What are the NHS requirements for Wegovy?

What does NICE actually say about who qualifies for Wegovy on the NHS?

NICE published its recommendation for semaglutide 2.4mg (Wegovy) in March 2023 under appraisal TA875. The recommendation is more specific than many people realise. To qualify, an adult needs a BMI of 35 or above, at least one weight-related comorbidity (such as type 2 diabetes, high blood pressure, cardiovascular disease, or obstructive sleep apnoea), and must be receiving care within a specialist weight management service that provides multidisciplinary support — dietitian input, psychological support, and activity guidance alongside the medicine.

BMI thresholds are adjusted downward by 2.5 kg/m² for people from South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds, reflecting the higher cardiometabolic risk at lower BMIs in these groups. So the threshold for those backgrounds is effectively 32.5 rather than 35.

Critically, NICE caps the recommended course at a maximum of two years. This is different from the private licence, where duration is a clinical decision made with your prescriber. If you haven't lost at least 5% of your body weight after six months on the maintenance dose, NICE guidance suggests reconsidering whether to continue. These details matter because they shape what NHS services can actually offer you. The BMI criteria for Wegovy on the NHS go into greater depth if you want to check your exact numbers.

Is Wegovy available through a GP, or only through specialist services?

This is where a lot of confusion sits. At the time of writing, Wegovy on the NHS flows through specialist weight management services, not standard GP appointments. That means a referral is generally required, and those services carry waiting lists that can stretch to many months in some areas.

Tirzepatide (Mounjaro) has been added to the GP prescribing contract from April 2026 for eligible patients, but semaglutide for weight management has not been given the same primary care route on the NHS. So even if your GP is supportive, they are not currently commissioned to prescribe Wegovy for weight loss in most areas. Scotland, Wales and Northern Ireland operate under different commissioning arrangements, so if you're outside England the specifics may differ.

The practical result is that NHS waiting lists for Wegovy can be long. For people who meet the private licensed criteria (BMI 30 or above, or 27 or above with a qualifying condition) a private prescription through a regulated pharmacy is the alternative. The NHS Wegovy overview page covers the commissioning landscape in more detail, including what specialist services look like in practice.

How do the NHS Wegovy requirements compare to the private licence?

The gap between the two is significant, and it catches many people off guard. On the NHS under NICE TA875, you need a BMI of at least 35, a comorbidity, and a place within a specialist service. The medicine's private licence (what Novo Nordisk received MHRA authorisation for) covers adults with a BMI of 30 or above, or 27 or above with a weight-related condition. No specialist service is mandated, and there is no two-year cap built into the licence itself.

That difference means many people who are genuinely eligible for Wegovy as a licensed medicine cannot access it on the NHS today. The NHS criteria are about what the health service has committed to fund and commission, not about what the medicine is safe and approved for.

If you're weighing up cost alongside access, the Wegovy cost and access page sets out what private treatment involves, including what a complete private prescription service should include. For a fuller picture of what prescription requirements look like regardless of funding route, the prescription requirements page covers the clinical assessment in detail. If you are managing type 2 diabetes and want to understand what your first consultation should cover, the page on semaglutide prescription requirements for diabetes patients attending their first visit walks through exactly what to expect.

Private treatment through a GPhC-registered pharmacy means a prescriber reviews your full health picture before any medicine is prescribed. At nume, a GPhC-registered Independent Prescriber reads every consultation personally. There are no waiting lists. If approved, your order is dispatched the same day (for orders before 12pm, Monday to Friday), and a plain, unbranded box arrives via tracked DPD delivery the next working day. That is what the process looks like practically, once the clinical review is complete.

For more on how treatment options compare, the weight-loss treatment overview sets out the broader landscape, including where Wegovy sits alongside other licensed medicines.