Strict rules as GPs start to prescribe weight loss jab Mounjaro

Prescriptions for Mounjaro jabs, to help people lose weight, will be available at GP surgeries in England from today – but only for those who meet very strict criteria.

NHS England says while the long-term plan is for the jabs to be more widely available, a staggered approach is needed to reach those most at need, manage GPs’ workload and NHS resources.

The weekly injection makes you feel full so you eat less, and can help people lose 20% of their body weight.

GPs say they don’t have enough doctors to deal with demand for the medicine and are urging people not to approach their local surgery unless they are eligible.

Mounjaro, or tirzepatide, was initially licensed to help treat type 2 diabetes, but is now also prescribed to help those with obesity lose weight.

According to NHS England, the first group of patients who will be able to get the jab from their GP or a community clinic, will be those most in need.

This is people with:

• a BMI of 40 or over (or 37.5 if from a minority ethnic background)
• and four out of five of the following conditions: type 2 diabetes, high blood pressure, heart and vascular disease, high cholesterol and obstructive sleep apnoea

People will also get “wrap-around” care – including regular check-ups, support with exercising and advice on eating healthily, for example.

But prescriptions for the drug will not necessarily be available from all local GPs. In some cases, they will come from other primary care services.

NHS England says people should check their integrated care board (ICB) website for more information. (That’s the organisation that is responsible for planning the health services for a local population).

Dr Claire Fuller, co-national medical director of primary care at NHS England, says greater access to weight-loss drugs will make a “significant difference to the lives of people living with obesity and experiencing severe ill health”.

“This is an important next step in the rollout of weight-loss drugs, with community-based services now able to offer this treatment from today,” she said.

But some GP practices have issued notices on their websites saying very few patients on their lists will qualify for the medicine straight away. One GP surgery is asking for patience while community services are set up.

Prof Kamila Hawthorne, chair of the Royal College of General Practitioners, said weight-loss injections do work but GPs are “over-burdened” already and don’t have a big enough workforce to deal with demand.

“It’s a lot safer to come to us than buying online or over the counter, but we are asking people not to approach GPs unless they think they meet the criteria,” she added.

It is unlikely all patients who want Mounjaro and meet the criteria, will get it straight away, according to the trade association for large pharmacies, the Company Chemists’ Association.

Chief executive Malcolm Harrison said although the medicines are likely to “transform the lives” of millions, “it is unlikely that the planned GP provision will be sufficient to meet patient demand”.

And weight-loss jabs are relatively new in healthcare terms. Some GPs and other healthcare staff need training in how to offer them safely and appropriately.

Mounjaro also requires monthly check-ups for patients during the first few months of taking it, making this a labour intensive process for doctors.

Surgeries will also be looking at their capacity to provide the wrap-around care needed alongside the injection.

Then there will be those who can’t take Mounjaro right now – for example, women who are pregnant, trying to become pregnant or breastfeeding.

People who have had certain conditions – like pancreatitis or certain thyroid tumours – should not take the drug either.

Individuals will need to have a chat with their GP or clinic to discuss the potential side-effects too.

Mounjaro has been available in specialist NHS weight loss clinics since March.

Wegovy, also known as semaglutide, is another weight-loss jab which works in a similar way. It can be prescribed to certain groups of people under the care of specialist NHS weight-loss management clinics.

Both medicines can also be bought privately.

Dr Claire Fuller, of NHS England, says not everyone will be eligible for weight-loss drugs.

“It’s important that anyone who is worried about the impact of their weight on their health discusses the range of NHS support available with their healthcare professional,” she explained.

Interim guidance from NHS England suggests Mounjaro will be available to some 220,000 people over the next three years.

Their current plan suggests it may be available in phases:

• June 2026: expanded to include people with a BMI of 35 to 39.9 who have four out of five conditions listed above
• April 2027: also offered to people with a BMI of 40 and above who have just three out of five conditions listed above

The health watchdog, NICE, will then take stock of how the rollout has been going and decide if it is the right to time to offer it to more people with obesity.

Around 3.4 million people are likely to be eligible over the next 12 years, estimates suggest.

Mounjaro is available through specialist weight management services in the NHS in Wales. The Welsh government is considering other arrangements, including involving primary care, in the future.

In Northern Ireland, a new regional obesity management service will be introduced gradually over the next few years, with a community-based service where patients will have access to lifestyle support and obesity medication if appropriate.

Very few people are currently being prescribed drugs for weight loss on the NHS in Scotland, research by BBC Scotland News has established. In Scotland, health boards make decisions on which medicines are available in their areas.

Get our flagship newsletter with all the headlines you need to start the day. Sign up here.