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These letters appear to be indiscriminate cost saving initiatives and are being sent out as individual practice directives and not that of the CCG (Clinical Commissioning Group)

28.7% average body weight loss

IGF-1 LR3 Reconstitution Reference (1 mg / 1,000 mcg vial) BAC water added 1 mL Concentration 1,000 mcg/mL 20 mcg dose 0.02 mL (2 units) 40 mcg dose 0.04 mL (4 units) 50 mcg dose 0.05 mL (5 units) 80 mcg dose 0.08 mL (8 units) 100 mcg dose 0.10 mL (10 units) BAC water added 2 mL Concentration 500 mcg/mL 20 mcg dose 0.04 mL (4 units) 40 mcg dose 0.08 mL (8 units) 50 mcg dose 0.10 mL (10 units) 80 mcg dose 0.16 mL (16 units) 100 mcg dose 0.20 mL (20 units) BAC water added 3 mL Concentration 333 mcg/mL 20 mcg dose 0.06 mL (6 units) 40 mcg dose 0.12 mL (12 units) 50 mcg dose 0.15 mL (15 units) 80 mcg dose 0.24 mL (24 units) 100 mcg dose 0.30 mL (30 units) Units refer to U-100 insulin syringe markings

This is one reason people sometimes stop losing weight without changing anything, degraded medication delivering less drug than expected