Injectable weight loss management options and their prescribing in Primary Care (eg Liraglutide (Saxenda), Semaglutide (Wegovy) and Tirzepatide (Mounjaro)
Injectable weight loss Liraglutide (Saxenda®), semaglutide (Wegovy®) and tirzepatide (Mounjaro®) are medications to help people living with obesity to lose weight, alongside a healthy diet and physical activity. Liraglutide is given as a daily injection, whilst semaglutide and tirzepatide are weekly injections. Liraglutide and semaglutide are used for up to 2 years. Tirzepatide may be used for longer. However, it is common to re-gain weight quickly after stopping these medications. They can be delivered using a pen device normally used by the patient themselves.
How is Mounjaro Taken?
- Mounjaro is given as a once-weekly injection using a pen-like device.
- You usually start on a low dose (2.5 mg) and gradually increase to a higher dose over several months, depending on how your body responds.
⚠️ Are There Any Side Effects?
Like all medicines, Mounjaro can cause side effects. The most common are:
- Nausea (feeling sick)
- Diarrhoea or constipation
- Loss of appetite
- Vomiting
These are usually mild and improve over time.
👉 Important for women using the pill: Mounjaro may reduce how well the contraceptive pill works. You’ll need to use extra protection (like condoms) for 4 weeks after starting or increasing your dose.
Currently Herts And West Essex ICB have strict prescribing criteria for injectable weight loss drugs and therefore their instruction is:
Injectable weight loss drugs cannot be taken over if started privately
Please see more in depth information on this guidance from Herts And West Essex ICB ICB Guidance – Implementation of Tirzepatide (Monjaro) in Primary Care Final
Centra East ICB Guidance on the NHS Prescribing of Mounjaro
From Monday 23rd June 2025, in line with NHS England Guidance, Mounjaro, will made available on the NHS. From this date Healthcare professionals can start a discussion with potentially eligible patients about using Mounjaro as part of their overall weight-loss journey.
It will be available initially for a small number of eligible patients whose body mass index is above 40 and have been diagnosed with four or more obesity-related health conditions
There is more information on eligibility below.
You may be considered for NHS funded treatment if it is considered the most suitable treatment option.
NHS England’s interim commissioning guidance sets out who may be eligible for Tirzepatide over the 3-year period from its introduction in June 2025.
Your eligibility for Tirzepatide will depend on your BMI and how many of
the following weight-related health conditions you have and have to be aged 18 or over
- High blood pressure (hypertension) — requiring treatment with medication
- Dyslipidaemia (abnormal blood fats, High cholesterol or triglycerides) — usually based on blood test results or if you take medication like statins.
- Obstructive sleep apnoea (OSA) — confirmed by a sleep study and requiring treatment, such as CPAP.
- Cardiovascular disease (Heart and blood vessel disease) — such as ischaemic heart disease, stroke, heart failure, or peripheral vascular disease. (This does not include conditions such as atrial fibrillation or valvular heart disease.)
- Type 2 diabetes
You may be eligible now if you have:
4 or more of the listed weight-related health conditions and a BMI of 40 kg/m2
or more.
From around June/July 2026 you may be eligible if you have:
4 or more of the listed weight-related health conditions and a BMI between 35 kg/m2
and 39.9 kg/m2
From around March 2027 you may be eligible if you have
3 of the listed weight-related health conditions and a BMI of 40 kg/m2 or more.
From June/July the practice will be be able to offer this to patients who meet the above criteria and Are willing to take part in a weight management programme, which includes
- Healthy eating support
- Physical activity
- Ongoing lifestyle advice
- ⚠️ Please note: This treatment is not a quick fix and must be used alongside lifestyle changes.
What Happens If You’re accepted for prescribing?
If you are accepted, a healthcare professional from the service will review your full clinical history and work with you to discuss the risks, benefits, and expectations of treatment. A final decision will be made together with you, based on whether Monjauro is appropriate for your individual circumstances.
If treatment goes ahead, you will need to take part in a 9-month healthy lifestyle wraparound support programme, which includes help with food choices, physical activity, and behavior change. If you are started on the medicine, you will be reviewed regularly to check your progress and whether the medicine should continue.
Private Prescribing
There are many private medical and pharmacy companies who will assess patients and prescribe to those who want to receive the treatment by funding it themselves.
In line with Good Medical Practice guidance, it is the responsibility of the prescriber to make an assessment of the patient and judge their suitability to receive the prescription.
Therefore, If you access weight management support through a private provider, the provider may requested that we (your GP practice) provide medical information for them to help them make safe decisions regarding your care.
The information can safely be given to the provider via the NHS app yourself. If you are unable to do this then we can supply the same information in a computer generated summary for you to forward, although we will make it clear that this does not mean we have made an assessment as to the suitability or safety of the private provider commencing a specific treatment.
The responsibility for prescribing your weight loss treatment sits with the company you have chosen.
Alternative Weight loss Support
If you are a Hertfordshire resident or patient living with obesity and you have not recently attended a free 12 week weight loss programme, you can access the My Healthy Weight Programme by TBC Healthcare. This is a 14 week programme, with a range of ways to access. You can self-refer here:
An alternative for patients living with obesity is the 12 week Shape Up Programme delivered by Watford Football Club. Originally just for men, there are now some sessions for women too. For more details, please see their website or email shapeup@watfordfc.com .
If you are living with obesity and also have diabetes or high blood pressure, the 12 week NHS National Digital Weight Management Programme could help you.
Specialist weight management service
My Healthy Weight Plus + provide 12 months of intensive support delivered by a team of specialists, including dieticians, physical activity specialists and psychologists. Each service has a range of ways to access which the service will discuss with you. My Healthy Weight Plus +. provided by TBC Healthcare. You can self-refer here.
This service can also help prepare and refer you for possible bariatric surgery (weight loss surgery), if that is the most appropriate option for you.