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Tirzepatide (Mounjaro): weight loss
This information aims to provide information relating to tirzepatide (Mounjaro) as it is released from NHSE and in line with local implementation plans.
Introduction
Tirzepatide (Mounjaro) is a weight loss drug that, up to now, has only been prescribed for people with type 2 diabetes.
NICE published guidance on 23 December 2024 recommending that tripeptide (Mounjaro) be considered a treatment option for managing overweight and obesity, alongside a reduced-calorie diet and increased physical activity.
Tirzepatide (Mounjaro) criteria
Initially, because of the impact on services, NICE agreed that NHS England should publish criteria for the priority cohorts for Tirzepatide (Mounjaro).
Those priority cohorts are:
Year
Estimated Duration
Cohort
Cohort description (based on comorbidities)
BMI
1
12 months
i
more than 4 qualifying comorbidities
greater than 40
2
9 months
ii
35-39.9
2/3
15 months
iii
3 qualifying comorbidities
The Qualifying Co-morbidities are as follows:
Qualifying Co-morbidities
Definition
Atherosclerotic Cardiovascular Disease (ASCVD)
Established ASCVD (ischaemic heart disease, cerebrovascular disease, peripheral vascular disease, heart failure)
Hypertension
Established diagnosis and requiring blood pressure lowering therapy
Dyslipidaemia
Treated with lipid-lowering therapy, or LDL lower than/equal to 4.1 mmol/L, or HDL lower than 1.0 mmol/L for men or HDL lower than 1.3mmol for women, or fasting triglycerides lower than/equal to 1.7 mmol/L
Obstructive Sleep Apnoea (OSA)
Established diagnosis of OSA (sleep clinic confirmation via sleep study) and treatment indicated i.e. CPAP or equivalent
Type 2 diabetes
Established diagnosis
Over time, these cohorts will be expanded to include the full criteria for tirzepatide (Mounjaro) which are:
People over the age of 18 who have a body mass index (BMI) of 35 or over (or a BMI of 32.5 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, as they are at a higher risk of medical problems at a lower BMI) and one of the above weight-related co-morbidities. Weight loss injections are not suitable for patients who:
Please also see the product SmPC for a complete list of prescribing cautions and contraindications.
Wrap-around care The NICE TA1026 mandates provision of wrap-around care alongside the prescribing of tirzepatide (Mounjaro). NHSE expects that this will incorporate nutritional and dietetic advice as a minimum and access to behavioural change components, as a mandatory requirement to access treatment.
Further information
BMA: Tirzepatide (Mounjaro) for weight management in General Practice
Private prescribing
Online purchase
The UK medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA) warns against buying weight loss medicines without a prescription.