In England, the NHS can prescribe Wegovy, Mounjaro and Saxenda if you have a BMI of 35 or above (32.5 for some ethnic groups) and a weight-related health condition. Most people need a specialist referral, and waits range from a few months to several years depending on where you live.
At a glance: NHS weight loss medication eligibility
What weight loss medication can you get on the NHS?
Four medications can be prescribed for weight loss on the NHS in England. Three are injections and one is a tablet.
| Medication | What it is | Who prescribes it |
|---|---|---|
| Wegovy (semaglutide) | Weekly injection | Specialist weight management service |
| Mounjaro (tirzepatide) | Weekly injection | Specialist service, or a GP practice taking part in the NHS rollout |
| Saxenda (liraglutide) | Daily injection | Specialist service only |
| Orlistat | Tablet that reduces fat absorption | Your GP |
Wegovy, Mounjaro and Saxenda help you feel fuller for longer. Orlistat reduces the amount of fat your body absorbs from food. It is older than the injections and generally easier to access, because it doesn't need a specialist referral.
Mounjaro is the exception to the specialist-referral rule. Since June 2025, it has been rolling out through some GP practices directly, without a Tier 3 referral, though only for a narrow group of patients so far.
How the NHS weight management tiers work
The NHS in England organises weight support into four tiers. Understanding them helps explain why access to injections isn't as simple as asking your GP.
| Tier | What it is | Who delivers it | Do you get medication here? |
|---|---|---|---|
| Tier 1 | General advice and health promotion | Public health campaigns, GP | No |
| Tier 2 | Structured lifestyle programmes (diet, activity, behaviour change) | Community services, often free 12-week courses | No, but orlistat may be prescribed by your GP alongside this |
| Tier 3 | Specialist multidisciplinary weight management, including dietitians, psychologists and specialist doctors | Hospital or specialist NHS service, by referral only | Yes, Wegovy, Saxenda and Mounjaro are prescribed here |
| Tier 4 | Bariatric surgery | Hospital, by referral from Tier 3 | Not medication, but part of the same pathway |
Not sure which tier applies to you?
The tier system is confusing - and your GP may not explain it clearly. Message us on WhatsApp and we'll help you understand where you'd sit and what to ask for. For free.
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Who qualifies for weight loss injections on the NHS?
Each medication has its own criteria. Thresholds are 2.5 BMI points lower if you're from a South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean background, because these groups face higher health risks at a lower BMI. The criteria below apply in England.
BMI and health condition thresholds by medication
| Medication | Standard BMI threshold | Adjusted threshold | Health conditions needed | Access route |
|---|---|---|---|---|
| Wegovy (semaglutide) | 35 or above | 32.5 or above | At least one weight-related condition | Specialist weight management service only |
| Wegovy (lower BMI band) | 30 to 34.9 | 27.5 to 32.4 | Weight-related condition plus specialist criteria | Specialist weight management service only |
| Mounjaro (tirzepatide), specialist route | 35 or above | 32.5 or above | Fewer conditions may qualify, varies by local NHS area | Specialist weight management service |
| Saxenda (liraglutide) | 35 or above | 32.5 or above | Non-diabetic hyperglycaemia and a high risk of cardiovascular disease | Specialist weight management service only |
If you're from one of the groups above, ask your GP about the lower threshold, because it's easy to miss. NICE guidance limits Wegovy to a maximum of 2 years of treatment through the NHS, so ask your specialist team what happens after that point, as this varies by service.
Mounjaro from your GP: who qualifies
Mounjaro is being rolled out through GP practices in phases, starting with people who have the highest BMI and the most weight-related conditions.
| Cohort | BMI | Conditions needed | Status |
|---|---|---|---|
| Cohort 1 | 40 or above (37.5 or above for some ethnic groups) | At least 4 of 5 | Available since 23 June 2025 |
| Cohort 2 | 35 to 39.9 (32.5 to 37.4) | At least 4 of 5 | Rolling out since 23 June 2026 |
| Cohort 3 | 40 or above (37.5 or above) | At least 3 of 5 | Planned for 2027/28 |
The 5 qualifying conditions are type 2 diabetes, high blood pressure, high cholesterol, cardiovascular disease and sleep apnoea. GP practices opt in to the rollout, so your surgery may not offer Mounjaro yet.
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How the referral process works
- You see your GP. Bring your BMI (or let them calculate it) and be ready to talk about your general health and any conditions you have.
- You'll usually be asked to try Tier 2 first. Most areas expect evidence you've engaged with a lifestyle programme, often for at least 12 weeks, before a Tier 3 referral is considered.
- Your GP refers you to Tier 3, or to the Mounjaro pathway if your practice offers it. Not every practice offers Mounjaro yet, since the rollout is happening in phases.
- You're assessed by the specialist service. This includes blood tests, a full medical history, and a discussion about whether medication is appropriate for you specifically.
- If approved, you start on the medication with ongoing monitoring from the specialist service.
If you don't meet the criteria for Tier 3 or the GP Mounjaro pathway, orlistat has a lower BMI threshold, and your GP can prescribe it without a specialist referral.
Local criteria can be stricter than national guidance
Some specialist services set their own referral criteria on top of NICE guidance. These can include a higher BMI threshold, or a requirement to have completed a Tier 2 programme first. Meeting the national criteria does not guarantee a referral locally, so ask your GP what applies in your area.
Compare prices for weight loss treatment
The NHS route can take months to years. If you'd rather explore private options now, compare prices from regulated UK pharmacies - all GPhC-registered.
What you'll get
- Prices from regulated pharmacies only
- See costs side by side, no sign-up
- Know what safety checks to expect
How long are NHS waiting times for weight loss medication?
Tier 3 waiting times vary hugely depending on where you live. Some areas report waits of a few months, while others report waits of several years from referral to first appointment. A 2024 NHS England survey of integrated care boards (ICBs) found an average Tier 3 wait of 16 months, and around 2 years for medication in the ICBs that keep a separate medication waiting list. Demand has increased significantly since then, and some areas have paused new referrals while they manage their waiting lists.
These figures are for England. Scotland, Wales and Northern Ireland run their own NHS services, so access and waiting times differ. Check with your GP or local health board.
What can you do if you don't qualify or can't wait?
There are still several options available to you:
- Tier 2 lifestyle programmes. These are usually free, don't require meeting a BMI threshold as strict as Tier 3, and provide structured lifestyle support without medication.
- Orlistat from your GP. Your GP can prescribe it with a BMI of 30 or above, or 28 or above with a weight-related health condition, without a specialist referral.
- Orlistat over the counter. Alli, a lower-dose version, is available from pharmacies without a prescription for adults with a BMI of 28 or above.
- Private prescription. Weight loss injections are available privately through registered pharmacies and online doctor services, typically from a BMI of 27 to 30 depending on the provider and your health conditions. Costs vary a lot between providers, so you can compare weight loss medication prices from UK pharmacies before deciding what is affordable.
- Reapplying later. If your health changes, for example you're diagnosed with a new weight-related condition, speak to your GP again, since this can change your eligibility.
If you're unsure which route fits you, speak to one of our care navigators and they can help you understand your NHS and private options.
Not eligible on the NHS? See what private costs look like.
Weight loss injections are available privately through registered pharmacies, but costs vary a lot. Compare prices before you commit.
What you'll see
- Prices by medication and dose
- GPhC-registered pharmacies only
- No commitment, no sign-up
Frequently asked questions
Related guides
What can the NHS prescribe for weight loss?
What's available, and who can prescribe it.
NHS vs private weight loss medication: which route is right for you?
Comparing waiting times, cost and ongoing clinical support.
Private GLP-1 prescriptions: what to know before you buy
Regulated providers, red flags and MHRA guidance on buying safely.
GLP-1 medication costs in the UK
Comparing Wegovy, Mounjaro and Saxenda pricing across providers.
Sources
- NICE TA875: semaglutide for managing overweight and obesity
- NICE TA664: liraglutide for managing overweight and obesity
- NICE TA1026: tirzepatide for managing overweight and obesity
- NHS England: interim commissioning guidance for tirzepatide
- NICE TA1026 supporting documentation: specialist weight management service survey
Last reviewed October 2026