The Prescribing Criteria for Wegovy: What the Guidelines Actually Say

The most common misconception: meeting the BMI cut-off is enough to get a prescription

A lot of people come to this question having already worked out their BMI and decided they qualify. The number matters, but it is not the whole story. The prescribing criteria for Wegovy sit at the intersection of two separate frameworks: what the medicine's licence permits and what NICE recommends for NHS use. They are not identical, and confusing them leads to real frustration.

The UK licence for Wegovy, granted by the MHRA, covers adults with a BMI of 30 or above, or a BMI between 27 and 29.9 if at least one weight-related condition is present, think high blood pressure, high cholesterol, prediabetes, type 2 diabetes, or obstructive sleep apnoea. That licensed population is reasonably broad. NICE's recommendation under TA875, which governs NHS access, is narrower: a BMI of at least 35 plus one comorbidity, treatment within a specialist multidisciplinary weight management service, and a two-year maximum duration. NHS England quotes adjusted thresholds for people from certain ethnic backgrounds, generally 2.5 kg/m² lower than the published figures. The gap between what is licensed and what NICE recommends for NHS funding is one reason many people look at private routes.

Beyond the numbers, a prescriber will also consider your medical history, current medicines, and whether any contraindications apply. History of medullary thyroid carcinoma, multiple endocrine neoplasia type 2, current pregnancy, or breastfeeding places Wegovy outside recommended use. The BMI gets you to the door; the clinical assessment decides whether you walk through it. You can read more about the specific BMI thresholds on our BMI requirements for Wegovy page.

What the NHS criteria for Wegovy actually look like in practice

NHS access to Wegovy follows NICE TA875 and is routed through specialist weight management services. In practical terms, this means a GP referral, a place in a service that may have a long waiting list, and ongoing multidisciplinary support. The NICE recommendation specifies that treatment should be reviewed and stopped if less than five percent of body weight has been lost after six months on the maintenance dose. It also sets an explicit two-year treatment window, a ceiling that does not exist in the licence itself.

The wegovy prescribing criteria on the NHS therefore look markedly different from what a private prescriber applies. NHS England notes that availability varies by area and that meeting the clinical criteria does not guarantee access, commissioning decisions and local resources both play a role. If you are in Scotland, Wales or Northern Ireland, the thresholds and service structures differ again. Our page on NICE's criteria for Wegovy goes into that framework in more detail.

For people who do not meet the NHS BMI threshold, who are waiting for a referral, or who live in an area where specialist services are not yet accessible, a private prescription through a regulated pharmacy follows the licensed criteria rather than the NICE funding criteria. That distinction is worth understanding before you assume the NHS route is closed to you, or before you assume a private route will wave through any application.

Which health conditions count toward Wegovy eligibility?

The licensed criteria list weight-related conditions without being exhaustive. In clinical practice, prescribers consider conditions that are either caused or meaningfully worsened by excess weight. The ones that appear most consistently in UK guidance include type 2 diabetes, prediabetes, hypertension, dyslipidaemia (raised triglycerides or low HDL cholesterol), obstructive sleep apnoea, and osteoarthritis. Cardiovascular disease also features in NICE's framework.

Having one of these conditions at a BMI between 27 and 29.9 places you within the licensed indication, but it does not mean treatment is automatic. A prescriber still assesses severity, current management, and what benefit semaglutide is likely to bring alongside your diet and activity changes. For a fuller picture of how those conditions interact with the eligibility decision, our Wegovy eligibility guide covers the landscape in plain terms. The NHS England weight management injections page also sets out how these criteria are applied in practice.

One practical note: if you are using oral contraceptives, current NHS guidance does not suggest equivalent absorption concerns for semaglutide that it does for tirzepatide, but it is always worth raising your full medicines list at consultation. And if you keep your Wegovy pen in the fridge door at home, check the patient information leaflet for the exact storage window if you ever take it out for travel; the prescriber can advise.

How a private prescription assessment differs from the NHS route

Private prescribing for Wegovy follows the medicine's licence, not the NICE funding recommendation. That means the BMI threshold can be 30 rather than 35, and there is no mandated two-year ceiling, though a prescriber will still set review points and assess whether treatment continues to be clinically appropriate. This is not a lighter-touch process. At a properly regulated service, the consultation involves identity verification, documented weight confirmation, a review of your medical history and current medicines, and a clinical decision made by a named prescriber.

At nume, every application is read personally by a GPhC-registered Independent Prescriber on the day it is submitted, not processed by software. If the application is clinically suitable, treatment is dispatched the same day for free next-working-day delivery. If it is not, you will hear why. The private route is not a workaround for clinical standards; it is a different commissioning model that operates within the same regulatory framework. Our Wegovy overview explains the treatment from the ground up, and our criteria for Wegovy for weight loss page walks through the full eligibility picture if you want to check your position before starting a consultation, including a detailed look at the wegovy criteria that shape every assessment we carry out. If you are ready, start your free consultation and our clinical team will take it from there.