What are the criteria for a Wegovy prescription in the UK?

What the licensed criteria actually say

The Wegovy SmPC, which the MHRA uses as the authority on licensed use, sets the baseline: adults with an initial BMI of 30 kg/m² or more, or adults with a BMI of 27.0 to 29.9 who also have at least one weight-related comorbidity. The conditions that count in that second group include type 2 diabetes, prediabetes, high blood pressure, raised cholesterol, obstructive sleep apnoea and cardiovascular disease, among others, the prescriber will confirm whether your specific diagnosis qualifies.

BMI thresholds are adjusted downward for some ethnic backgrounds. UK guidance recognises that South Asian, Chinese, Middle Eastern, Black African and African-Caribbean populations carry a higher cardiometabolic risk at lower BMI values, so the relevant threshold is typically 2.5 kg/m² lower throughout. The BMI requirements for a Wegovy prescription page covers this in more detail if you want the specifics.

Equally important is what the criteria rule out. Wegovy is not licensed for anyone under 18. It is not recommended during pregnancy, while breastfeeding, or when actively trying to conceive. A personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia type 2 is a contraindication. Pancreatitis history and certain gastrointestinal conditions require careful prescriber discussion. These exclusions apply whether you are going through the NHS or a private route, how a Wegovy prescription is issued explains the assessment process in full.

What NICE says, and how it differs from the licence

NICE's technology appraisal of semaglutide for weight management (TA875, published March 2023) recommends the medicine on the NHS under narrower conditions than the licence alone would suggest. The NICE recommendation applies to adults with a BMI of 35 or above (or 32.5 for the ethnic backgrounds listed above) who have at least one weight-related comorbidity, and only when treatment is delivered within a specialist weight management service that provides multidisciplinary support, dietary, psychological and activity-based. Treatment is time-limited to a maximum of two years under TA875, and NICE advises considering stopping if weight loss is below 5% after six months on the maintenance dose.

For the NHS route, those specialist service criteria are significant. You can read how NHS access works, including the current phased rollout, on our Wegovy NHS criteria page. The private licensed route follows the SmPC thresholds rather than the NICE funding criteria (a BMI of 30, or 27 with a qualifying condition, is the clinical starting point) but private eligibility still requires the same rigorous clinical assessment.

The STEP 1 trial, published in the New England Journal of Medicine, underpins much of this guidance: 68 weeks of treatment at 2.4mg produced an average body-weight reduction of around 15% in adults with obesity, alongside lifestyle changes. That evidence base is why the medicine reached NICE at all.

Contraindications and clinical factors beyond BMI

Passing the BMI threshold is a starting point, not a finish line. A responsible prescriber will look at your current medicines (some interactions require extra care) your kidney and liver function, your cardiovascular history and whether you have any symptoms that need investigating before weight-loss treatment begins. The January 2026 MHRA Drug Safety Update highlighted acute pancreatitis as an infrequent but serious risk: severe stomach pain that extends to the back, with or without vomiting, warrants immediate medical attention. Prescribers factor in any relevant history at assessment.

For people considering Wegovy while using hormonal contraception, NHS England notes there is no established evidence that semaglutide reduces pill effectiveness, unlike tirzepatide, where additional contraceptive precautions are advised for the first weeks of treatment. If you take HRT or are planning surgery, it is worth discussing this at your consultation; our frequently asked questions page covers several common clinical situations.

The NICE appraisal (TA875) provides a useful reference for anyone navigating NHS access, alongside the NHS England guidance on weight-management injections, which sets out what wraparound support looks like in practice.

Getting assessed: NHS waiting lists versus a private prescription

NHS access is phased and genuinely competitive, waiting lists for specialist weight management services are long in most areas, and the NICE criteria mean many people who meet the licensed BMI threshold do not yet meet the NHS funding threshold. If you are also trying to work out whether the medicine is actually available right now, it is worth checking how the Wegovy stock situation currently looks before you begin. A private prescription through a regulated pharmacy follows the licensed criteria and can move quickly, and our page on how to get a Wegovy prescription walks you through exactly what the process involves.

Private assessment through a service like ours involves a free consultation reviewed the same day by a GPhC-registered Independent Prescriber, identity and weight verification, and a clinical decision based on your full health history. If treatment is appropriate and you order before noon, the pen is dispatched the same day; it arrives via DPD the next working day in plain, unbranded packaging, there is nothing on the box to announce what is inside.

Our clinical team reviews every application personally. Approval is never automatic; it depends on what your answers show. If you want to understand the broader treatment options available, the weight-loss treatment overview sets out how the different medicines compare. When you are ready to take the next step, you can start your free consultation and have your eligibility assessed the same day.