmacy.

What naltrexone with bupropion and orlistat offer

Oral medicines are less effective than injections, but suit some patients better. Mysimba contains naltrexone and bupropion, which act on brain centres involved in pleasure and thus reduce emotional eating. In COR-I, weight fell by 6.1 percent after 56 weeks versus 1.3 percent on placebo; the product information requires stopping if loss has not reached 5 percent after 16 weeks. We do not use it with uncontrolled high blood pressure, epilepsy, bipolar disorder, a history of bulimia or anorexia, opioid treatment, monoamine oxidase inhibitor use or during alcohol withdrawal. We ask separately about stop-smoking medicines, as one contains bupropion and it must not be taken in two products simultaneously. Xenical with orlistat blocks absorption of around one third of meal fat, gives around 3 kg more loss than placebo after a year, and requires dietary fat restriction to avoid oily stools. We therefore consider Mysimba for emotional eating and orlistat when injections are contraindicated.

Semaglutide's product information lists one absolute contraindication, hypersensitivity to the active substance, but there are more situations in which we do not start it. We do not start during pregnancy or breastfeeding. We do not use it in gastroparesis, markedly delayed stomach emptying, or end-stage kidney failure, where safety data are lacking; after previous pancreatitis we consider it particularly cautiously. The US leaflet additionally lists a personal or family history of medullary thyroid cancer and multiple endocrine neoplasia type 2. The European product information does not contain this wording, but we do not offer it to these patients. For people with diabetes taking insulin or sulfonylureas, we reduce their doses together with the diabetes specialist, otherwise hypoglycaemia risk rises. We also ask about long-term oral steroids, used by some severe asthma patients, because these themselves increase weight and make it harder to assess whether obesity medication works.

Side effects involving the digestive tract and gallbladder

In the first weeks, most calls concern the stomach and intestines. A pooled analysis of STEP 1 to 3 illustrates the scale: nausea was reported by 43.9 percent on semaglutide versus 16.1 percent on placebo, diarrhoea by 29.7 percent, vomiting by 24.5 percent and constipation by 24.2 percent of participants. In half, nausea resolved within eight days. In STEP 1 alone, these symptoms caused 4.5 percent on medication and 0.8 percent on placebo to stop treatment. Symptoms usually worsen temporarily after a dose increase, so we keep a 4-week interval and retain the current dose for another month if tolerance is poor. Smaller portions, slower eating and avoiding fatty dishes while adjusting help. We also watch the gallbladder: stones occurred in 1.6 percent of treated patients and inflammation in 0.6 percent, as rapid weight loss encourages stone formation. Acute pancreatitis affects around 0.2 percent of treated patients.

Symptoms for which we ask you to call the same day

Please call the same day if vomiting lasts longer than a day and you cannot keep fluids down, if the whites of your eyes or skin turn yellow, or if weight falls by over 2 kg in a week despite normal meals. Severe abdominal pain radiating to the back is different: it needs urgent hospital assessment, so go to the emergency department instead of waiting to contact us. We additionally ask patients with diabetes to call if vision deteriorates rapidly, because rapid improvement in blood glucose can temporarily worsen changes at the back of the eye. A separate request concerns asthma patients using their reliever more often during treatment: contact us and arrange a respiratory specialist assessment; we do not change inhaler doses independently. We answer calls daily from 8am to 8pm; outside these hours, night and holiday healthcare is available.

How to know the medicine is not counterfeit

Counterfeit semaglutide pens have appeared in Europe and came from outside the legal supply chain. The European medicines verification system helps protect against them: when dispensing, the pharmacist scans the package's two-dimensional code and checks the batch number. Please do not buy through classified ads, auction sites or acquaintances, even at half the price. Patients receive our prescription by text message as a four-digit code and can use it at any pharmacy in Poland.

Medication reduces appetite, while a plan made with the dietitian determines what and when the patient eats. The dietitian starts with a dietary history and daily schedule, including shift hours where relevant. We set an energy deficit of 500 to 750 kcal daily. We calculate protein at 1 to 1.5 g per kilogram of reference weight, the weight appropriate for the patient's height, and spread it across all meals. Rapid weight loss removes muscle along with fat, and breathing muscles work harder in someone with obesity than in a lean person, so losing them affects fitness. We add fibre from vegetables, groats and whole grains to reduce constipation risk when bowel activity slows, and at least one and a half litres of fluids daily.

We plan activity separately. Its task is to preserve muscle and fitness, because exercise burns fewer calories than people think. The more muscle remains, the higher resting metabolism stays, including after medication stops. We suggest resistance exercises twice weekly at home with bands and body weight, and daily walking between sessions. For someone breathless after one flight of stairs, we choose level-ground walking at a pace that allows full sentences. Patients use this test over the following months to judge whether the pace is appropriate. We increase the load only when speaking at that pace is comfortable, and the first goal is fifteen minutes of activity daily.

What we do when a patient eats in response to tension

Some patients reach for food when tense, after a difficult day or an argument. A GLP-1 analogue suppresses hunger but does not remove a response learned over years. Such patients can be disappointed in the first weeks: the medicine works, but the urge to reach for food remains. The specialist in the psychology of eating teaches them to recognise the moment just before reaching for food and arrange the day so they do not come home ravenous. People who recently quit smoking and replaced cigarettes with food are a separate group: we work mainly on the impulse to snack. For binge eating disorder, repeated episodes of eating very large portions with a sense of lost control, we also suggest a psychiatric consultation. Throughout the first year, the doctor, dietitian and specialist in the psychology of eating work with the same measurements and notes.

The body uses alcohol calories before all others, so while the liver breaks it down, fat from the same dinner is stored. One gram of alcohol provides 7 kcal, closer to fat's 9 kcal than sugar's 4 kcal. Half a litre of beer is around 250 kcal and 50 ml of vodka around 110 kcal. Three beers in one evening therefore provide 750 kcal, the entire daily deficit at its upper limit, or even one and a half days of a 500 kcal deficit. Alcohol also raises blood pressure, weakens control over eating and interrupts sleep in the second half of the night, especially when used to fall asleep.

GLP-1 analogue treatment adds further reasons to limit drinking. The stomach empties more slowly, delaying alcohol absorption, so patients feel its effects later than expected and more easily exceed their usual amount. Alcohol also worsens nausea after an injection. In people taking insulin or sulfonylureas, hypoglycaemia risk rises, most often towards morning. We remind people quitting smoking that drinking in the evening is the situation in which returning to cigarettes is most common, so it is better to avoid alcohol in the first weeks after quitting. We do not require abstinence, but ask for an honest account of how much and how often patients drink, because the rate of weight loss depends on it.

Sometimes a weight discussion turns to drinking, which proves more urgent. If an evening beer has become a daily habit, changing the meal plan alone will not suffice, so we suggest addressing drinking first. At the same address we provide alcohol dependence treatment in Radom and addiction therapy. Naltrexone, present in one oral obesity medicine, is also used at a different dose and for a different indication to treat alcohol dependence.

The first consultation can be remote, and some patients start that way. The doctor reviews results, asks about weight history and chronic illnesses, and reads recorded home blood pressure measurements. Patients measure their own waist following instructions given during the appointment. The limit is the physical examination: inspecting and examining the patient. When we need to examine the thyroid, listen to the lungs or inspect underarm and groin skin, where glucose metabolism disorders cause dark, velvety patches, we ask patients to attend. We then measure blood pressure on both arms with a cuff matched to their circumference: a cuff that is too narrow overestimates pressure in someone with obesity.

Reviews during dose escalation take place on camera because they involve discussing tolerance and reading home measurements. We meet in person for the first appointment and quarterly afterwards, with additional visits for symptoms needing examination. Patients give blood at the laboratory nearest home and send results before the appointment. The prescription code arrives by text regardless of consultation format. We ask patients with breathlessness to have their first appointment in person, because listening to the lungs is where we start looking for its cause.

Broadly, insurance covers investigations and patients pay for obesity medication, with a few exceptions. Under NFZ, a GP can diagnose obesity, refer for blood tests and specialist consultation, and for spirometry when breathlessness is present. However, NFZ does not provide someone to guide the patient through subsequent months of treatment, because a primary care appointment lasts around fifteen minutes and there are few metabolic disease clinics in Poland.

Asthma inhalers are reimbursed, with patient copayments set by the reimbursed medicines list. Imaging with a referral and bariatric surgery after meeting the criteria are also free. Tobacco dependence clinics and the nationwide Telephone Smoking Cessation Support Service offer free help without a referral. Patients pay for our consultations, medication from the pharmacy and dietitian and psychology-of-eating appointments according to the price list. No medicine registered for obesity is reimbursed, so we ask about the monthly budget at the first appointment; sometimes budget determines which product is chosen.

Eligibility criteria changed in 2022 when the international federation of bariatric societies, IFSO, and the American ASMBS lowered thresholds; the Metabolic and Bariatric Surgery Section of the Association of Polish Surgeons belongs to IFSO. Surgery is considered from a BMI of 35 regardless of associated diseases, and from 30 with metabolic disease, primarily type 2 diabetes. These are scientific society recommendations; the bariatric centre determines eligibility for NFZ-funded surgery using its own criteria. The Polish Society for the Treatment of Obesity estimates that around half a million people in Poland qualify, while several thousand operations are performed annually.

We suggest referral in two situations. The first is a patient who meets the criteria but has not lost weight, or has regained it, despite a dozen or so months of nonsurgical treatment. The second is a BMI above 40, class III obesity, together with diabetes or severe sleep apnoea. The referral is valid nationwide, so patients can choose a hospital outside their own region. Before surgery, weight must be reduced, diabetes and blood pressure controlled, iron and vitamin D deficiencies corrected, and a psychological consultation completed. We separately ask patients to stop smoking because wounds heal less well in smokers and respiratory complications after anaesthesia are more common. Vitamin and micronutrient supplementation after surgery is lifelong; blood tests are more frequent in the first year and usually annual afterwards.

Some patients return to medication after several years because weight rises again. This is how a chronic disease behaves.

Patients come to Mireckiego 10 from across southern Mazovia: Skaryszew, Jedlnia-Letnisko, Pionki, Zwoleń, Szydłowiec, Iłża, Kozienice, Białobrzegi, Przysucha and Grójec. We organise treatment to minimise travel. The first appointment and quarterly measurements take place in person, monthly reviews by video, and blood is taken at the patient's local laboratory.

There are few NFZ obesity treatment clinics in the region, and the nearest respiratory clinic is often in Radom itself. When a patient needs spirometry and a consultation with us, we try to arrange both on the same day to save a second trip.

Radom has one NFZ metabolic disease clinic. It publishes neither queue numbers nor waiting times in the NFZ treatment availability directory, so patients need to check dates with reception and obtain a GP referral. Of 24 such clinics in Mazovia, most are in Warsaw; among those reporting data, average waits in July and August 2026 ranged from 8 to 101 days. A referral is valid nationwide, but a Radom resident would then need to travel to Warsaw every few weeks for reviews throughout the year.

A GP can order spirometry for breathlessness and blood tests free of charge. The results are useful at any of these clinics just as they are with us, and the medicine costs the same at the pharmacy whichever route is taken.