Can anyone have the weight loss injection, or is it only for some people?

The biggest misconception: high BMI alone is not enough to qualify

A lot of people arrive at this question assuming the answer is simple: if you are overweight, you can have the injection. That is understandable, and letting go of it gently matters here, because the reality is more protective than that. BMI is the starting point, not the finish line. A prescriber reviewing your case is also looking at your medical history, any current medicines you take, conditions that might make treatment unsuitable, and whether you have a weight-related health condition that shifts the eligibility threshold. You can read more about the specific factors involved on our page covering who the injections are licensed for in the UK.

The licensed BMI thresholds in the UK are clear: 30 or above for most adults, or 27 or above if you have at least one qualifying condition. Lower thresholds apply for some ethnic backgrounds under UK guidance, reflecting differences in health risk at a given BMI. But even sitting comfortably above those numbers does not guarantee approval. History of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, severe gastrointestinal conditions and some other factors are contraindications the prescriber will screen for. This is a feature of the process, not a bureaucratic hurdle.

The NHS patient information for tirzepatide sets out these criteria clearly, including the conditions and circumstances under which the medicine should not be used.

Groups for whom weight loss injections are not suitable

Certain people cannot use Mounjaro or Wegovy regardless of BMI. The clearest categories are: people who are pregnant, those who are breastfeeding, and anyone trying to conceive. These medicines are not recommended during pregnancy or while breastfeeding, and women who could become pregnant are advised to use effective contraception throughout treatment and for a period after stopping. For tirzepatide specifically, women using oral contraceptive pills are advised to add a non-oral method for the first four weeks of treatment and for four weeks after each dose increase, because the pill's absorption may be reduced.

Weight loss injections are not licensed for anyone under 18. They are also not suitable for people with a personal or family history of medullary thyroid carcinoma or MEN2, or for those with a history of pancreatitis. Anyone with significant kidney, liver or gallbladder problems needs to have these discussed with a prescriber before starting. If you are unsure whether any of your current medicines interact, that is another reason the individual clinical review exists rather than a tick-box form, a prescriber sees the whole picture. Our page on who cannot have weight loss injections goes into each of these exclusions in more detail.

For people wondering whether they are close to the threshold, the NHS BMI calculator is a useful first check before starting a consultation.

NHS access versus private treatment: different thresholds, different waiting times

Even for people who clearly meet the licensed criteria, access through the NHS looks quite different from accessing treatment privately. NICE has recommended tirzepatide (TA1026, published December 2024) for NHS use, but the rollout is phased. As of June 2025, NHS eligibility requires a BMI of 40 or above plus four or more qualifying conditions from a defined list. From around June 2026, that extends to BMI 35 to 39.9 with four or more conditions. Wider NHS access for people with fewer or less severe conditions is expected to follow over the next couple of years, and waiting times through specialist services can be long. You can explore the difference between NHS and private access in more detail if this is relevant to your situation.

Private treatment through a regulated online pharmacy means no referral and no waiting list, provided clinical suitability is confirmed. The cost context is worth understanding before you start, our page on weight loss treatments at nume covers what private treatment includes and how pricing works. The one thing private treatment shares with NHS treatment is this: a prescriber still assesses you individually, every time. That does not change.

It is also worth knowing what this service is not: num's clinical pharmacy is GPhC-registered and MHRA-regulated, and every consultation is reviewed by a GPhC-registered Independent Prescriber, the same day, when you order before noon, Monday to Friday. A real clinician reads your answers; the decision is never automated.

What happens if you are not eligible right now

Not qualifying at this moment is not a permanent answer. Someone whose BMI sits just below the threshold may reach it; someone managing a weight-related condition through other means may have their situation change. A prescriber can also explain what other treatment routes exist. Orlistat, for example, is a different class of medicine available at lower thresholds for some patients. Our broader weight loss treatment overview covers the landscape of options currently available in the UK, so you have a clear picture before you start a consultation.

If you do not meet the criteria for any prescription treatment, the prescriber will say so clearly rather than approve treatment that is not appropriate. That transparency is the point of the assessment. Questions about whether the eligibility rules apply to your circumstances are answered in detail on our page about who weight loss injections are and are not suitable for, and if you want to understand how your personal health history fits into the picture, our page walking through whether you personally could have weight loss injections is a good place to start before booking a consultation. That question, can I specifically have this?, deserves a clinical answer, not a guess.