Weight Loss Medications – UPDATE 21/5/26

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Good news: As of the end of MAY 2026 NEL ICB has eased the criteria for NHS prescribing of weight loss injections (GLP 1s).

We can now refer some patients for Wegovy/Semaglutide to Oviva, a Right-to-choose provider of this service. Currently they can only provide Wegovy/Semaglutide injections and NOT Mounjaro/Tirzepatide as yet (at the time of writing). The criteria for Wegovy/Semaglutide are less stringent needing BMI ≥35 and 1 of the listed associated conditions.

We can now prescribe Mounjaro/Tirzepatide in the highest risk patients with very stringent criteria (BMI ≥35 and 4 of the listed associated conditions); and refer you for behavioural support (which you must engage with)

More detail below

Please note these medications are contraindicated in patients with 

1. Pregnancy or breast feeding

2. personal or family history of thyroid cancer

3. history of Multiple Endocrine Neoplasia

4. History of pancreatitis

5. Liver cirrhosis

6. Severe gastrointestinal disease

7. End-stage renal disease or those on dialysis

8. Proliferative diabetic retinopathy or macular oedema

9. Untreated or unstable major mental illness

10. Substance misuse including alcohol and drug dependence

Wegovy/Semaglutide 

NEL ICB Eligibility Criteria: Patients should only be referred to a specialist MDT service (Like Oviva) for treatment with semaglutide if they meet all the below:

1. BMI ≥ 35 (32.5 if from an ethnic minority background) kg/m2

   • OR 30.0 – 34.9 kg/m2 and 

     • the underlying causes of overweight or obesity need to be assessed

     • the person has complex disease states or needs that cannot be managed adequately in behavioural overweight & obesity management services (e.g. the extra support needs of people with learning disabilities)

     • less intensive management has been unsuccessful

     • specialist interventions (such as a very-low-calorie diet) surgery or certain medicines being considered
       [section 1.11.13 of NICE guideline NG246: Overweight and obesity management]

2. AND At Least ONE weight-related co-morbidity

   • Hypertension (high blood pressure) 
     Sleep apnoea (confirmed at a sleep clinic)
     Cardiovascular disease (heart disease, vascular disease or stroke)
     Hypercholesterolaemia (high cholesterol)

3. AND Semaglutide must be prescribed within a specialist weight management service providing multidisciplinary management of overweight or obesity

4. AND Patient must agree to a sustained programme of lifestyle interventions, including reduced-calorie diet and increased physical activity advice and management

Mounjaro/Tirzepatide

NEL ICB Eligibility Criteria, Patients should only be treated with Tirzepatide if they meet all the below::

1. BMI must be above 35 (or 32.5 if from an ethnic minority background). You can check your BMI here if you know your height and weight.

2. And a confirmed diagnosis of at least four out of the following five health conditions:
   – Hypertension (high blood pressure) needing medication
   – Sleep apnoea (confirmed at a sleep clinic and treatment indicated)
   – Type 2 diabetes
   – Cardiovascular disease (heart disease, vascular disease or stroke)
   – Hypercholesterolaemia (high cholesterol with LDL >/4.1mol/l or HDL <1.0mmol/l (men) <1.3(women)

3. Patient must agree to engage with wraparound care (nutritional and dietetic advice, physical activity guidance and behavioural change) for at least 9 months from tirzepatide prescribing

   • From January 2027 there will be additional eligibility criteria: BMI ≥40 kg/m2* and at least three out of the five above qualifying co-morbidities.

Type 2 Diabetes

The same medications are already licensed and being prescribed by WLMC for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise. The criteria for this has been eased by NICE and NEL ICB in 2026.