Getting Mounjaro with a BMI of 28: what decides your eligibility

The licence threshold and why 27 matters more than 30

Most people arrive at this question having heard that weight-loss medicines are for people with a BMI over 30. That is true for one bracket of the licence, adults with obesity. The second bracket, which is the one relevant to you, covers adults with a BMI of 27 or above alongside at least one weight-related comorbidity. At a BMI of 28, you sit inside that second bracket, so the medicine is licensed for your weight range.

What the licence does not do is hand you a prescription automatically. The threshold is the entry condition, not the approval itself. A prescriber still needs to weigh up whether treatment is appropriate given everything else about your health. You can read more about how these thresholds interact on the Mounjaro BMI guidance page.

It is also worth knowing that ethnic-background adjustments apply under UK clinical guidance: for South Asian, Chinese, Middle Eastern, Black African and African-Caribbean backgrounds, the BMI thresholds are set 2.5 kg/m² lower, meaning those groups may qualify at even lower starting weights. The full breakdown of BMI requirements for Mounjaro covers this in more detail. The NICE appraisal of tirzepatide, published in December 2024, uses the same adjusted thresholds when describing NHS eligibility.

Which conditions count, and whether yours qualifies

The comorbidity requirement is the part of this question that most people underestimate. At a BMI of 28, you need at least one of the following to be present: type 2 diabetes, prediabetes (impaired fasting glucose or impaired glucose tolerance), hypertension, dyslipidaemia (raised cholesterol or triglycerides), obstructive sleep apnoea, or established cardiovascular disease. These are the conditions that shift weight from a lifestyle concern into a clinical one, and that is precisely the context in which the medicine is licensed.

A condition does not have to be severe to count. Managed hypertension, for instance (even where blood pressure is controlled on medication) still qualifies, because the underlying condition exists. If you are unsure whether what you have meets the threshold, a prescriber can work through that with you during a consultation. The full eligibility overview sets out each qualifying condition clearly.

One thing our prescribers hear regularly: people who have been told they are on the edge of a diagnosis (prediabetes, borderline blood pressure) and are not sure whether that counts. In most cases, it does. A documented finding from a GP or blood test is exactly the kind of clinical evidence that supports a prescriber's decision.

How private eligibility differs from the NHS criteria

The NHS route to Mounjaro is considerably narrower than the licensed criteria. NICE's appraisal of tirzepatide (TA1026) recommends NHS prescribing for adults with a BMI of 35 or above plus at least one weight-related condition, and even then, access is being phased in gradually. At a BMI of 28, you will not currently qualify for NHS Mounjaro regardless of your health conditions.

Private prescribing follows the licensed criteria instead, the broader ones described in the SmPC. That is why a regulated online pharmacy can lawfully prescribe for someone at BMI 27 or above with a comorbidity, while the NHS cannot yet. It is not a loophole; it is simply the difference between what a medicine is licensed for and what the NHS has chosen to fund so far.

If you are curious about the cost side of private treatment, the Mounjaro price comparison page sets out what the UK private market looks like and what a transparent single price typically covers. Prices vary between providers, and it is worth understanding what is included before comparing.

What the consultation at a BMI of 28 actually involves

If you submit a consultation at nume, a GPhC-registered Independent Prescriber reads your responses the same day, your answers land on a real clinician's screen, not in an automated queue. They will look at your BMI, the qualifying condition you have noted, any other medicines you take, and your overall health picture. If treatment is appropriate, your prescription is issued and your order is dispatched the same day for free next-working-day delivery via DPD, in plain unbranded packaging.

Order before 12pm on a weekday and that same-day dispatch applies, useful if you want to have everything sorted before the afternoon gets away from you. If there are any clinical questions, the prescriber may ask for more information before making a decision.

For a BMI of 28, the consultation matters more than for someone clearly in the 30-plus bracket, because the comorbidity evidence needs to be there. Be ready to describe your qualifying condition clearly, when it was diagnosed, how it is managed, and whether you have any relevant test results. You can also explore how the criteria apply at a BMI of 27 if you want to understand the lower boundary. The NHS's own guidance on tirzepatide for patients gives a useful lay summary of the medicine's profile and what to discuss with a prescriber before starting.

Ready to find out whether treatment is right for you? Speak to our prescribers through a free consultation, there's no obligation, and your answers are reviewed by a named clinician, not software.