NHS access to GLP-1 weight loss medications is expanding — but it remains tightly controlled, and the criteria and pathways differ meaningfully between Mounjaro, Wegovy and Saxenda. This guide sets out what the eligibility criteria actually say and what they mean in practice.
For the full technical detail on eligibility criteria, doses and sources, see our dedicated NHS eligibility page. This article focuses on the practical question of how to access treatment.
The three medications and their NHS routes
Mounjaro (tirzepatide) is the most accessible on the NHS. From April 2026, it is prescribed through GP practices under a new Quality and Outcomes Framework (QOF) indicator, as well as through specialist weight management services. GP participation is voluntary — not all practices are prescribing yet — but the intention is to make it available in primary care at scale over the coming years.
Wegovy (semaglutide) has two NHS routes. For weight management, it is only available through specialist (Tier 3) weight management services — not from a GP for this indication. For cardiovascular risk reduction in people with established heart disease, a new route opened in April 2026 following NICE approval, and this may be accessible via a GP or cardiologist.
Saxenda (liraglutide) is the oldest of the three and also requires a specialist service. Availability varies widely between areas, with many ICBs not commissioning it.
What the eligibility criteria say
For Mounjaro in primary care, the current year-1 priority group requires a BMI of 40 or above, plus four or more weight-related health conditions from a specified list (type 2 diabetes, hypertension, dyslipidaemia, cardiovascular disease, obstructive sleep apnoea). These thresholds are adjusted downward by 2.5 kg/m² for South Asian, Chinese, Middle Eastern, Black African and African-Caribbean backgrounds.
The full NICE TA1026 criteria are broader — BMI 35 or above with one qualifying condition — but NHS England is phasing in access over up to 12 years to manage demand on services. Meeting the NICE criteria does not mean you will be offered treatment immediately.
For Wegovy weight management, the NICE TA875 criteria require a BMI of 35 or above (or lower with specific specialist service criteria) and at least one weight-related comorbidity, accessed only through a specialist service.
What to do if you do not qualify
NHS criteria are stricter than those used for private prescriptions. All three medications are available privately with a BMI of 30 or above (or 27 with a qualifying condition) from GPhC-registered online pharmacies. Most people currently accessing these medications in the UK do so privately.
If private cost is a barrier, the NHS also offers free Tier 1 and Tier 2 community weight management programmes, GP referrals to dietitians, the NHS Digital Weight Management Programme, and orlistat on NHS prescription for BMI of 30 or above.
Wraparound support
A requirement that often surprises patients: all NHS GLP-1 prescriptions come with a mandatory support programme covering dietary guidance and physical activity advice. For Mounjaro in primary care this is formalised as the Healthier You: NHS Behavioural Support for Obesity Prescribing programme. You cannot receive the prescription without being enrolled in this support. Disengaging from it may result in your prescription being discontinued.