Can Anyone Use Wegovy, or Does It Require Specific Criteria?

What the trial evidence tells us about who responded well to Wegovy

The STEP 1 trial, published in the New England Journal of Medicine, followed 1,961 adults with obesity or overweight plus at least one weight-related condition for 68 weeks. Participants receiving semaglutide 2.4mg once weekly achieved an average body-weight reduction of around 15%, compared with roughly 2.4% in the placebo group. That headline figure comes from a population with BMI ≥30, or ≥27 with a qualifying condition, mirroring the licensed criteria almost exactly.

What the trial also showed is that results were not uniform. Some participants lost considerably more; others less. Biology, starting weight, adherence to lifestyle changes, and how well each person tolerated the titration schedule all played a role. If you want a realistic sense of what outcomes tend to look like in practice, our guide to typical Wegovy weight loss goes through the evidence in detail.

The broader Wegovy programme also included people with established cardiovascular disease, where the medicine showed benefits beyond weight loss. That is a separate licensed indication; for weight management specifically, the criteria above are what matter. Eligibility begins with BMI and health context, not with how much weight you feel you need to lose.

Groups who cannot use Wegovy, and why the prescriber's role matters

Wegovy is not suitable for everyone who meets the BMI threshold. Pregnancy rules it out entirely, as does breastfeeding; women trying to conceive are also advised against using it, and they should discuss an appropriate wash-out period with their prescriber before attempting pregnancy. Under-18s are outside the licensed population.

A history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 is a contraindication. People with a past or current history of pancreatitis should discuss this carefully with a clinician before starting. The MHRA has flagged acute pancreatitis as a known, though infrequent, side effect across the GLP-1 class, severe, persistent stomach pain that radiates to the back warrants urgent medical attention. You can report any suspected side effects through the MHRA Yellow Card scheme.

Other medicines and health conditions factor in too. That is precisely why a prescriber reviews your consultation personally, not to create paperwork, but because two people with the same BMI can have very different clinical pictures. For a broader look at safety considerations, the evidence on serious adverse events with Wegovy is worth reading alongside this.

NHS access versus private prescribing: the practical difference for most people

NICE recommends semaglutide (Wegovy) on the NHS under Technology Appraisal TA875, but with conditions that narrow access significantly. It must be prescribed within a specialist weight management service, used alongside multidisciplinary support, and limited to a maximum of two years. BMI thresholds start at 35 with at least one comorbidity for most patients, or 30–34.9 where specialist referral criteria are met. Waiting lists for those services are commonly long.

Private prescribing follows the licensed criteria rather than the NICE commissioning criteria, which is why the BMI threshold for a private prescription is 30 (or 27 with a qualifying condition) rather than 35. Both routes require a real prescriber to assess and approve the prescription; the difference is the service context and how long you wait. You can read more about the practical steps on our page covering how to get Wegovy in the UK.

For context on what private treatment costs, our Wegovy price comparison guide sets out what private providers typically charge and what to watch for when comparing prices. A lower price does not always mean a simpler process, it sometimes means a thinner clinical review or hidden fees elsewhere.

The consultation step that determines your eligibility in practice

Reading the licensed criteria is a reasonable starting point, but it does not tell you whether Wegovy is the right choice for you personally, or whether a different approach might suit you better. Weight-related conditions, current medicines, and your own health history all shape that picture. Our prescribers review every consultation the same day, a named clinician reads your answers, not a screening algorithm.

If you are currently on semaglutide treatment elsewhere and wondering whether your circumstances have changed, the broader picture on who semaglutide is appropriate for may be useful reading. For those still weighing up options between different weight-loss medicines, the treatment overview page compares the licensed options available in the UK.

It is worth knowing that some people find it easiest to send their consultation in during a quiet moment, before the school run, for instance, since orders placed by 12pm on weekdays mean same-day dispatch once clinically approved. If you think you might be eligible and want a prescriber's view, speak to our prescribers through a free consultation with no obligation to proceed.