How GLP-1 weight-loss medicines are prescribed in the UK

A prescriber should know your height and weight, your medical history, your current medicines and whether you could be pregnant or are planning pregnancy. They should ask about previous pancreatitis, gallbladder disease, diabetic eye disease, kidney problems, thyroid cancer in the family and any history of an eating disorder.

The General Medical Council expects prescribers to work from enough information to make a safe decision, to explain alternatives and to keep records. The General Pharmaceutical Council applies similar standards to online pharmacies and prescribers working with them: a form alone is not generally considered enough for a medicine of this kind.

• Verified identity, so the person assessed is the person receiving treatment.

• Measured or verified weight and height rather than a number typed into a box.

• A conversation with a clinician, in person or by video or phone, where you can ask questions.

• A clear explanation of side effects, what to do if they occur, and who to contact.

• A plan for follow-up, dose changes and when treatment will be reconsidered.

On the NHS, access is governed by NICE appraisals and by local commissioning decisions. NICE has issued guidance on tirzepatide (TA1026) and semaglutide (TA875) for weight management, and wider obesity guidance (NG246). The NHS has been introducing tirzepatide in phases, starting with people at highest clinical need, so availability depends on where you live and when your area opens the next phase.

Depending on the area, the medicine may be started by a GP, a community weight-management service or a specialist hospital clinic. Treatment is normally offered alongside support with food, activity and behaviour change rather than as a stand-alone supply.

Privately, treatment can be started by a doctor, a pharmacist independent prescriber or another registered prescriber, face to face or remotely. The same legal rules apply: prescribing must be clinically justified and documented. Private services are not bound by NICE eligibility thresholds, which is why a careful assessment of risk and benefit matters even more than usual.

A private prescriber should be clear about what is on-label and what is not. Using these medicines outside their licence, for example at a lower BMI than the licensed threshold, is a clinical judgement that the prescriber owns and should explain openly.

These medicines are started at a low dose and increased in steps over weeks or months, because that helps tolerability. A prescriber should not simply issue a maximum-dose supply at the start. At each step they should ask about nausea, vomiting, constipation, abdominal pain, food intake and hydration.

The licence for each product sets out when to review whether it is working. If there has been little response after an adequate period at an effective dose, the sensible clinical option is usually to stop rather than continue indefinitely.

You do not have to tell your GP about private treatment, but doing so is strongly advisable. Your GP holds information that affects safety, such as other medicines, diabetes control and kidney function. Reputable services ask for consent to share information. Your GP is under no obligation to prescribe or monitor a medicine started privately, so agree beforehand who is responsible for what.

• Treatment is offered on the basis of a questionnaire alone.

• A specific brand or dose is promised before any assessment.

• No questions about pregnancy, past eating disorders or pancreatitis.

• Pressure to buy quickly, bundles or time-limited offers for a prescription-only medicine.

• No named prescriber or no registration number you can check.