Weight loss injections

A new weight loss injection (tirzepatide - Mounjaro®) is starting to become available on the NHS as part of a national rollout. This page explains how this medication is being phased in for patients who meet eligibility criteria as well as providing information about other weight management services and support.

What are the injectable medications for weight loss?

Liraglutide (Saxenda®), semaglutide (Wegovy®) and tirzepatide (Mounjaro®) are medications to help people living with obesity to lose weight, alongside a healthy diet and physical activity. Liraglutide is given as a daily injection, whilst semaglutide and tirzepatide are weekly injections. Liraglutide and semaglutide are used for up to 2 years. Tirzepatide may be used for longer. However, it is common to re-gain weight quickly after stopping these medications.

How can I access these medications?

Access to tirzepatide (Mounjaro®)

Initially tirzepatide will only be available on the NHS to patients with the highest medical need.  It will be made available to eligible patients alongside a programme of diet and nutrition support and increased physical activity. This support is an essential part of being prescribed these injections.

Eligibility

In line with NHS England guidance, this treatment will be available initially for a small number of eligible patients whose body mass index is above 40* and have been diagnosed with four or more obesity-related health conditions from the list below:

  • Type 2 diabetes  
  • High blood pressure (hypertension) — requiring treatment with medication  
  • Heart and blood vessel disease (cardiovascular disease) — such as ischaemic heart disease, stroke, heart failure, or peripheral vascular disease. (This does not include conditions such as atrial fibrillation or valvular heart disease.)  
  • Obstructive sleep apnoea (OSA) — confirmed by a sleep study and requiring treatment, such as CPAP.  
  • High cholesterol or triglycerides) — usually based on blood test results or if you take medication like statins.  

* If you are from a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds your BMI should be 37.5 or more. 

Suitability: Tirzepatide (Mounjaro®) may not be suitable for everyone — even for those who meet the eligibility criteria.  

Tirzepatide (Mounjaro®) is not recommended if you are pregnant or planning to get pregnant, breastfeeding, or if you have certain health conditions. Some people may choose not to use it or may benefit more from other types of support.  

From 23 June, tirzepatide, will start becoming available for use in primary care settings, in addition to the specialist weight management services which currently offer access to it.

The ICB is setting up a new service to provide access to tirzepatide for patients referred through their GP or other healthcare professionals. This service will provide access to tirzepatide injections as part of a nine-month healthy lifestyle programme.  

It will be some time before the first eligible patients are able to access tirzepatide through this new service. However, from now GPs or other healthcare professionals can start a discussion with potentially eligible patients about using tirzepatide as part of their overall weight-loss journey.  

Although the new service has not yet launched, GPs or other health professionals can now start a discussion with potentially eligible patients about using tirzepatide as part of their overall weight-loss journey and refer eligible patients.

Referrals from GPs or other healthcare professionals will be reviewed by a dedicated team from Hertfordshire and West Essex Integrated Care Board to confirm referrals are in line with the NHS England guidance. The ICB team will share details of eligible referred patients with the new tirzepatide prescribing service once it goes live. The new service will advise if tirzepatide is the most appropriate option for a patient based on a full clinical assessment and discussion with the patient.

GPs or healthcare professionals will not be able to prescribe tirzepatide directly. Patients will only be able to access it through the new service.

What happens if you’re referred 

  • If you are referred, a healthcare professional from the service will review your full clinical history and work with you to discuss the risks, benefits, and expectations of treatment. A final decision will be made together with you, based on whether tirzepatide is appropriate for your individual circumstances.  
  • If treatment goes ahead, you will need to take part in a nine-month healthy lifestyle wraparound support programme, which includes help with food choices, physical activity, and behaviour change.  
  • If you are starting on the medicine, you will be reviewed regularly to check your progress and whether the medicine should continue.  

Access to liraglutide (Saxenda®) or semaglutide (Wegovy®)

National guidance from the National Institute for Health and Care Excellence (NICE) makes recommendations on eligible groups and does not recommend GPs prescribe liraglutide (Saxenda®) or semaglutide (Wegovy®) for obesity. These medicines are only to be used within specialist weight management services.

We will update this page with further information if the situation changes.

What if I am receiving treatment for diabetes?

Patients who are eligible for liraglutide, semaglutide (Ozempic®/ Rybelsus®), dulaglutide (Trulicity®), tirzepatide (Mounjaro®) to manage their Type 2 diabetes can be started on treatment and can continue to take their medication in line with local guidance.

Can my GP prescribe tirzepatide, semaglutide or liraglutide for weight loss that has been started privately?

No, your GP cannot prescribe tirzepatide, semaglutide or liraglutide for weight loss that may have been started privately.

Where can I get help to lose weight?

Body Mass Index (BMI) is a measure that can help you work out if your weight is healthy and which services may be appropriate for you. Use the NHS BMI calculator to work out and understand your BMI. You will need your height and weight.

Self-help resources

The NHS Better Health website is a great place to start for advice on losing weight, as well as getting active, drinking less and quitting smoking. Here you will find:

  • the free NHS Weight Loss Plan app
  • Advice and tools to get started
  • Free weight loss programmes available nationally, such as FIT FANS
  • Special offers on other weight loss plans

Services available locally to support you

There are a range of free programmes available locally to support you. These include a range of ways to access, so whether you prefer face to face or virtual, 1:1 or group support, there should be something that works for you. You can self-refer to most online.

Whatever your BMI, if you are at risk of type 2 diabetes, you can access the Healthier You NHS Diabetes Prevention Programme. This provides 9 months of face to face group support, or digital 1:1 support to make healthy lifestyle changes which will reduce your risk of type 2 diabetes and help you lose weight if you need to.

If you are living with obesity and also have diabetes or high blood pressure, the 12 week NHS National Digital Weight Management Programme could help you.

 If you are eligible and would like to access this programme, ask your local pharmacy or GP practice to refer you.

If you are a Hertfordshire resident or patient living with obesity and you have not recently attended a free 12 week weight loss programme, you can access the My Healthy Weight Programme by TBC Healthcare. This is a 14 week programme, with a range of ways to access. You can self-refer here:

An alternative for Hertfordshire residents or patients living with obesity is the 12 week Shape Up Programme delivered by Watford Football Club. Originally just for men, there are now some sessions for women too. For more details, please see their website or email [email protected] .

If you are a West Essex resident or patient, the Essex Wellbeing Service provide a range of programmes and support to help with weight loss, as well as support with other healthy lifestyle changes. You can find out more and self-refer here.

Specialist weight management services

These services provide 12 months of intensive support delivered by a team of specialists, including dieticians, physical activity specialists and psychologists. Each service has a range of ways to access which the service will discuss with you.

In Hertfordshire, this specialist service is provided by TBC Healthcare. The programme is called My Healthy Weight Plus +. You can self-refer here.

In West Essex, this specialist service is provided by Morelife. Check the eligibility criteria here. If you are eligible and would like to be referred, please talk to your GP practice.

These specialist services can also help prepare and refer you for possible bariatric surgery (weight loss surgery), if that is the most appropriate option for you.

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