Which injections are on the NHS
Three weight-loss injections have been recommended by NICE for NHS use, but they aren’t accessed in the same way.
| Medication |
Drug |
How it works |
Average weight loss |
How you get it on the NHS |
| Mounjaro |
Tirzepatide |
Mimics two appetite hormones (GLP-1 and GIP) |
22.5% (SURMOUNT-1) |
From a GP, through a phased rollout |
| Wegovy |
Semaglutide |
Mimics one appetite hormone (GLP-1) |
14.9% at 2.4 mg (STEP 1) |
Through a specialist weight-management service |
| Saxenda / Nevolat |
Liraglutide |
Mimics one appetite hormone (GLP-1) |
Around 5 to 7% (SCALE) |
Specialist service only, and rarely used now |
Mounjaro is the most effective of the three, producing an average weight loss of 22.5% at the highest dose in its SURMOUNT-1 trial.5
It mimics two hormones that reduce appetite and cravings, GLP-1 and GIP, whereas Wegovy and Saxenda mimic only GLP-1, which is the likely reason for the difference.
Wegovy produced an average weight loss of 14.9% at the 2.4 mg dose used on the NHS in its STEP 1 trial.6
Saxenda was the first of these GLP-1 weight-loss injections, but Novo Nordisk has discontinued the branded version.
A generic liraglutide called Nevolat is now available, which contains the same drug at the same doses, though it’s rarely the first choice as it’s side effect rates are much higher and it doesn’t support the same level of weight loss as Wegovy or Mounjaro.
NHS eligibility criteria
The criteria differ by medication and area, and the Mounjaro criteria are being widened in stages.
Mounjaro
Mounjaro is recommended for NHS use under NICE guidance (TA1026), and it’s being rolled out through GPs over several years, starting with those with the greatest clinical need.1,4
In the first phase, it’s limited to adults with a BMI of 40 or above who also have at least four weight-related conditions, from a list that includes type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea (interrupted breathing during sleep), and heart disease.4
For people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean backgrounds, the BMI thresholds are lowered by 2.5.4
The criteria are set to broaden in later phases, gradually including people with a lower BMI or fewer weight-related conditions, with around 220,000 people expected to start treatment in the first 3 years.4
Wegovy
Wegovy is recommended under separate NICE guidance (TA875), through specialist weight-management services rather than GPs.2
You may qualify with a BMI of 35 or above (or 32.5 for the ethnic groups above) and at least one weight-related condition.2
NHS treatment with Wegovy is funded for up to 2 years, and it’s usually continued only if you’ve lost at least 5% of your starting weight after 6 months.2
How to get them on the NHS
The first thing everyone must do to get weight-loss injections on the NHS is to speak with their GP about getting support to lose weight.
For Mounjaro, if you meet the eligibility criteria for the current phase of the rollout, your GP can prescribe it in primary care, alongside support to introduce healthy lifestyle changes for at least 9 months.4
For Wegovy, your GP refers you to a specialist weight-management service, where a team of dietitians, nurses, and doctors assesses your situation and decides whether the medication is suitable.2
In many areas, your GP may first suggest a community weight-management programme, and engaging with it can support your case for a specialist referral.
Once you’re on treatment, you’ll have regular reviews to check your progress and manage any side effects, and the treatment will continue as long as it’s working for you.
Talking to your GP
Raising your weight with a GP can feel awkward, but it helps to note your weight history and any previous attempts to lose weight, how your weight affects your physical and mental health, and any weight-related conditions you’ve been diagnosed with.
You could open the conversation simply, for example: ‘I’d like to talk about managing my weight, and whether a weight-loss injection might be right for me.’
Framing it around your health rather than appearance tends to be the most useful angle, such as explaining that your weight is affecting your mobility and energy, or that you’re worried about type 2 diabetes given your family history.
It also helps to ask directly what’s available locally, for example, whether you meet the criteria for an NHS prescription or for a referral to a specialist weight-management service.
Many GPs will suggest changes to diet and activity first, which is in line with NHS guidance on managing weight.
What to do if you’re not eligible, or can’t afford it privately
Many people don’t meet the NHS criteria for a weight-loss injection, or face a long wait, and can’t afford to pay for one privately either. If that’s your situation, there are still several options.
- Ask your GP about a referral to an NHS specialist (Tier 3) weight-management service, which is how Wegovy is prescribed on the NHS. It’s free, and in some areas Second Nature is an approved Tier 3 provider, so you can ask to be referred to us.
- Use the free checker at the top of this page to see which other NHS weight-management programmes are available in your area. Some of these support weight loss without medication.
- If you’ve exhausted the options for getting a prescription, structured support without medication can still improve your health by helping you build healthy habits and a better relationship with food. Second Nature’s non-medicated programme costs £33 a month.
- If private medication is affordable, a private prescription avoids the NHS waiting list, as covered below.
Private options
For many people, it won’t be possible to get weight-loss injections on the NHS, either because the criteria are too strict or because local services don’t have capacity.
A private prescription is the main alternative, and it gives you access to Mounjaro or Wegovy for more people, usually a BMI of 30 or above, or 27 or above with a weight-related condition.
| Aspect |
NHS pathway |
Private pathway |
| Eligibility |
Mounjaro: a BMI of 40 or above with four weight-related conditions in the first phase. Wegovy: a BMI of 35 or above with a condition, through a specialist service |
A BMI of 30 or above, or 27 or above with a weight-related condition (varies by provider) |
| Waiting time |
Variable, and specialist waits can run from several months to over a year |
Often 1 to 2 weeks |
| Cost |
£9.90 per item in England, free elsewhere in the UK |
Around £150 to £375 a month, depending on the medication and dose |
| Support included |
NHS reviews, with wraparound support in the Mounjaro rollout |
Varies, from medication only to full habit-change programmes |
Private services differ in how much support they include. Some offer the medication with a basic online questionnaire, while others combine it with ongoing clinical care and habit-change support.
When you’re comparing providers, check that the service is registered with the Care Quality Commission, dispenses through a pharmacy registered with the General Pharmaceutical Council, provides a thorough clinical assessment rather than a quick form, and offers support to help you keep the weight off.
Second Nature has worked with the NHS for over eight years, combining Mounjaro or Wegovy with one-to-one support from registered dietitians designed to help you avoid weight regain in the future.
Take our 3-minute eligibility quiz, and a clinician will review your answers.
Frequently asked questions
Which weight-loss injections are available on the NHS?
Mounjaro and Wegovy are both available on the NHS for eligible people, and Saxenda has largely been replaced.1,2
Mounjaro is prescribed by GPs through a phased rollout, while Wegovy is prescribed through specialist weight-management services.
Can my GP prescribe weight-loss injections?
Your GP can prescribe Mounjaro if you meet the eligibility criteria for the current phase of the NHS rollout, but not every practice has started yet.4
Wegovy isn’t prescribed by GPs on the NHS; they can only refer you to a specialist service for it.2
Who qualifies for Mounjaro on the NHS?
In the first phase, NHS Mounjaro is for adults with a BMI of 40 or above who also have at least four weight-related conditions, such as type 2 diabetes, high blood pressure, high cholesterol, sleep apnoea, or heart disease.4
The thresholds are lowered by 2.5 for several ethnic groups, and the criteria are set to widen in later phases.4
How do I get Wegovy on the NHS?
Your GP refers you to a specialist weight-management service, usually if you have a BMI of 35 or above (or 32.5 for some ethnic groups) and a weight-related condition.2
The service assesses you and prescribes Wegovy if it’s suitable, for up to 2 years.2
Is Saxenda still available in the UK?
Novo Nordisk has discontinued branded Saxenda, but a generic liraglutide called Nevolat is available, containing the same drug at the same doses.
It’s a daily injection that produces less weight loss and side effects are more common than Mounjaro or Wegovy, so it’s rarely the first choice of treatment now.
How long is the NHS waiting list?
There’s no single national waiting list, and waits vary by area and by medication.
Specialist weight-management services can have waits of several months to over a year, and the Mounjaro GP rollout is phased, so not everyone who is eligible can start straight away.4
How do I get weight-loss injections for free?
The only way to get a weight-loss injection for free is on the NHS, if you meet the eligibility criteria.
You’ll pay the standard prescription charge of £9.90 per item in England, and nothing in Scotland, Wales, and Northern Ireland, where prescriptions are free.
The criteria are strict, so many people don’t qualify yet. If you don’t, ask your GP about a free NHS specialist weight-management service, or use the checker at the top of this page to see what other NHS support is available in your area.
What can I do if I can’t afford Mounjaro or Wegovy?
You have options that don’t involve paying privately.
Ask your GP whether you qualify for a free NHS prescription, or for a referral to a specialist weight-management service. You can also use the checker at the top of this page to see what NHS support is available where you live.
If medication isn’t an option for now, structured support without it can still help. Second Nature’s non-medicated programme costs £33 a month.
Can I get weight-loss injections on the NHS outside England?
Access differs across the UK. Scotland was the first nation to approve Mounjaro for obesity, at a lower BMI threshold of 30 with a weight-related condition, through primary care.8
In Wales, a clear NHS route is still being developed, and in Northern Ireland, the medication isn’t yet routinely available for obesity, with a phased introduction planned.
Which weight-loss injection is best?
Mounjaro produces the most weight loss of the injections available in the UK, with an average of 22.5% at its highest dose, compared with 14.9% for Wegovy at 2.4 mg.5,6
Wegovy is the only one with a recognised heart-health benefit on its UK label, which can matter for people with existing heart disease.2
Both have similar, mainly digestive side effects, so the best option depends on your health, your goals, and what you can access, which your prescriber can help you decide.
What’s the difference between Mounjaro, Wegovy, and Saxenda?
Mounjaro mimics two appetite hormones, GLP-1 and GIP, and produced an average weight loss of 22.5% at its top dose.5
Wegovy and Saxenda mimic only GLP-1. Wegovy produced an average of 14.9% at the 2.4 mg dose, and Saxenda produced around 5 to 7%, and Saxenda is a daily injection rather than a weekly one.6
What’s the difference between Mounjaro and Ozempic?
Mounjaro is licensed for weight loss and mimics two appetite hormones, GLP-1 and GIP. Ozempic contains semaglutide, is licensed for type 2 diabetes rather than weight loss, and mimics only GLP-1.
The semaglutide medication licensed for weight loss is Wegovy, which is the same drug as Ozempic at higher doses. Our guide to getting Ozempic on the NHS covers this in more detail.
How long can I stay on weight-loss injections on the NHS?
For Wegovy, NHS treatment is funded for up to 2 years, and it’s usually continued only if you’ve lost at least 5% of your starting weight after 6 months.2
Mounjaro is reviewed regularly and continued as long as it’s helping, alongside the support that comes with the rollout.4
What happens when I stop taking the medication?
If you stop suddenly without building habits to manage hunger naturally, some weight regain is likely because your appetite tends to return to its previous level.
In the SURMOUNT-4 trial, people who stopped tirzepatide and switched to a placebo regained much of the weight they had lost, while those who kept taking it largely maintained their loss.7
We recommend gradually coming off the medication and using the time you’re on it to build habits that help keep the weight off.
Our free weight regain prevention planner walks you through this.
Are weight-loss injections addictive?
Weight-loss injections aren’t inherently addictive.
However, as they reduce hunger and quieten food noise, it may feel challenging to come off them in the future if you haven’t developed the habits to manage hunger naturally.
In that situation, some people may feel dependent on the medication to manage their weight.
But obesity is a chronic condition, and many people may need to be on these medications for the long term to help them manage it.
Take home message
Weight-loss injections are available on the NHS, but the route depends on the medication.
Mounjaro is prescribed by GPs through a phased rollout that currently reaches only those with the greatest clinical need, while Wegovy is prescribed through specialist weight-management services.
Saxenda has largely been replaced, and the generic version, Nevolat, produces less weight loss than the weekly injections.
If you don’t meet the NHS criteria or you’re facing a long wait, a private prescription offers faster access to Mounjaro or Wegovy across a wider range of BMI thresholds, at a monthly cost.
These medications work best when they’re combined with healthy lifestyle changes.
We recommend eating a diet based on whole foods that contains enough protein, fibre, fat, and complex carbohydrates and limits ultra-processed foods.
Research suggests you’re more likely to avoid weight regain when a weight-loss injection is combined with structured habit-change support than when it’s prescribed on its own.
Second Nature combines Mounjaro or Wegovy with the balanced-plate approach and one-to-one support from registered dietitians.
In our published evaluation of a GLP-1-supported programme, members lost an average of 19.1% of their body weight at 12 months, with 77.7% losing at least 10%.9
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.
