Wegovy restrictions: who qualifies, who doesn't, and what the rules mean in practice

You've looked up Wegovy and you're not sure if you'd actually be eligible

This is, genuinely, one of the most common points of confusion. The licence says BMI of 30 or above, full stop, in one reading. But there's a second group: adults with a BMI between 27 and 29.9 who have at least one weight-related condition. That condition list includes type 2 diabetes, prediabetes, high blood pressure, high cholesterol, obstructive sleep apnoea and cardiovascular disease, among others. So a BMI of 28 with well-controlled hypertension could qualify; a BMI of 30 with no other health concerns also qualifies.

Lower BMI thresholds may apply for certain ethnic backgrounds. UK guidance recognises that health risks associated with excess weight emerge at lower BMIs for South Asian, Chinese, Middle Eastern, Black African and African-Caribbean populations, the standard thresholds are typically reduced by 2.5 kg/m² for these groups. If you're close to a cut-off, that adjustment can matter.

What a BMI reading alone can't tell you is whether Wegovy is clinically appropriate for you specifically. A prescriber needs your medical history, any current medicines, and a verified current weight, not just a number you've typed in a form. The Wegovy overview page sets out the full licence context, and the semaglutide information page covers the mechanism and trial evidence if you want the clinical background first.

The restrictions that mean a prescriber will say no

Some contraindications are absolute. Wegovy must not be used by anyone with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia type 2 (MEN2), this is written into the licence. Anyone who has previously had pancreatitis faces a careful assessment; the MHRA Drug Safety Updates page carries a January 2026 communication highlighting acute pancreatitis as an infrequent but serious known risk with GLP-1 medicines, and prescribers take that history seriously. Severe gastrointestinal conditions, including gastroparesis, are also a reason for caution or refusal.

Wegovy is not recommended during pregnancy, during breastfeeding, or for anyone actively trying to conceive. If there is any chance of pregnancy, effective contraception is required, and there is a specific note for tirzepatide users about oral contraceptive absorption; for semaglutide the guidance is slightly different, but the principle of reliable contraception while on treatment is consistent across GLP-1 medicines. You can read the detail on the interactions with Wegovy page.

Wegovy is not licensed for under-18s, and it is not licensed for rapid or cosmetic weight loss, the MHRA has been explicit on this point. If a provider is offering it outside those licensed uses, that is a compliance problem, not a flexibility.

How the NHS restrictions differ from private access

Under NICE technology appraisal TA875, Wegovy is recommended on the NHS only when prescribed within a specialist weight management service, for a maximum of two years, for adults with a BMI of 35 or above and at least one weight-related comorbidity. The ethnic-background thresholds apply here too. Waiting lists for these specialist services are long in most parts of England, and the two-year limit is firm. Scotland, Wales and Northern Ireland operate different criteria.

Private prescription removes the specialist-service requirement and the two-year NHS ceiling, the licensed eligibility criteria still apply, but a GP referral is not needed. You'll still need a clinical assessment from a registered prescriber, verified ID and a live weight check. At nume, a GPhC-registered Independent Prescriber reads every consultation personally before any prescription is issued. The process, and what it costs, is on the treatment page, there is one transparent price that covers assessment, prescription and delivery with no subscription.

For context on how private pricing compares with NHS access, the Wegovy access and cost page sets that out honestly. Worth reading before you decide which route suits your situation.

Medicines that interact with Wegovy, a restriction that often gets overlooked

The restrictions don't stop at eligibility. Wegovy slows gastric emptying, which can affect how quickly other oral medicines are absorbed. This matters most for medicines with narrow therapeutic windows (certain thyroid drugs, blood thinners, some diabetes medicines) and for oral contraceptives as noted above. It's not a reason to avoid Wegovy, but it is a reason to disclose every medicine, supplement and herbal product when you complete your consultation. A prescriber working through that list is doing exactly what the licence requires.

The Wegovy drug interactions page covers the specific pairs that need attention. If you want to go through the instructions and storage requirements before starting, the instructions page has those details. And if video guidance helps, the video instructions page walks through the injection technique step by step.

None of these restrictions are designed to make access harder than it needs to be. They exist because Wegovy is a clinically active medicine with a real physiological effect. Getting the assessment right at the start (through a prescriber who has your full picture) is what makes the treatment work safely. When your prescription does come through, the pen arrives in plain, unbranded packaging via DPD with tracking, the same working day it's dispatched. The clinical care precedes all of that; it's not a formality.

Speak to our prescribers if you're ready to work through whether Wegovy is appropriate for you, start your assessment at joinnume.co.uk/pages/weight-loss-treatments.