Getting weight loss injections through your GP: a step-by-step guide

Step 1, Check whether your GP practice is participating

From 1 April 2026, GP practices in England can prescribe tirzepatide for weight management under the new GP contract (QOF 2026/27). This was a significant change: previously, NHS weight-loss injections were only available through specialist services. However, practice participation is optional. Some surgeries signed up immediately; others have not yet done so. The quickest way to find out is to call your practice directly and ask whether they are currently prescribing weight-management medicines, it takes under a minute and saves a wasted appointment.

Wegovy (semaglutide) on the NHS remains tied to specialist weight management services under NICE technology appraisal TA875, which specifies use within a multidisciplinary programme of up to two years. GP-led prescribing for Wegovy is not part of the current rollout. So in most cases, the GP route today means tirzepatide.

Scotland, Wales and Northern Ireland operate their own access criteria, which differ from England's. If you are outside England, checking with your GP practice directly is the most reliable first step, as the phasing and thresholds vary.

Step 2, Understand the current NHS eligibility thresholds

NHS tirzepatide prescribing follows a phased cohort system. As of summer 2026, two cohorts are open. The first cohort, active since June 2025, requires a BMI of 40 or above alongside four or more of five specific weight-related conditions: type 2 diabetes, high blood pressure, dyslipidaemia, obstructive sleep apnoea, and cardiovascular disease. The second cohort (activated on 23 June 2026) extends access to adults with a BMI between 35 and 39.9 who also have four or more of those same conditions.

A third cohort, for adults with BMI 40 or above and three qualifying conditions, is expected around March 2027. Throughout all cohorts, BMI thresholds are set 2.5 kg/m² lower for South Asian, Chinese, Middle Eastern, Black African and African-Caribbean backgrounds. You can check your BMI quickly using the NHS BMI calculator.

Meeting the numbers is necessary but not sufficient. Your GP will look at your full medical history, any contraindications, and whether you can engage with the required diet and activity support that must accompany the prescription. If you would like more detail on what this involves, our page on GP weight loss injections explains how the GP-led pathway works in practice. Treatment through the NHS also means joining a structured programme, wraparound care is built into the pathway, not optional.

Step 3, What happens if you don't qualify or don't want to wait

Many people looking into weight loss injections fall below the current NHS BMI thresholds, or have fewer than four qualifying conditions, or simply cannot wait for their surgery to start participating. Both Mounjaro and Wegovy are also licensed for private prescribing, and there is a growing range of options for adults with a BMI of 30 or above (or 27 or above with a weight-related condition).

One legal route is a regulated online pharmacy, where a GPhC-registered Independent Prescriber reviews your consultation the same day. It is worth understanding how this differs from the NHS route: private prescribing means no waiting list and no requirement to meet the stricter NHS cohort thresholds, but it does mean paying for treatment out of pocket. There are honest cost considerations to weigh up, you can read more about how private weight management treatment works before deciding.

If you want to understand specifically what is available privately without a GP referral, the options without a GP referral page covers the regulated private route in detail. Those wondering about the prescriber's legal role may find the page on whether a GP can prescribe weight loss injections useful background reading.

Step 4, Whichever route you take, here is what to expect from clinical assessment

Whether your prescriber sits in an NHS surgery or reviews your case through a regulated online pharmacy, the clinical process shares the same foundations. You will be asked about your current weight, height, and BMI; your medical history, including any existing conditions; the medicines you currently take; and whether you have any contraindications, such as a personal or family history of medullary thyroid carcinoma, or a history of pancreatitis. Our page on getting a weight loss injection from a GP sets out what that initial conversation typically covers and what your GP will need to assess. For women who use oral contraceptives, prescribers following NHS guidance on tirzepatide will discuss adding a barrier method for the first four weeks of treatment and after each dose increase, since absorption of the pill may be affected.

Treatment almost always begins at the lowest dose (2.5mg for tirzepatide) to give your body time to adjust, before moving up through the schedule at the prescriber's direction. If you are new to this type of treatment, our overview of what a weight loss injection involves covers how these medicines work and what to expect from the dosing schedule. Side effects are most commonly gastrointestinal (nausea, constipation, or an unsettled stomach) and tend to ease within a week or two of starting. You should not adjust the dose schedule yourself; that decision sits with your prescriber at every stage.

If you would like to explore whether you might be eligible for treatment through a regulated private pharmacy, our prescribers are available seven days a week. Check your eligibility with a free consultation, there is no obligation to proceed.