As weight loss drugs become more widely available, we take a look at these ‘miracle’ medications and why for Calinda Robinson, 31, moving to the UK opened her eyes on her morning commute
From June this year, NHS England GPs have been able to prescribe Mounjaro (tirzepatide) injections – but with strict criteria. Dubbed a ‘miracle’ weight loss drug, it was originally licensed for type 2 diabetes treatment, but it also has appetite-suppressing properties.
The medication works by activating two receptors called GLP-1 and GIP to increase the level of incretins – hormones – in the body. It helps your body produce more insulin when needed, reduces the glucose produced by the liver and slows down the rate of food digestion, all helping to lower blood sugar levels.
In England, an estimated 3.4 million people will be eligible for this medication in the long term, but it’s expected that just 220,000 people will be able to access Mounjaro in the first three years, as it will initially be rolled out to those with the greatest need.
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As a result of long NHS waiting lists, many Brits purchase the weight loss medication privately for around £200 a month, but users should still seek the advice of a healthcare professional. Highlighting the importance of a blood test in confirming patient suitability for GLP-1 medications, Rachael Joy, chief clinical officer at SheMed (shemed.co.uk), says, “These medications can pose risks if underlying conditions like liver issues, thyroid dysfunction or high triglycerides go undetected, which is common in self-reported, online prescriptions. Without lab work, patients may be unknowingly put at risk. To ensure safety and effectiveness, blood testing must be a standard part of obesity treatment for every patient.”
Here are some useful things to know about GLP-1 medications and weight management..
Eligibility
Patients currently need a Body Mass Index (BMI) of40 or higher to be eligible for Mounjaro on the NHS, but if you’re from a Black, Asian or other minority ethnic background, you may be eligible with a BMI of 37.5 or over. You’l lalso need to have been diagnosed with four of five weight-related health issues: Type 2 diabetes, high blood pressure, heart and vascular disease, high cholesterol and obstructive sleep apnoea.
BMI calculations
Your BMI is calculated by comparing your height and weight, with ethnicity also taken into account. This measurement has faced criticism for not considering muscle mass, health conditions and gender, but it still remains the most common method for assessing obesity. The NHS provides an online BMI calculator. According to this tool, a BMI of 18.5-25 is healthy, below 18.5 is underweight, 25-30 is overweight, and over 30 is obese.
Location matters
While the core eligibility criteria for Mounjaro injections are set nationally, the rollout is managed at a local level by Integrated Care Boards (ICBs). This can lead to variations in how the drug is prescribed. While GPs can prescribe Mounjaro in England, the injections are currently only accessible via specialist weight management services in Wales. Northern Ireland is implementing a regional obesity management service and the Scottish Medicines Consortium (SMC) has also approved the use of Mounjaro, but with a lower BMI requirement.
Lifestyle changes
Even if receiving a GLP-1 prescription, lifestyle changes and medical aftercare are still required. Katharine Jenner, director of the Obesity Health Alliance, says, “We welcome investment that helps people living with excess weight access much-needed support, but drugs alone are not the solution.” Nutritionist and psychologist Dr Naomi Newman-Beinart adds that a healthy lifestyle is important. She says, “GLP-1s can be a helpful tool, but they work best as part of a bigger picture, and always with proper medical support.”
Future drugs
For people who don’t qualify or live in regions where GPs aren’t offering the treatment, BBC Morning Live’s Dr Xand van Tulleken said, “If you think these drugs would help but you don’t meet the criteria, I think it’s worth saying there are lots of drugs in the pipeline, and it is very likely that the price can come down. I think over the next few years, the picture is optimistic for people who want these drugs.”
For Calinda Robinson, 31, from Tennessee, Mounjaro changed everything. She has been on a weight-loss programme since moving to London, and was careful to choose one that carried out in-depth checks. It was a moment one morning on her commute to work that gave her the push she needed.
“I moved to London in July 2023 and realised that the city is not designed for large sizes. On my first day of commuting to work, I realised how much I stood out in the crowd. The seats on the Victoria line are very snug and when the crowds entered I found myself shrinking back and trying to make myself take up less space.
“I have always been large, even as a teenager at high school, and despite running three miles a day my weight never budged. I have a thyroid condition, which makes it harder to lose weight, and I accepted I was always going to be big.
“When everyone started talking about weight loss jabs, I was sceptical at first. I’d tried many things and nothing seemed to work. But after doing some research I ordered from a reputable company, knowing that if I experienced any side effects a clinician would talk to me directly. It felt like someone was there, holding my hand.
“After six weeks I noticed I hadn’t touched any of my snacks and I was not going for seconds at dinner. Eight weeks later I had to buy new trousers. I started at 116kg and I’m now 75kg – down 41kg.
“The medication makes me feel powerful, like I can finally take control of my health. It’s good to see the NHS making this medication more accessible to those who need it. I really think that having a clinician hear your concerns and be proactive with healthcare makes all the difference. I have never felt as confident in my life.”
