Jump to: NHS eligibility criteria | Medication options | NHS referral pathway | Speaking to your doctor | Private treatment options | Frequently asked questions
You can get weight-loss injections on the NHS if you meet specific eligibility criteria and are referred to a tier 3 weight management service.
As of September 2025, Saxenda and Wegovy are available through the NHS, while Mounjaro is currently only accessible through private prescription in the UK1.
The number of patients who have received weight-loss injections through the NHS since their introduction is unknown, with demand far exceeding current capacity.
The National Institute for Health and Care Excellence (NICE) has established strict guidelines for NHS eligibility, focusing on those with the highest clinical need3.
Second Nature has worked with the NHS since 2017, supporting over 250,000 patients through digital weight management programmes.
While NHS weight-loss injection access remains limited, understanding the referral pathway and eligibility criteria can help you discuss options with your GP.
NHS eligibility criteria for weight-loss injections
To qualify for weight-loss injections on the NHS, you must meet the following clinical criteria established by NICE3:
| Requirement |
Details |
| BMI threshold |
≥35 kg/m² (≥30 kg/m² for people from certain ethnic groups) |
| Health conditions |
At least one weight-related comorbidity, such as type 2 diabetes, hypertension, or sleep apnoea |
| Prior weight loss attempts |
Evidence of previous structured weight-management programmes |
| Service availability |
Be eligible for referral to a local tier 3 weight management service |
Tier 3 weight management services are specialised multidisciplinary teams typically including dietitians, psychologists, specialist nurses, and consultant physicians.
These services are commissioned by local Integrated Care Boards (ICBs), leading to significant regional variation in availability across the UK.
While the number of weight management services has increased significantly since 2020, there remains a substantial gap between need and provision across most regions.
Weight-loss injections available on the NHS
The NHS currently offers three approved weight-loss injections, with different eligibility criteria for each:
| Medication |
Active Ingredient |
NHS Availability |
Average Weight Loss |
NICE Approval |
| Saxenda |
Liraglutide 3mg |
Yes – for eligible patients |
5-10% over one year |
TA664 (2020)6 |
| Wegovy |
Semaglutide 2.4mg |
Yes – limited availability |
15-17% over one year |
TA875 (2023)7 |
| Mounjaro |
Tirzepatide |
Yes – limited availablity |
20-25% over one year |
TA936 (2024)8 |
Mounjaro (tirzepatide) received NICE approval in March 2024 and is now being prescribed via specialist NHS weight management programmes.
Most patients referred for weight-loss injections through the NHS may initially be prescribed Saxenda, with Wegovy and Mounjaro reserved for those with the highest clinical need or those who haven’t responded adequately to Saxenda.
NHS pathway for accessing weight-loss injections
The pathway to accessing weight-loss injections on the NHS involves several steps:
- Initial GP consultation
- Discuss weight concerns with your GP
- Complete health assessment, including BMI calculation
- Review of weight-related health conditions
- Evaluation of previous weight management attempts
- Tier 2 weight management services
- Most patients must first complete a tier 2 programme
- Typically, 12-week community-based interventions
- Focus on diet, physical activity, and behaviour change
- Need to demonstrate engagement before tier 3 referral
- Tier 3 referral and assessment
- Specialist multidisciplinary team assessment
- Comprehensive medical and psychological evaluation
- Personalised care plan development
- Discussion of medication options if appropriate
- Medication initiation and monitoring
- Initial prescription and training on administration
- Regular follow-up appointments (typically monthly)
- Ongoing support from the multidisciplinary team
- Weight loss assessment against NICE continuation criteria
- Treatment review
- Assessment at 12 weeks for Saxenda and 16 weeks for Wegovy
- Continuation only if achieving at least 5% weight loss
- Regular monitoring for side effects and efficacy
- Maximum NHS treatment duration is typically 2 years
NHS England guidance requires that weight-loss injections are prescribed alongside a comprehensive lifestyle intervention programme, not as a standalone treatment10.
How to speak to your doctor about weight-loss injections
Discussing weight concerns with healthcare professionals can be challenging, but a structured approach may help:
Be prepared with specific information:
- Your weight history and previous management attempts
- Impact of weight on your physical and mental health
- Specific symptoms of weight-related conditions
- Records of previous structured weight loss programmes
Use clear, direct language:
“I’d like to discuss options for managing my weight, including whether weight-loss injections might be appropriate for me.”
Focus on health implications rather than appearance:
“My weight is affecting my mobility and energy levels, and I’m concerned about developing type 2 diabetes given my family history.”
Ask specific questions about the referral process:
“Could you explain what tier 3 weight management services are available locally and whether I might be eligible for a referral?”
Many GPs may suggest other approaches to support weight loss before recommending weight-loss injections. This stepped approach aligns with NHS England’s guidance on obesity management11.
Private treatment options when NHS isn’t accessible
For many people, accessing weight-loss injections through the NHS isn’t possible due to strict eligibility criteria or local service limitations. Private options provide an alternative path:
Second Nature’s medication programmes:
- Evidence-based approach combining medication with comprehensive lifestyle support
- Proven results: our published research shows participants achieved 19.1% average weight loss at 12 months
- Support from registered dietitians and nutritionists available 5 days per week
- Structured behaviour change programme to develop sustainable habits
Comparing NHS and private pathways:
| Aspect |
NHS Pathway |
Second Nature Programme |
| Eligibility |
Strict BMI and health criteria |
Broader criteria (BMI ≥30 or ≥27 with health conditions) |
| Waiting time |
Often 3-6 months or more |
Typically 1-2 weeks |
| Medication options |
Primarily Saxenda, limited Wegovy |
Mounjaro and Wegovy |
| Support model |
Varying levels of MDT support |
Consistent access to dietitians/nutritionists |
| Cost |
Free at point of use |
From £149 monthly (with £50 off first month) |
| Duration |
Typically limited to 1-2 years |
Flexible duration based on individual needs |
While NHS treatment provides cost-free access, private programmes like Second Nature offer broader eligibility, faster access, medication choice, and consistent professional support.
Frequently asked questions
How long will I need to wait for NHS weight-loss injections?
Waiting times vary significantly across the UK, but most patients wait between 3 and 6 months for an initial Tier 3 assessment, with some areas reporting waits of up to 12 months.
These timeframes reflect current NHS capacity challenges for specialist weight management services.
What’s the difference between Saxenda, Wegovy, and Mounjaro?
All three medications belong to the class of GLP-1 receptor agonists, but they work slightly differently. Saxenda (liraglutide) was the first approved and typically produces 5-10% weight loss.
Wegovy (semaglutide) is more potent, leading to 15-17% weight loss. Mounjaro (tirzepatide) targets both GLP-1 and GIP receptors, resulting in 20-25% weight loss in clinical trials.
Does the NHS prescribe Mounjaro for weight loss?
Yes, Mounjaro is now available via specialist weight management services, but it’s currently being reserved for individuals with the greatest clinical need.
Will my GP prescribe weight-loss injections directly?
Generally no. Most GPs cannot prescribe these medications directly and will instead refer eligible patients to tier 3 weight management services. This reflects the need for specialist support and monitoring when using these medications.
If I don’t qualify for NHS treatment, what are my options?
If you don’t meet NHS eligibility criteria, private options like Second Nature’s medication programmes provide an alternative.
These combine prescription medication with professional support from registered dietitians and nutritionists to help you develop sustainable habits for long-term weight management.
How long can I stay on weight-loss injections through the NHS?
NHS guidelines typically limit treatment duration to 2 years, with continuation dependent on achieving and maintaining a weight loss of at least 5% from baseline.
Patients are assessed at regular intervals to determine if treatment should continue based on effectiveness and tolerability.
What happens when I stop taking the medication?
Research shows that without developing sustainable habits, most people regain approximately two-thirds of lost weight within a year of stopping medication.
This highlights the importance of using medication as a tool to build healthier habits rather than as a standalone solution.
Take home message
Accessing weight-loss injections on the NHS requires meeting strict eligibility criteria and navigating the referral pathway to specialist weight management services.
While Saxenda and Wegovy are available through the NHS for eligible patients, Mounjaro remains accessible only through private prescription despite its NICE approval.
For those who don’t qualify for NHS treatment or face long waiting times, private options like Second Nature’s medication programmes offer an evidence-based alternative, combining medication with professional support to develop sustainable habits for long-term weight management.
The most effective approach to weight loss combines appropriate medication with comprehensive lifestyle support, regardless of whether you access treatment through the NHS or privately.
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
-
- NHS England. (2025). Clinical Commissioning Policy: GLP-1 receptor agonists for weight management.
- National Institute for Health and Care Excellence. (2023). TA875: Semaglutide for managing overweight and obesity.
- NHS Digital. (2024). Weight Management Programme Data Analysis.
- National Institute for Health and Care Excellence. (2020). TA664: Liraglutide for managing overweight and obesity.
- National Institute for Health and Care Excellence. (2023). TA875: Semaglutide for managing overweight and obesity.
- National Institute for Health and Care Excellence. (2024). TA936: Tirzepatide for managing overweight and obesity.
- Department of Health and Social Care. (2025). Future funding allocation for weight management medications.
- NHS England. (2024). Adult Weight Management Services: Guidance for Commissioners and Providers.
- NHS England. (2024). Guidance on discussing weight management in primary care.
- Aronne, L. J., Sattar, N., Horn, D. B., et al. (2023). Continued Treatment With Tirzepatide for Maintenance of Weight Reduction in Adults With Obesity: The SURMOUNT-4 Randomized Clinical Trial. JAMA, 2024;331(1):38-48. doi:10.1001/jama.2023.24945
