Who can have weight loss injections in the UK

Does the BMI threshold alone decide who can have the weight loss injection?

BMI is the starting point, not the finish line. The licensed criteria for both Mounjaro and Wegovy set the threshold at 30 or above, with a lower entry point of 27 when at least one weight-related comorbidity is present. Qualifying conditions include type 2 diabetes, hypertension, dyslipidaemia, obstructive sleep apnoea and cardiovascular disease, among others. If your BMI sits at 28 and you have been told your cholesterol is elevated, you are within scope. If your BMI is 32 and you have no relevant conditions, you would still qualify under the primary threshold.

UK guidance also recognises that BMI alone is an imperfect measure. For people of South Asian, Chinese, Middle Eastern, Black African or African-Caribbean backgrounds, the thresholds are typically set 2.5 kg/m² lower, so 27.5 becomes the relevant starting point rather than 30. The NHS BMI calculator is a quick way to check your number before you speak to a clinician; it takes under a minute. The result does not make the decision for you, but it tells you where you stand on the licensed criteria before anything else.

Beyond BMI, the prescriber weighs medical history, current medications, any contraindications and your overall health. Conditions such as a personal or close family history of medullary thyroid carcinoma, or certain gastrointestinal disorders, require careful discussion. BMI is one input; the clinical picture is the actual determinant. You can read more about the broader eligibility framework on our weight loss injection eligibility page.

Are there people who cannot have these injections regardless of BMI?

Yes. Some groups fall outside the licence regardless of where their BMI sits. Neither Mounjaro nor Wegovy is licensed for use in people under 18. Both are not recommended during pregnancy, and the guidance extends to women who are trying to conceive or who are breastfeeding. If pregnancy is a possibility, the conversation about contraception is part of the clinical assessment, not an afterthought.

For women using oral contraceptives and starting tirzepatide specifically, UK guidance recommends adding a non-oral method such as condoms for the first four weeks of treatment and for four weeks after each dose increase. This is because the way tirzepatide slows gastric emptying may reduce how well the pill is absorbed. The same concern does not currently apply to semaglutide, though the broader advice to use effective contraception remains. NHS England's guidance on weight management injections covers this and other interaction considerations in detail.

There are also relative contraindications, circumstances that do not automatically rule someone out but that need careful review. A history of pancreatitis, certain eating disorders, or a mental health condition affected by weight-focused interventions all warrant an honest clinical conversation. The people who are not suitable for weight loss injections page goes into the specifics.

How does the NHS eligibility differ from private treatment criteria?

This is one of the questions our prescribers hear most often. NHS access to tirzepatide (Mounjaro) is being rolled out in phases under NICE technology appraisal TA1026, published in December 2024. The NHS criteria are considerably stricter than the licensed criteria: from around June 2025, the first cohort required a BMI of 40 or above plus four of five specified conditions. Cohort 2 (BMI 35 to 39.9 plus four conditions) activated in June 2026. Further cohorts are planned through to 2027. Even within those cohorts, access depends on your GP practice's participation and on completing a supported diet and activity programme alongside treatment.

Private treatment follows the licensed criteria rather than the NHS commissioning thresholds, and you can find a full breakdown of who can use weight loss injections on that dedicated page. That means a broader group of adults can access treatment privately without meeting the NHS's four-comorbidities test or waiting for their cohort's activation date. For many people, a private route through a regulated service is simply the more realistic path right now. If you are unsure which route applies to you, our eligibility self-check guide sets out the comparison plainly.

One point worth making directly: private does not mean unregulated. Any legitimate UK provider must supply these medicines only following a clinical assessment by a prescriber registered with a UK regulatory body. Check that any online pharmacy you consider is listed on the GPhC register. Dispensing a prescription-only medicine without that process in place is illegal, and the MHRA has warned repeatedly about counterfeit pens sold online. The service model matters as much as the price.

What happens during the clinical assessment at nume?

A free consultation is the first step. You complete a detailed health questionnaire covering your BMI, relevant medical history, current medications and lifestyle context, and our guidance on who can take weight loss injections is a helpful read before you begin. That information is read the same day by a GPhC-registered Independent Prescriber. A real clinician reviews it, not software. Photo ID verification and live weight confirmation via video are part of the process, not bureaucracy for its own sake, but the infrastructure that makes a safe remote prescription possible.

If treatment is clinically appropriate, your prescription is issued and your first pen is dispatched the same day (for orders received before noon, Monday to Friday), arriving the next working day with DPD in plain packaging. If the prescriber has questions or needs more information, they will get in touch. If treatment is not suitable at that point, you will be told why. The assessment is clinical throughout. To see what treatment options are available and start the process, the weight loss treatments page is the right place to begin. Our clinical approach and the team behind it are set out there too. For more general reading on how these treatments fit into a broader weight management plan, the weight loss overview covers the wider context.