Key takeaways
- UK licences for semaglutide, tirzepatide and orforglipron cover adults with a BMI of 30 or more, or 27 or more with at least one weight-related health condition.
- NHS access is narrower. NICE recommends semaglutide within specialist services, and tirzepatide is being rolled out in phases starting with the highest-need patients.
- Lower BMI thresholds (usually by 2.5) apply for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background.
- Since February 2025, online prescribers must independently verify your weight and speak with you. A questionnaire alone isn't allowed.
If you’re living with excess weight, you’ve probably seen a lot of conflicting information about who can get weight loss medication, and where. Part of the confusion is that there are two different sets of rules: what a medicine is licensed for, and what the NHS will fund.
This guide explains both, as of September 2026. It’s general information. Whether a medicine is suitable for you can only be decided by a prescriber after a full assessment.
The licensed criteria
The MHRA licenses a medicine for specific uses. For weight management in adults, semaglutide (Wegovy injection and tablet), tirzepatide (Mounjaro) and orforglipron (Foundayo) are licensed for people with [1, 2, 3, 4]:
- a BMI of 30 or more, or
- a BMI of 27 to 29.9 with at least one weight-related health condition
Weight-related conditions include high blood pressure, abnormal cholesterol, prediabetes or type 2 diabetes, obstructive sleep apnoea and cardiovascular disease [2]. In every case, the medicine is licensed alongside a reduced-calorie diet and increased physical activity.
A licence sets the outer limits. It doesn’t mean everyone within them should be prescribed a medicine.
NHS criteria (NICE)
NICE decides whether medicines are cost-effective for the NHS in England. Its criteria are narrower than the licences.
Semaglutide (Wegovy injection): NICE TA875
Recommended for adults with at least one weight-related condition and either [5]:
- a BMI of 35 or more, or
- a BMI of 30 to 34.9 who meet the criteria for referral to specialist weight management services
It must be prescribed within a specialist weight management service, for a maximum of 2 years.
Tirzepatide (Mounjaro): NICE TA1026
Recommended for adults with a BMI of at least 35 and at least one weight-related condition [6]. Because so many people are eligible, NHS England is introducing it in phases over up to 12 years, prioritising those with the greatest clinical need [7]:
| Phase | Who is prioritised |
|---|---|
| Year 1 (2025/26) | BMI 40+ with at least 4 qualifying conditions |
| Year 2 (2026/27) | BMI 35–39.9 with at least 4 qualifying conditions |
| Year 3 (2027/28 onward) | BMI 40+ with at least 3 qualifying conditions |
The qualifying conditions for prioritisation are: high blood pressure, abnormal blood fats (dyslipidaemia), obstructive sleep apnoea, cardiovascular disease and type 2 diabetes [7].
Newer tablets
The semaglutide tablet (authorised June 2026) and orforglipron (authorised August 2026) are not currently available on the NHS while NICE evaluates them [3, 4].
Lower BMI thresholds for some ethnic groups
People from some backgrounds develop weight-related conditions at a lower BMI. NICE recommends using lower thresholds, usually 2.5 points lower, for people of South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family background [6, 8]. For example, the NHS tirzepatide threshold of 35 becomes 32.5.
See our guide to healthy BMI in the UK for more on these thresholds.
Private prescribing: what a safe service must check
Private services can prescribe within the licensed criteria, but they must follow professional regulation. Since February 2025, the General Pharmaceutical Council (GPhC) has required that for weight management medicines supplied online [9]:
- prescribing can’t be based on an online questionnaire alone
- the prescriber must independently verify your weight and/or BMI (for example by video consultation, in person or through clinical records)
- there must be a way for you and the prescriber to speak with each other before a decision is made
- the service should share information with your GP, with your consent
If a website offers to prescribe after a quick form with no checks, that’s a red flag.
Who may not be suitable
A prescriber should review your full medical and medication history. These medicines aren’t suitable during pregnancy, or when trying to conceive, and the MHRA advises effective contraception during treatment [10]. Breastfeeding advice differs between products and has recently changed, so check the leaflet for the specific medicine. Extra caution, or a different approach, may be needed if you have:
- a history of pancreatitis
- gallbladder disease or significant stomach or bowel conditions
- type 1 diabetes, or diabetes treated with insulin or sulfonylureas
- a current or past eating disorder
- diabetic eye disease
- upcoming surgery
Medicines aren’t the only option
Whatever your BMI, diet, activity, sleep and behavioural support remain the foundation. NICE’s obesity guideline covers lifestyle services, medicines and surgery as parts of a tiered approach [8]. For some people with very high BMIs, bariatric surgery is also an option to discuss with a GP.
Next steps
- Check your BMI and waist-to-height ratio.
- If you think you might be eligible for NHS treatment, ask your GP about local weight management services.
- Read about how Mounjaro and Wegovy compare and their side effects.
Frequently asked questions
What BMI do you need for weight loss injections in the UK?
Under the UK licences, adults generally need a BMI of 30 or more, or 27 or more with a weight-related condition such as high blood pressure, type 2 diabetes, prediabetes, abnormal cholesterol, sleep apnoea or heart disease. NHS criteria are stricter, and a prescriber must also consider your overall health before deciding whether a medicine is appropriate.
Can I get Mounjaro on the NHS?
Possibly, but access is being phased in. NICE recommends tirzepatide for adults with a BMI of at least 35 and at least one weight-related condition. NHS England is prioritising people in stages, beginning with those with a BMI of 40 or more and four qualifying conditions. Ask your GP about local availability.
Can I get weight loss medication if my BMI is 27?
Under the licences, a BMI of 27 to 29.9 can qualify if you also have at least one weight-related health condition. If you're from a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background, clinicians use lower thresholds when assessing risk. A prescriber still decides whether treatment is suitable.
Who shouldn't take weight loss medication?
These medicines aren't suitable during pregnancy, or when trying to conceive, and breastfeeding advice differs between products. Extra caution is needed for people with a history of pancreatitis, some gallbladder or digestive conditions, type 1 diabetes, eating disorders, or those taking certain other medicines. A prescriber should review your full medical history.
References
- Novo Nordisk Limited. Wegovy 2.4 mg FlexTouch: Summary of Product Characteristics. Electronic Medicines Compendium. www.medicines.org.uk/emc/product/13803/smpc
- Eli Lilly and Company Limited. Mounjaro KwikPen: Summary of Product Characteristics. Electronic Medicines Compendium. www.medicines.org.uk/emc/product/15481/smpc
- MHRA. First GLP-1 tablet for weight loss approved in the UK. GOV.UK, 11 June 2026. www.gov.uk/government/news/first-glp-1-tablet-for-weight-loss-approved
- MHRA. UK first in Europe to authorise orforglipron for weight management and type 2 diabetes. GOV.UK, 10 August 2026. www.gov.uk/government/news/uk-first-in-europe-to-authorise-orforglipro
- National Institute for Health and Care Excellence. Semaglutide for managing overweight and obesity (TA875). 2023. www.nice.org.uk/guidance/ta875/chapter/1-Recommendations
- National Institute for Health and Care Excellence. Tirzepatide for managing overweight and obesity (TA1026). 2024. www.nice.org.uk/guidance/ta1026/chapter/1-Recommendations
- NHS England. Interim commissioning guidance: implementation of the NICE technology appraisal TA1026 and the NHS England funding variation for tirzepatide. www.england.nhs.uk/long-read/interim-commissioning-guidance-nice-ta102
- National Institute for Health and Care Excellence. Overweight and obesity management (NG246). Published 14 January 2025. www.nice.org.uk/guidance/ng246/chapter/Identifying-and-assessing-overw
- Pharmacy Magazine. GPhC bans standalone use of web questionnaires for weight loss drugs. 4 February 2025. www.pharmacymagazine.co.uk/profession-news/gphc-bans-standalone-use-of
- The Pharmaceutical Journal. MHRA urges women taking weight-loss drugs to use effective contraception. 5 June 2025. pharmaceutical-journal.com/article/news/mhra-urges-women-taking-weight
Medical reviewer
Naeem Teni
Clinical Lead at Manova. Registered pharmacist and independent prescriber, GPhC 2215591. Reviews Manova’s clinical content for accuracy and safety.
Written by
Manova Editorial Team
Researched and written to our editorial policy, using NICE, NHS, MHRA and peer-reviewed sources.
This article is for general information and isn’t a substitute for advice from your own clinician. If you feel unwell, contact your GP or NHS 111. In an emergency, call 999.