Licensed criteria for adult weight management

The UK licence covers adults with a starting BMI of at least 30, or a BMI from 27 to below 30 with at least one weight-related condition. The product information lists examples including high blood pressure, abnormal blood fats, obstructive sleep apnoea, cardiovascular disease, prediabetes and type 2 diabetes.

Starting BMI means the measurement when treatment begins. Keep reliable records of your starting weight, height and past prescriptions when you change provider. A lower BMI after successful treatment does not on its own decide whether maintenance treatment is right for you.

BMI starts the assessment

BMI relates weight to height and helps define who the licence covers. BMI says nothing about body composition, nutrition, pregnancy, illness or your full pattern of weight-related risk. Your prescriber should read the number alongside your medical history, health goals and other treatments.

NICE's NHS recommendation uses different criteria from the marketing authorisation, with lower BMI thresholds for specified ethnic backgrounds. Funding criteria and licence wording are two separate sets of rules. Your clinician should tell you which rule applies to your prescription and why.

When you need a more careful discussion

A history of pancreatitis, severe gastrointestinal disease, diabetic retinopathy, repeated dehydration, frailty or a complex list of medicines may shift the balance of benefit and harm. An allergy to tirzepatide or a listed ingredient is a contraindication. Some cautions are not absolute bans. Meeting the BMI threshold also does not override a safety concern.

Talk about pregnancy plans, including contraception, before treatment starts. If you take an oral contraceptive, you need specific advice about extra protection when you start tirzepatide and after each dose increase. A history of an eating disorder or current restrictive eating calls for a sensitive assessment. A quick approval based on weight alone falls short.

Diabetes prescribing is a different indication

The September 2026 UK product information covers insufficiently controlled type 2 diabetes in adults and in children and adolescents aged 10 and above. This use has its own treatment considerations. The lower age limit does not authorise Mounjaro for weight management in children.

You do not need diabetes to qualify under the licensed obesity indication. Nor is a diabetes prescription a workaround for someone below the weight-management threshold. Your clinical record and follow-up plan should state clearly which condition is being treated.

What a good consultation covers

Expect questions about your medicines, past treatment, weight history, relevant diagnoses and symptoms. Safe remote prescribing includes independent checks on the information you give. Tell the prescriber about another provider's prescription, a recent break in treatment or use of unregulated products. Hidden treatment creates risks of doubling up or wrong doses.

Ask which outcome will be reviewed, who to contact about side effects and what happens if treatment needs to stop. Eligibility is your entry into an ongoing care plan, and more than a one-off permission to buy a pen.

Sources

Your own medicine leaflet and prescriber come first. A source from another country does not mean the same rule applies in the UK.

  1. Mounjaro UK Summary of Product Characteristics, updated September 2026 medicines.org.uk
  2. NICE TA1026: recommendations nice.org.uk
  3. NICE: prescribing, reviewing and stopping tirzepatide nice.org.uk
  4. GPhC: guidance for pharmacies providing services at a distance assets.pharmacyregulation.org

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