Diary of a Medic

As a medic, I’ve seen the growing interest and importance of effective weight-management strategies including injectable medications. There is a lot of confusion as to whether weight loss injections like Tirzepatide (Mounjaro) are available on the National Health Service (NHS). On diaryofamedic.com, I aim to shed light on the strict regional criteria we must follow when prescribing on the NHS.

What Are Weight-Management Injections?

Mounjaro is the brand name for the medication Tirzepatide. It is a new type of weight-loss and diabetes injection that works by mimicking natural hormones in your body called incretins. These hormones (GLP-1 and GIP) play an important role in controlling your blood sugar and appetite. It is a weekly self-injection that helps suppress appetite, making you feel fuller for longer.

Mounjaro in a bit more detail:

• ✅ Improves insulin release – it tells your pancreas to make more insulin, but only when your blood sugar is high.
• ✅ Reduces sugar from the liver – it signals your liver to make less glucose, so blood sugar levels stay lower.
• ✅ Slows digestion – food moves more slowly through your stomach, helping you feel fuller for longer and reducing cravings.

By combining these effects, Mounjaro not only lowers blood sugar (including HbA1c levels) but also supports long-term weight loss when used alongside healthy eating and physical activity.

NICE (National Institute for Health and Care Excellence) provides evidence based guidelines for prescribing in England and Wales. NICE has awarded tirzepatide a green light for weight management in people with severe obesity and serious weight-related medical conditions.

Who’s Eligible—and Where?

The National Criteria for Mounjaro (NICE & NHS England) (As of August 2025)

• Eligible adults must have a BMI of 40 kg/m² or more (or 37.5 for some ethnic groups). I recently wrote a post about the importance of BMI in certain ethnic groups.
• Must also have at least four obesity-related health issues, such as type 2 diabetes, hypertension, high cholesterol, cardiovascular disease, or obstructive sleep apnoea.
• The rollout is phased: initially reserved for those with the most pressing clinical need, with around 220,000 patients expected to benefit over the first three years

My Experience: Navigating the Criteria as a Medic

In my day-to-day work within the NHS, I’ve seen how carefully we must assess eligibility and document comorbidities before considering tirzepatide. Here’s how the process typically unfolds:

1. Comprehensive Assessment: We evaluate BMI, review patient history, and confirm at least four weight-related conditions.
2. Referral to a Specialist Service (especially early roll-out phase) or Primary Care—if they’ve been authorised and trained to manage the treatment.
3. Wraparound Support: Beyond prescribing, we coordinate diet, exercise, behavioural advice, and follow-up monitoring.
4. Adhering to Local Policies: local guidelines must be followed. We also must consider external pressures like workload, limited clinic slots, and drug supply concerns and possible future tariffs.

Conclusion

Mounjaro and other weight-loss injections are changing the way we manage obesity and diabetes in the NHS. Right now, access is limited and only those who meet strict criteria can get them. But the future looks hopeful—guidelines may expand, and as these treatments become more available, more people could benefit.

For anyone struggling with weight and health, this could be a new way to kickstart your journey.

See my other posts on exercise and diet which are key components to long-term healthy weight loss.

References:
https://www.england.nhs.uk/ourwork/prevention/obesity/medicines-for-obesity/weight-management-injections/
https://www.nwlondonicb.nhs.uk/news/news/tirzepatide-and-nhs-north-west-london
https://www.nice.org.uk/guidance/ta1026

*As of August 2025, Eli Lilly, the manufacturer of Mounjaro has paused shipments to the UK: https://www.theguardian.com/business/2025/aug/28/weight-loss-drug-mounjaro-uk-price-rise-eli-lilly-pauses-shipments