The NHS criteria for getting Mounjaro, explained clearly

Which BMI and conditions does the NHS actually require?

NICE's recommendation for tirzepatide (published 23 December 2024, updated 1 September 2025) sets out the qualifying conditions as a fixed list of five: high blood pressure, dyslipidaemia, obstructive sleep apnoea, cardiovascular disease, and type 2 diabetes. To qualify, you need a BMI that meets the current cohort's threshold and you need to have a certain number of those conditions recorded in your health record. Meeting one criterion without the other is not enough.

From June 2025, the first cohort required a BMI of at least 40 alongside four or more of those five conditions. That is a deliberately narrow starting group. The second cohort, which opened on 23 June 2026, brings in adults with a BMI between 35 and 39.9 who also have four or more of the same conditions. From around March 2027, the threshold is expected to drop to three conditions for people with a BMI of 40 or above. Each stage has to be funded and implemented before the next one can open, which is why waiting lists are a real factor for many people.

If your background is South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean, the BMI thresholds are each reduced by 2.5 kg/m², in line with UK guidance on the health risks associated with a lower BMI in those populations. The practical effect is that a BMI of 37.5 may qualify where 40 would otherwise be the floor. You can check your BMI against these figures using the NHS BMI calculator.

Does meeting the numbers mean you'll get it quickly from your GP?

Not automatically. From 1 April 2026, GP practices can prescribe tirzepatide under the new GP contract (QOF 2026/27), but participation is optional. Some practices are doing it; others are not yet set up for it, either because of capacity or because their ICB has not yet released local funding. If you want to understand exactly what criteria a GP needs to follow before prescribing Mounjaro, that will give you a clearer picture of what your surgery has to put in place before it can participate.

Every NHS patient who receives tirzepatide must also take part in wrap-around diet and activity support. That is a condition of the NICE recommendation, not optional admin. If your practice is not currently offering that support programme, it may not be in a position to prescribe under the new pathway regardless of your BMI or conditions. It is worth asking your GP directly where your practice stands, rather than assuming the criteria alone open the door. The fuller picture of how the NHS rollout works is covered in our guide to getting Mounjaro on the NHS.

Scotland, Wales and Northern Ireland operate devolved systems with their own thresholds and referral routes, so the NHS England phases described here do not apply directly if you live elsewhere in the UK.

What if you meet the clinical criteria but can't wait?

This is the question our prescribers hear most weeks. Mounjaro is a Prescription-Only Medicine, so the only legal routes are NHS (via the criteria above) or a private prescription following clinical assessment. The licensed eligibility for private prescribing is broader: adults with a BMI of 30 or above, or 27 or above with at least one weight-related condition, are potentially eligible, subject to a prescriber's full assessment. You do not need to meet the NHS four-conditions rule to access treatment privately.

For people who are clinically suitable but outside the NHS cohorts, or who are inside them but facing a long wait, a regulated private pharmacy is the practical alternative. Mounjaro's tiered dosing schedule and the clinical oversight that should sit around it matter regardless of which route you take, the medicine is the same, but the supervision model around it varies significantly between providers. If you are weighing up the cost side of private treatment, our breakdown of Mounjaro NHS criteria versus private eligibility sets out the differences plainly.

What a legitimate private route looks like in practice: a consultation reviewed by a real prescriber (not a decision algorithm), identity and weight verified, and a prescription issued only if clinically suitable. A private prescription does not come with the wrap-around programme that NHS access requires, so personal lifestyle support alongside treatment matters all the more. Details on what that process looks like at our pharmacy are set out on the about page.

Practical next steps depending on where you land

If your BMI and conditions suggest you are in or near the current NHS cohort, the first move is a conversation with your GP. Ask specifically whether your practice is participating in the new GP contract pathway and, if so, what the referral or waiting-list position looks like. Your GP can also check whether your recorded conditions match the qualifying list, which matters because a condition needs to be formally diagnosed and in your records, not just suspected.

If you are below the NHS BMI thresholds or have fewer than four of the five conditions, NHS access under TA1026 is not currently available to you regardless of how much weight you want or need to lose. The honest picture is that the current NHS criteria exclude a large proportion of adults who would benefit from treatment, and our page covering what the criteria for Mounjaro on the NHS actually involve goes through each requirement in detail. A GPhC-registered pharmacy with a prescriber who reviews every consultation the same day is meaningfully different from a seller operating outside the licensed supply chain. You can verify any online pharmacy's registration on the GPhC pharmacy register before committing.

The NICE appraisal of tirzepatide (TA1026) is publicly available and worth reading if you want the original source. It sets out not just the thresholds but the clinical evidence behind them, including the trial data from the SURMOUNT programme that informed the recommendation. For a full overview of tirzepatide in the UK, including how it works and what the evidence shows, the Mounjaro treatment page is a good starting point. And if you want to explore whether you might be eligible for a private prescription, including the option of getting a same day Mounjaro prescription if you are clinically suitable, you can start a free consultation and have a prescriber assess your full picture.