NHS weight loss medication explained

What weight loss medications the NHS can prescribe

The NHS can prescribe weight loss medications, including the weight loss injections (often called weight loss jabs) Wegovy (semaglutide), Mounjaro (tirzepatide) and Saxenda (liraglutide), as well as orlistat capsules (sometimes called weight loss tablets). You need to meet NICE criteria on BMI and weight-related health conditions.

Your GP can prescribe orlistat. Wegovy and Saxenda are only prescribed through a specialist weight management service. Mounjaro can sometimes be prescribed directly by a GP practice taking part in the NHS rollout.

Brand name	Medicine	Type	Who can prescribe it on the NHS
Wegovy	semaglutide	Injection	Specialist weight management service only
Mounjaro	tirzepatide	Injection	Specialist weight management service, or a GP practice that has opted in to the current phase of the NHS primary care rollout
Saxenda	liraglutide	Injection	Specialist weight management service only
Orlistat (also sold as Xenical)	orlistat	Capsule	Your GP

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Weight loss injections and capsules available on the NHS

Wegovy, Mounjaro and Saxenda are weight loss injections, often called weight loss jabs. They belong to a group of medicines known as GLP-1 medicines, which mimic gut hormones involved in appetite and blood sugar control. Orlistat is a capsule that works differently.

Wegovy (semaglutide) on the NHS

Who prescribes it: a specialist weight management service only. Prescribing stays with the specialist service for as long as you're on the medicine, and there's no route back to a GP prescription.
Eligibility: at least one weight-related health condition, and a BMI of 35 or more (32.5 or more for some minority ethnic groups), or a BMI of 30 to 34.9 if you also meet the criteria for referral to a specialist weight management service.
Review: reviewed at 6 months and usually stopped if you haven't lost at least 5% of your starting weight. Capped at a maximum of 2 years' treatment on the NHS.

Mounjaro (tirzepatide) on the NHS

Who prescribes it: a specialist weight management service, or a GP practice that has opted in to the current phase of the NHS primary care rollout.
Eligibility: at least one weight-related health condition, and a BMI of 35 or more (32.5 or more for some minority ethnic groups). NHS primary care access is currently limited to people with a higher BMI and several weight-related conditions, widening over time.
Review: reviewed at 6 months and usually stopped if you haven't lost at least 5% of your starting weight. No fixed maximum treatment period.

Mounjaro's NHS rollout is happening in phases agreed between NICE and NHS England, starting with people who have the highest BMI and the most weight-related conditions and gradually widening.

GP practices also have to opt in to prescribe Mounjaro, so even if you meet the current criteria, it may not yet be available at your surgery.

Saxenda (liraglutide) on the NHS

Who prescribes it: a specialist weight management service only.
Eligibility: a BMI of 35 or more (32.5 or more for some minority ethnic groups), plus non-diabetic hyperglycaemia and a high risk of cardiovascular disease - a narrower set of criteria than for Wegovy or Mounjaro.
Review: reviewed after around 12 weeks on the full dose and usually stopped if you haven't lost at least 5% of your starting weight.

Saxenda has also faced ongoing UK supply constraints and is prescribed far less often now that Wegovy and Mounjaro are more widely available.

Orlistat (Xenical): the capsule your GP can prescribe

Orlistat (also sold under the brand name Xenical) is a weight loss capsule, sometimes called a weight loss tablet, that works by reducing the amount of fat your body absorbs from food. It's the main weight loss medicine that GPs can generally prescribe directly, without a referral to a specialist service.

Your GP will usually only prescribe orlistat if you have a BMI of 30 or above, or 28 or above with a weight-related health condition, and have already tried to lose weight through diet, exercise and behaviour changes. It's usually only continued beyond the first 3 months if you've lost at least 5% of your starting weight, and your GP will discuss the benefits and limitations with you before continuing treatment beyond 12 months.

Who qualifies for weight loss medication on the NHS?

Each medication has its own NICE criteria, set out in the sections above. In general, you need a BMI above a set threshold plus at least one weight-related health condition, and you will usually be expected to have tried lifestyle changes first.

For the full eligibility breakdown and how the referral process works, see our guide to NHS weight loss medication eligibility. Not sure where you stand? Check with our short quiz below to see if you're likely to qualify for weight loss medication on the NHS.

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Why BMI thresholds are sometimes lower

For semaglutide, tirzepatide and liraglutide, NICE guidance sets a lower qualifying BMI, usually by 2.5 points, for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or Black Caribbean backgrounds. This reflects evidence that these groups face a higher risk of weight-related health problems at a lower BMI than White populations. If you're unsure which threshold applies to you, ask your GP.

How NHS weight management support is structured

NHS weight management support in England is organised into tiers. Understanding where medication fits in helps explain why not everyone can simply ask their GP for a prescription.

Tier 1: general health advice and support, usually from your GP or a community programme.

Tier 2: lifestyle programmes, such as the NHS Digital Weight Management Programme, focused on diet, activity and behaviour change. Orlistat can be prescribed at this stage.

Tier 3: specialist weight management services, with a multidisciplinary team of doctors, dietitians and psychologists. Wegovy, Mounjaro and Saxenda are prescribed here.

Tier 4: bariatric (weight loss) surgery, for people who meet the surgical criteria.

Most people are expected to have tried lifestyle changes, and in many areas Tier 2 support, before being referred further up the pathway. How tiers are organised, and how long referral takes, varies by integrated care board (ICB), so it's worth asking your GP practice what's available locally.

What the NHS won't prescribe for weight loss

Medication for cosmetic reasons. If you don't meet the BMI and health criteria, the NHS won't prescribe weight loss medicines, however much you'd like to lose weight.
Unlicensed or compounded versions. The NHS only prescribes medicines with a UK marketing authorisation from the MHRA, in the licensed dose and formulation.
Long-term treatment without review. NHS prescribing is reviewed at set points, and treatment is usually stopped if you're not losing enough weight, or, for Wegovy, once you reach the 2-year NHS treatment limit.
A prescription for Wegovy or Saxenda from your GP. Even if you meet the criteria, your GP can't prescribe these directly, and this doesn't change once you're established on treatment - it stays with the specialist service throughout. Mounjaro is the exception: some GP practices can now prescribe it directly to patients who meet the current phase of the NHS rollout.

How much do weight loss injections cost on the NHS?

Weight loss injections prescribed on the NHS are free apart from the standard prescription charge in England (£9.90), and prescriptions are free in Scotland, Wales and Northern Ireland. If you're likely to need repeat prescriptions over several months, an NHS Prescription Prepayment Certificate (PPC) can work out cheaper than paying per item, since it covers all your prescriptions for a set period for one upfront cost.