GLP-1 injections for weight loss and diabetes

You may have seen information in the media recently about the release of NICE guidance (TA1026) Mounjaro (Tirzepatide) injections for managing Obesity and Overweight in Adults, as well as its use to treat Type 2 Diabetes.

GLP-1 medicines and what they are used for

Glucagon-like peptide-1 receptor agonists (GLP-1s or GLP-1RAs) are medicines that help people feel fuller by mimicking a natural hormone released after eating. Some newer medicines, like Mounjaro, also act on a second hormone involved in appetite and blood sugar control. You may see them referred to in the media as “weight loss injections” or “skinny jabs” but not all of these medicines are authorised for weight loss.

In the UK, there are several licensed GLP-1 medicines including semaglutide (sold under the brand names Wegovy, Ozempic and Rybelsus), tirzepatide (Mounjaro) and liraglutide (sold under various brand names). “Licensed” means they have been assessed carefully by the UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), and approved as safe and effective for certain uses, outlined in the table below.

The MHRA has not assessed the safety and effectiveness of these medicines when used outside of their licensed use, for example when used for weight loss in people who are not obese or overweight.

GLP-1s are medicines licensed to treat specific medical disorders and should only be used if you are overweight or diabetic, and not if you want to lose weight for aesthetic or cosmetic purposes.

Mounjaro for Obesity:

Alert

From 23rd June 2025 GPs will be able to prescribe Mounjaro on the NHS to certain cohorts of patients that meet strict eligiblity criteria. 

This service has not yet been developed by NHS Devon and we are currently unable to initiate prescribing for Mounjaro to patients for Obesity until this has been agreed and developed. 

Warning

NHS Devon are advising against the independent initiation of tirzepatide (Mounjaro®) prescribing for weight management until the point at which further guidance is provided.

Cohorts for Mounjaro prescribing in General Practice

NHS England have defined the first 3 cohorts of patients who will be able to access Mounjaro via their GP on the NHS. 

The cohorts have been decided nationally by NHS England, this is to prioritise treatment by clinical need.

The initial first 3 years will see approximately 220,000 individually nationally become eligible for treatment on the NHS. 

At a practice level, we estimate that the number of our patients eligible for Mounjaro for weight management will be less than 50

It is expected that after the first 3 years, the cohorts for eligiblity will expand again; however this is to be confirmed. 

The interim commissioning policy from NHS England can be viewed here: Interim commissioning guidance NICE TA1026 - Mounjaro for the management of obesity

Expand the buttons below to view the cohorts as defined by NHS England. 

Cohort 1: 23 June 2025

A BMI of 40 or higher, or 37.5 or higher if from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.

At least 4 of the following comorbidities:

  • Hypertension and on treatment for blood pressure
  • Dyslipidaemia (high cholesterol) or on cholesterol treatment "statins"
  • Obstructive Sleep Apnoea 
  • Cardiovascular disease 
  • Type 2 diabetes
Cohort 2: June 2026 (exact date to be confirmed)

A BMI of 35 or higher, or 32.5 or higher if from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.

At least 4 of the following comorbidities:

  • Hypertension and on treatment for blood pressure
  • Dyslipidaemia (high cholesterol) or on cholesterol treatment "statins"
  • Obstructive Sleep Apnoea 
  • Cardiovascular disease 
  • Type 2 diabetes
Cohort 3: April 2027 (exact date to be confirmed)

A BMI of 40 or higher, or 37.5 or higher if from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds.

At least 3 of the following comorbidities:

  • Hypertension and on treatment for blood pressure
  • Dyslipidaemia (high cholesterol) or on cholesterol treatment "statins"
  • Obstructive Sleep Apnoea 
  • Cardiovascular disease 
  • Type 2 diabetes
I think I meet the criteria for Cohort 1, what do I do?

If you feel that you meet the criteria in Cohort 1, the first step is to contact the practice to provide an up to date height and weight, so that we can calculate your BMI. 

We will then check your other conditions (comorbidities) to confirm whether or not you meet the criteria. 

If your BMI and comorbidities suggest you may be suitable for Mounjaro, we will then contact you to book an appointment with our Specialist Pharmacist. 

Please note that you will also be weighed by the practice at this appointment. 

You will also be required to engage in a weight management support programme which will be commissioned nationally by NHS England to support patients being prescribed Mounjaro. This is a condition of prescribing set by NHS England.  

There are a number of local weight management services currently available for people living with obesity or overweight,  and we are happy to discuss these and support you with your weight management goals.

Here is a link to the Services available in Devon

MyHealthDevon - Weight Management

Mounjaro for Type 2 Diabetes:

Alert

Mounjaro is licensed to treat some patients with type 2 diabetes under NICE TA924.

It is not suitable for everyone with Type 2 diabetes, and there are oral medications that we would prescribe first, before even considering if Mounjaro is a suitable option.

More information on the use of Mounjaro for Type 2 Diabetes can be found on the Diabetes UK site

Important

If after reading the Diabetes UK article above, you think that you may be suitable for Mounjaro to treat your Type 2 Diabetes, please contact the surgery to book an appointment with Catherine, our Diabetes Specialist.