Who can take Mounjaro — and what the clinical evidence says about eligibility

What the NICE guidance and the licence actually require

Tirzepatide's UK marketing authorisation covers adults with a BMI at or above 30, used alongside a reduced-calorie diet and increased physical activity. For people with a BMI between 27 and 29.9, at least one weight-related comorbidity must be present, examples include type 2 diabetes, prediabetes, hypertension, dyslipidaemia, obstructive sleep apnoea, or osteoarthritis. NICE's recommendation (TA1026, published December 2024) broadly mirrors this, though the NHS route carries stricter phasing criteria on top.

One misconception worth clearing up gently: Mounjaro is sometimes thought to be only for people with diabetes. It isn't. The diabetes licence exists separately; the weight-management licence is for adults with obesity or excess weight alongside a health condition, regardless of whether diabetes is present.

NICE also notes that ethnic background affects the relevant thresholds. For South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds, the BMI cut-offs sit 2.5 kg/m² lower. That means a BMI of 27.5 rather than 30, or 24.5 rather than 27, can qualify someone depending on their circumstances. These adjustments reflect differences in metabolic risk at lower body weights, and they matter practically. You can explore the BMI thresholds in more detail on our Mounjaro BMI eligibility page.

The SURMOUNT-1 trial, published in the New England Journal of Medicine, enrolled adults with a BMI of 30 or above (or 27 with at least one comorbidity), meaning the licensed population is drawn directly from the trial population. That alignment gives the eligibility criteria a robust evidence base, not just a regulatory one. NICE's full appraisal of tirzepatide (TA1026) sets out the recommendation in detail.

Conditions that mean Mounjaro is not suitable

Several factors can make tirzepatide unsuitable, and a prescriber will ask about them directly. A personal or family history of medullary thyroid carcinoma (MTC) is a contraindication, as is a diagnosis of Multiple Endocrine Neoplasia syndrome type 2 (MEN2). A history of pancreatitis also requires careful prescriber assessment, the MHRA flagged acute pancreatitis as an infrequent but potentially serious risk for GLP-1 medicines in its January 2026 Drug Safety Update.

Pregnancy rules Mounjaro out. So does breastfeeding, or actively trying to conceive, the recommendation in each case is to stop treatment and observe an appropriate wash-out period before attempting pregnancy. Mounjaro is not licensed for anyone under 18.

Severe gastrointestinal conditions, certain kidney or liver presentations, and a range of other clinical factors are also assessed at consultation. This is exactly why the prescriber's review exists: not to create friction, but because these are medicines with a real physiological effect, and the right patient population matters for safety. If you want a detailed look at the conditions that affect suitability, our page on who cannot take Mounjaro covers them systematically.

Interactions are worth mentioning too. Oral contraceptives are one practical example: for the first four weeks of treatment and after each dose increase, a non-oral backup method is advised because tirzepatide may reduce pill absorption. If you take other regular medicines, your prescriber will work through them at consultation. A question many people have about supplements (for instance whether milk thistle can be taken alongside Mounjaro) is the kind of thing a prescriber can address individually.

Private eligibility versus NHS eligibility, they are not the same

NHS access to Mounjaro is rolling out in phased cohorts under NICE TA1026. As of mid-2026, only adults with a BMI of 35 or above and four or more qualifying conditions from the defined list are in scope for primary care prescribing. Cohort thresholds widen gradually through 2026 and into 2027. For most people, NHS access either does not apply yet or involves a wait through a specialist service.

Private eligibility follows the licensed SmPC criteria, which are considerably broader: BMI 30 or above, or 27 with a qualifying condition. No referral is needed. A prescriber assesses your consultation the same day and decides clinical suitability based on your individual history. It is worth understanding the difference between NHS and private routes before assuming you don't qualify.

The Mounjaro treatment overview covers how the medicine works and what the trial evidence showed for weight reduction. For a wider look at the options available, our weight-loss treatment page sets out the landscape. Pricing and what's included in a private prescription are explained on our Mounjaro cost and access page.

If you're still working out whether you'd be likely to qualify, the clearest next step is a free consultation. A real clinician reads every response and gives a considered clinical answer, there's no automated decision. Speak to our prescribers and get an answer based on your actual situation.