It is the biggest shake-up of obesity treatment in NHS history, it has been claimed. From later this month, GPs will be able to prescribe weight-loss jabs to thousands.
These once-a-week injections – Wegovy and Mounjaro – can help patients shed up to a fifth of their body weight in only a year.
Since Wegovy’s arrival in 2021, these appetite-suppressing drugs have already transformed the diet industry. In the UK alone, scores of private clinics offer them – known collectively as GLP-1s – from about £250-a-month. Yet the vast majority of NHS obesity patients do not receive weight-loss medication of any kind. Instead, most are simply offered diet and exercise advice, which has limited success.
Earlier this year the Government announced that GLP-1 jabs would be offered at specialist weight management clinics. But so far uptake has been limited – with few clinics and not enough weight specialists to staff them.
Currently just 4,000 patients a month are prescribed GLP-1 drugs on the NHS. By comparison, more than one million people in the UK are paying for the injections, often at great cost.
The need for easier access to these powerful drugs is clear.
Nearly a third of British adults are obese, which costs the economy about £75 billion a year and contributes to more than 30,000 deaths, largely due to increased risk of cancer, heart disease, diabetes and dementia.
But research shows that even modest weight loss can reduce the risk of developing these life-limiting conditions.
In the UK alone, scores of private clinics offer weight-loss jabs – known collectively as GLP-1s – from about £250-a-month
That’s why, at the end of last year, the NHS spending watchdog, National Institute for Health and Care Excellence (NICE), ruled that nearly four million Britons should be eligible for GLP-1 jabs via both weight management clinics and GP practices. However, there has been little information on how exactly GPs will go about prescribing the injections and, crucially, who will be first in line to receive them – until now.
The Mail on Sunday has been granted access to official NHS documents setting out the steps patients will have to take to get weight-loss jabs from their GP.
With the help of a team of GPs and weight-loss experts, we explain all you need to know…
Q. I already pay for a weight-loss jab – does this mean I can now get it from my GP?
A. Not necessarily. From June 23, GPs will be able to prescribe GLP-1 drugs, but only to the most unwell patients.
According to the NHS guidance, they must have a body mass index (BMI) of more than 40 – which classes them as severely obese – and at least four obesity-related conditions (known as comorbidities), such as high blood pressure, high cholesterol, sleep apnoea, heart disease, osteoarthritis or diabetes. In contrast, private clinics can offer GLP-1s to people with a BMI over 30 – which classes them as obese – or over 27 – they are deemed to be overweight – with at least one comorbidity.
‘There are lots of patients paying privately who want to switch to NHS treatment,’ says Oxford GP Dr Helen Salisbury, ‘but that won’t happen overnight.’
Still, many are expected to qualify. An estimated two million people in the UK have a BMI over 40, and most of them have related health issues.
‘Weight-related diseases are all connected,’ says Prof Naveed Sattar of the University of Glasgow. ‘So the number who now qualify is pretty sizeable.’
Q. That seems very unfair – will things change in the future?
A. Yes, that’s the plan. Many more patients will be able to access GLP-1s via their GP in the near future.
Experts say that the rollout is being carried out in stages to avoid overwhelming practices with patients requesting the injections.
From next year, the health requirements for getting the drugs will be relaxed. Those with a BMI of over 35, along with four comorbidities, will then be able to request a GLP-1 prescription from their GP.
Then, in September 2026, the rules will be relaxed further, meaning those with a BMI of over 40 and just three comorbidities will be able to get them.
NHS officials believe, through this staggered rollout, some 220,000 additional patients will be taking GLP-1s by 2028.
However, the NHS has said it will likely take 12 years to get the four million eligible patients on to weight-loss treatments.
In a move that is sure to prove controversial, some experts say they would advise patients who pay for GLP-1 injections but who have lost too much weight to qualify for a free prescription, to temporarily come off them in order to put weight back on.
‘Some people, having already started the drugs, might miss out because they are now a few kilos below a BMI of 40,’ says Prof Sattar. ‘They might choose to put the weight back on to qualify. That’s a decision which could save patients as much as £10,000 over the next decade.
‘Who’s to say that they’d be wrong to do this?’
Q. I think I qualify – what should I do now?
A. The earliest that GLP-1s will become available through GP practices is in three weeks’ time, but in some parts of the country it could take longer.
‘This is a brand new service,’ says Dr Dean Eggitt, a Doncaster-based GP. ‘Inevitably it’ll take some time for them to work out the most efficient way of prescribing these drugs.’
However, the NHS has already set out the basic step-by-step process through which patients can access a GLP-1 prescription from their GP.
First, patients who want to begin taking them will need to make an appointment with their GP. In an effort to combat ‘potential misuse’, GPs are not allowed to prescribe the injections based solely on an online questionnaire, meaning a face-to-face appointment will likely be required.
The GP will assess the patient’s medical records and, if necessary, contact other doctors who have recently treated them, to make sure they are a suitable candidate for treatment.
If the prescription is approved, then patients will initially need to have monthly face-to-face appointments with a ‘suitably trained healthcare professional’, such as a nurse. This is because patients taking GLP-1 injections begin on a small dose, which, over a number of months, is slowly increased in strength. During this period, patients need to be monitored for potential side effects.
While Wegovy and Mounjaro are considered safe for use, they can lead to uncomfortable symptoms such as nausea and indigestion.
In rare cases the injections can trigger severe side effects such as pancreatitis – a painful and potentially life-threatening swelling of the pancreas.
Should concerning side effects arise, the GP surgery may decide to delay increasing the dose, reduce the dose or, if the symptoms are severe enough, take the patient off the treatment.
Once patients reach the highest dose, they will no longer require monthly appointments. But GPs will need to regularly review the patient’s prescription, taking into account their BMI, comorbidities, side effects, and mental health, for at least the first year of treatment and possibly longer.
Q. Some private weight-loss firms also offer diet advice – will the NHS do that too?
A. Yes, GPs will be required to provide nutrition and diet advice, along with physical activity guidance and psychological support, for a minimum of nine months after beginning treatment.
This is because research shows GLP-1 drugs do not help people eat better – only less. Experts believe without diet and exercise advice, patients taking the injections could become malnourished or fail to lose as much weight as hoped.
This additional treatment – which weight-loss experts refer to as ‘wraparound care’ – is the biggest point of contention in the scheme.
‘In some areas, the GPs might pay for the dieticians and mental health professionals needed to provide wraparound care, along with the nurses to monitor patients’ progress,’ says Dr Eggitt. ‘This is something we are considering doing.’
Local authorities will also have the option to pay independent, private companies to do the wraparound care. This can be done via a free digital app, so patients don’t need to be seen in person.
‘There are lots of patients paying privately who want to switch to NHS treatment,’ says Oxford GP Dr Helen Salisbury (pictured), ‘but that won’t happen overnight’
Several online weight management companies are already offering wraparound care for patients who have received GLP-1 injections via specialist weight clinics, and The Mail on Sunday understands some are now in discussions to provide a similar service to GP practices.
Q. Will I get to choose which injection I take?
A. It is expected that the vast majority of NHS patients will be offered Mounjaro. While Wegovy was the first weight-loss jab to be approved for use in the UK, research now shows that Mounjaro is more effective.
Wegovy patients, on average, lose about 15 per cent of their body weight, compared to the 22.5 per cent loss seen in Mounjaro patients.
However, experts say this may change. At present, both injections cost roughly the same – with private clinics offering them for about £250 a month.
‘The fact the NHS is going to prioritise Mounjaro, might force Novo Nordisk [the Danish manufacturer of Wegovy] to lower prices,’ says Prof Sattar.
Q. I have heard that patients who come off the injections then put the weight back on – will the NHS stop paying for them once I reach a certain measurement?
A. There are no plans to limit the time that patients can take GLP-1 injections.
Previously, NHS patients given Wegovy had been restricted to two years’ treatment. But the new guidance for Mounjaro has abolished this limit, based on evidence that it is suitable for ‘indefinite prescribing’. For many, a lifelong GLP-1 prescription might be necessary.
Research shows that more than half who come off the drugs regain at least two-thirds of the weight they lost. Nearly one in five put all the weight back on – or even exceed it.
Q. What happens if I don’t lose any weight?
A. Not everyone loses weight on GLP-1 jabs. About one in ten Mounjaro users lose less than five per cent of their bodyweight after a year.
NHS guidance states that treatment can be stopped if patients don’t reach this target after six months on the highest dose. Alternative therapies, including weight-loss surgery, may then be offered.
Surgery is usually reserved for those with a BMI over 40 who haven’t lost weight through other methods. While as effective as jabs, it carries more risk due to the invasive nature of the procedure. It has been suggested that a future pathway may involve starting with the injections and progressing to surgery if needed.
Newer, more powerful GLP-1 drugs are also on the horizon.
One in development and undergoing clinical trials is retatrutide. It has shown to deliver up to 30 per cent weight-loss in trials, with 99 per cent of patients losing at least five per cent bodyweight. But it is unlikely to become available until 2026-’27.
‘These drugs will become central to obesity care,’ says Prof Sattar. ‘Every GP needs to get comfortable using them.’
I SPENT £4,500 – IT’S WORTH EVERY PENNY
Caroline Ward before she started taking Wegovy, left, and after the weekly jabs. She has lost 4st 5lb and now has a BMI of 26
In the past year, Caroline Ward has spent nearly £4,500 on weight-loss jabs – and says they’ve been ‘worth every penny’.
The 63-year-old retired accounts worker from Maidstone, Kent, had tried Weight Watchers, Slimming World and countless diets, but nothing worked. ‘I’d always have these food noises I couldn’t ignore,’ she says. ‘I craved crisps, chocolate and ice cream.’
At 5ft 8in and 16st, her weight affected her confidence and left her with constant hip and knee pain. ‘I struggled to walk far and couldn’t run at all.’
After reading about Wegovy in the Mail, she began weekly jabs via an online pharmacy in March 2024. She’s since lost 4st 5lb and now has a BMI of 26 – which is just outside the healthy range.
She adds: ‘I’ve had no side effects. It’s been marvellous. I don’t have the food noise any more and I’m exercising all the time. When I factor in eating less, it’s only costing me about £2,000 a year.
‘I recommend them – they’ve changed my life.’
WEIGHT-LOSS JAB ROLLOUT AT A GLANCE
From June 23, some patients will now be able to get weight-loss injections from their GP.
At first, access will be limited to those with a BMI over 40, as well as four obesity-related diseases, such as high blood pressure, high cholesterol, sleep apnoea, heart disease or diabetes.
Over the next three years, these requirements will be slowly relaxed to allow more patients to get the jabs for free.
Patients who want to begin treatment will need to see their GP for an assessment. They will initially need to attend monthly face-to-face check-ups with a healthcare professional – likely a nurse – who will monitor them for side effects.
GP surgeries will be expected to provide nutrition and diet advice, as well as physical activity guidance and psychological support.
Patients who lose weight on the jabs will be allowed to stay on them indefinitely. However, those who fail to lose more than five per cent of their weight after six months on the maximum dose could be taken off.
