THEY are arguably the biggest medical breakthrough of recent times.
And from this week, so-called ‘fat jabs’ will be made available to many more Brits on the NHS.
GPs can now prescribe the weight-loss jab Mounjaro in the first anti-obesity rollout of its kind[/caption]
Health chiefs hope the Mounjaro rollout will turn the tide on England’s obesity crisis[/caption]
In what marks the dawn of a new era, GPs have begun prescribing the weight loss jab Mounjaro in the first anti-obesity rollout of its kind.
More than three million people are thought to be eligible for tirzepatide – the active drug in Mounjaro – the strongest jab on the market.
Health chiefs hope it will turn the tide on England’s obesity crisis which has seen rates double since the 1990s.
Injections including Ozempic and Wegovy have previously only been available for type 2 diabetes or through specialist slimming clinics.
Family doctors will now be encouraged to prescribe them in a bid to get more people on the meds.
Experts hope widespread use will slash work sick days and boost the economy, while reducing rates of cancer, heart disease and dementia.
But demand for the drugs is already huge and NHS clinics cannot dish them out fast enough.
From the exact weight you need to be to be eligible to what to do if your GP refuses you a prescription, here is everything you need to know now the rollout has begun.
What is Mounjaro and what has it been used for so far?
Studies found Mounjaro caused 20 per cent weight loss over 18 months[/caption]
FOR anyone who has missed the frenzy, Mounjaro, aka tirzepatide, is the newest weight loss injection used on the NHS.
It has been around since 2022 and triggers fullness hormones in the gut to prevent hunger and over-eating.
This works the same as older jabs Wegovy and Ozempic, all known as GLP-1 agonists, but a recent trial showed it is more effective.
A head-to-head study in the New England Journal of Medicine found Mounjaro caused 20 per cent weight loss over 18 months, while semaglutide – the active ingredient in Wegovy and Ozempic – led to 14 per cent.
All the jabs were originally invented to treat type 2 diabetes but trials found they could also cause major weight loss.
Pharma firms have cashed in on the discovery and UK prescriptions have skyrocketed.
NHS prescriptions of Mounjaro in England surged from just 3,300 in 2023 to 1.1million last year, and more than a million people are estimated to be buying it online.
Who is eligible in the new rollout?
THE new rollout allows GPs to prescribe tirzepatide for weight loss, starting with those patients whose weight places them at greatest health risk.
Top of the list will be those with a body mass index (BMI) of 40 or higher (or 37.5 if from a minority ethnic background) and four weight-related health conditions.
A BMI of 40 is roughly equal to weighing 16st (102kg) for an average height 5’3” woman, or 19st 6lbs (123kg) for an average 5’9” man.
Weight-related conditions include high cholesterol, high blood pressure, prediabetes, type 2 diabetes, obstructive sleep apnoea and heart disease.
High cholesterol
Everyone needs some cholesterol in their blood to stay healthy. But too much can lead to serious health problems.
If there is an excess, it can clog your arteries – the large blood vessels that carry blood around your body.
Fatty areas can form then harden over time, causing blockages, which puts strain on your heart and can result in blood clots.
This clogging process, known as atherosclerosis, can mean coronary heart disease, angina, heart attack, heart failure, stroke, mini strokes, peripheral arterial disease, and vascular dementia.
Unfortunately, most people don’t know they have high cholesterol because it doesn’t usually have any symptoms.
You can have your levels checked via a blood test at your GP surgery.
Some pharmacies also offer the service, but you might have to pay.
If you’re over 40, you may have a test during your NHS Health Check. You can also get this check at a pharmacy.
Generally, healthy cholesterol level are:
- Total (serum) cholesterol (mmol/L below 5.0 and mg/dL below 193)
- Non-HDL cholesterol (mmol/L below 4.0 and mg/dL below 155)
- LDL cholesterol (mmol/L below 3.0 and mg/dL below 116)
- HDL cholesterol (mmol/L above 1.0 for a man and 1.2 for a woman and mg/dL above 39 for a man and 46 for a woman)
- TC:HDL ratio (mmol/L and mg/dL above 6 is considered high risk)
Your doctor will be able to explain what your results mean.
There are treatments available for high cholesterol, but it’s usually possible to lower it naturally with healthy lifestyle changes.
High blood pressure
Blood pressure readings consist of two numbers, shown as one on top of the other.
The first (top) number is your systolic blood pressure – the force at which your heart pumps blood around your body, according to Blood Pressure UK.
The second (or bottom) number is your diastolic blood pressure – the resistance to the blood flow in the blood vessels between heartbeats when blood is pumped around your heart.
An ideal blood pressure reading is between 90/60mmHg (millimetres of mercury) and 120/80mmHg.
You have high blood pressure if your readings are consistently above 140/90mmHg.
If you’re over the age of 80, high blood pressure is considered to be from 150/90mmHg.
You can have your blood pressure checked at your GP surgery, pharmacies and some workplaces[/caption]
If your blood pressure is too high, it puts extra strain on your blood vessels, heart and other organs, such as the brain, kidneys and eyes, the NHS says.
Persistent high blood pressure can increase your risk of a number of serious and potentially life-threatening health conditions, such as heart disease, heart attacks, stroke, heart failure and kidney disease.
If you are one of the 14.4million Brits with high blood pressure, reducing it even a small amount through healthy eating, exercise and medication can help lower your risk of these health conditions.
You can get your blood pressure tested at your local GP surgery, some pharmacies and some workplaces.
Type 2 diabetes
Almost four million people have type 2 diabetes in the UK.
It’s when a hormone called insulin doesn’t work properly or there is not enough of it.
This causes the level of glucose (sugar) in your blood to become too high.
Having the condition increases your chances of getting other long-term health problems such as heart disease, foot ulcers and blindness.
Typical symptoms include feeling very thirsty, peeing more often and extreme tiredness.
Type 2 diabetes is diagnosed with a blood test that checks how high your blood glucose levels are.
You can check your risk using Diabetes UK’s Know Your Risk tool or by having a free NHS Health Check if you’re aged 40 to 74.
Obstructive sleep apnoea
Sleep apnoea is when your breathing stops and starts while you sleep.
It needs to be treated because it can lead to more serious problems.
Symptoms include:
- Breathing stopping and starting
- Making gasping, snorting or choking noises
- Waking up a lot
- Loud snoring
During the day, you may also:
- Feel very tired
- Find it hard to concentrate
- Have mood swings
- Have a headache when you wake up
It can be hard to tell if you have sleep apnoea. It may help to ask someone to stay with you while you sleep so they can check for the symptoms, or to record you as you snooze.
You should see a GP if you suspect you have it. They may refer you to a specialist clinic for tests.
Heart disease
Around 7.6million people in the UK live with heart and circulatory diseases.
If you notice any of the following symptoms, you might be one of them:
- Chest pain
- Feeling sick
- Stomach pain or indigestion
- Feeling sweaty or clammy
- Leg, arm, jaw or back pain
- A choking sensation
- Swollen ankles
- Extreme fatigue
- Irregular heartbeat
If a doctor feels you’re at risk of heart disease, they may carry out a risk assessment.
This might include your medical and family history, your lifestyle, a blood test, ECG, chest X-ray or angiogram.
Wes Streeting wants a more widespread use of the drugs but patients must also receive check-ups[/caption]
Patients will likely be expected to have tried diet and exercise first before being offered a jab.
Many are likely to miss out, as some 13.5million adults in England are obese but only 3.4million are estimated to be eligible in the rollout.
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: “Currently only patients who meet certain criteria – those who could benefit most – are eligible to be prescribed weight loss drugs on the NHS, and GPs will also need to follow local guidelines when prescribing.
“If your practice advises you that they won’t be able to provide weight loss medication, these will likely be the reasons why.
“We appreciate the idea of weight loss medication is an attractive prospect to many patients – and they do have a lot of potential benefits for patients and may be a valuable tool as we try to tackle obesity at a national level – but it’s important these medications aren’t seen as a silver bullet.
“Weight loss drugs do not come without risk, they can cause side effects which range in seriousness, and they won’t be suitable for everyone.
“It’s important we don’t lose sight of the role lifestyle factors play in achieving a healthy weight.
“The roll out of weight loss medications as a treatment for obesity must not come at the expense of other weight loss services.”
How will the rollout be run and what is new?
WHAT’S new is that the rollout will be the first run by NHS primary care, led by GP surgeries.
In theory this should make life easier for patients – but GPs will not be able to meet the huge demand.
NHS bosses have admitted it will take a staggering 12 years to treat everyone who is eligible.
Just 220,000 extra people are likely to get Mounjaro by 2028.
Private prescriptions, costing about £100 to £150 per month, already vastly outnumber that and are rising.
Health Secretary Wes Streeting wants a faster rollout and more widespread use of the drugs but patients must also receive regular check-ups and lifestyle help.
Officials are investigating whether they can dish them out through pharmacies or the NHS app to take a load off GPs.
Professor Jason Halford, of the European Association for the Study of Obesity, said: “These drugs have the potential to help millions.
“If the government and NHS are serious about prevention they need to reconsider their position on the speed of the rollout of these drugs.”
Professor John Deanfield, a heart doctor at University College London, added: “These drugs provide a real opportunity to delay many diseases of ageing all at the same time and potentially transform society.
“I hope it won’t take 10 years to do something that is so needed.”
Are you guaranteed Mounjaro if you meet the criteria?
IN short, no.
Firstly, there is the simple issue of supply.
Malcolm Harrison, chief executive of the Company Chemists’ Association, told the BBC: “It is unlikely that the planned GP provision will be sufficient to meet patient demand.”
But weight loss jabs are also relatively new – Mounjaro has only been around since 2022 – so some GPs and other healthcare staff will need training in how to offer them safely.
This will take time, and surgeries will need to stagger their prescriptions.
Once we are able to prescribe weight loss injections they will be offered to those with the highest medical need only, which may mean that a lot of patients will be disappointed
Fairhill Medical Practice in Kingston upon Thames
Patients must also be offered what’s known as “wrap-around care” – including time-consuming check-ups, support with exercise and advice on healthy eating.
Then there will be some people who can’t take Mounjaro immediately. For example, those who are pregnant or breastfeeding.
Pancreatitis and certain thyroid tumours can also take you off the list.
Dr Charlotte Refsum, director of health policy at theTony Blair Institute for Global Change, said: “If the UK is to take advantage of the transformational impact these medications could have on our health and economy, rollout must go further and faster.
“Insisting that the drug only be made available through the GP creates a huge bottleneck to supply.
“Many patients will be contacting their GPs in excitement, only to be met with the news that they are not yet eligible.
“We need a new approach to the way we value, fund and deliver prevention – meeting people where they are – which is online, at home and in the high street.”
What if my GP says no?
If you are eligible but your GP denies you a prescription, you may be able to ask for a referral to specialist weight management services[/caption]
MANY people are expected to miss out.
Experts warn only 220,000 people out of the 3.4million who are eligible are likely to get jabs by 2028, so some surgeries are already pouring cold water on patients’ hopes.
Fairhill Medical Practice in Kingston upon Thames said: “Once we are able to prescribe weight loss injections they will be offered to those with the highest medical need only, which may mean that a lot of patients will be disappointed.”
Millions who meet the prescription criteria will simply have to be denied the drugs because doctors are so busy.
On top of everything else England’s 6,300 doctors’ surgeries have to deal with, they do not have the capacity to offer the necessary long-term supervision for millions more people at once.
Experts reckon private prescriptions will rocket even more as frustrated patients give up waiting.
If you are eligible but your GP denies you a prescription, you may be able to ask for a referral to specialist weight management services.
Known as tier 2 and tier 3 weight management services, they may prescribe the jabs after other weight loss attempts.
When might I be able to get my hands on jabs?
INTERIM guidance from NHS England suggests Mounjaro will be available to 220,000 people over the next three years.
The current plan suggests it may be available in phases:
- June 2026: expanded to include people with a BMI of 35 to 39.9 who have four weight-related health conditions
- April 2027: also offered to people with a BMI of 40 and above who have just three weight-related health conditions
The health watchdog, NICE, will monitor the rollout and determine when is the right time to open out more widely.
Dr Hawthorne said: “The roll-out of weight loss medications in the NHS will need to be consistently evaluated to ensure that there is evidence that these prescriptions are of long-term benefit to patients.”
Where else can you get Mounjaro?
MANY people are expected to find it easier to go private, with the injections widely available from high street pharmacies like Boots, Superdrug, and even Asda.
There are also numerous online pharmacies offering the drugs.
Olivier Picard, of the National Pharmacy Association, said: “NHS provision won’t meet demand straight away, so we fully expect that many people will continue seeking it privately.”
Advice for people buying them privately
BUYING the drugs online might seem like the faster fix – but buyer beware.
Slimming success stories are everywhere but so, too, are tales of horror.
Many patients have been duped by dodgy sellers, suffered severe side effects or even died after taking jabs they bought online.
Bargain prices, easy tick-box applications, or prescriptions with no follow-up, should all be red flags to online shoppers.
Many pharmacies have been rapped for giving them away to people who do not meet the obesity criteria, potentially putting their health at risk.
Dose strength is partly based on size and pretending you are fatter than you are could mean you end up with a medication too strong for your body, raising the risk of serious side effects.
The most common side effects from the injections include feeling sick, vomiting, diarrhoea or other gut troubles.
If not treated properly people can suffer more serious impacts like dehydration, gallstones, pancreatitis or allergic reactions – and more than 100 deaths in the UK have so far been linked to the jabs.
The General Pharmaceutical Council issued new rules in February to say that all pharmacies must verify a patient’s height and weight, and conduct at least a video call – if not face-to-face appointment – before prescribing weight loss injections.
Dr Emily Pegg, associate vice president at Lilly, which makes Mounjaro, said: “This is still a prescription-only medicine, should only be prescribed by a registered healthcare professional and needs to be dispensed by a registered pharmacy.
“It is not something that people should be able to buy by just going out and going on to a social media site and clicking a button and it gets delivered to them.
“That is not appropriate and is probably illegal.
“Patient safety is a high priority.”
Everything you need to know about fat jabs
Weight loss jabs are all the rage as studies and patient stories reveal they help people shed flab at almost unbelievable rates, as well as appearing to reduce the risk of serious diseases.
Wegovy – a modified version of type 2 diabetes drug Ozempic – and Mounjaro are the leading weight loss injections used in the UK.
Wegovy, real name semaglutide, has been used on the NHS for years while Mounjaro (tirzepatide) is a newer and more powerful addition to the market.
Mounjaro accounts for most private prescriptions for weight loss and is set to join Wegovy as an NHS staple this year.
How do they work?
The jabs work by suppressing your appetite, making you eat less so your body burns fat for energy instead and you lose weight.
They do this my mimicking a hormone called GLP-1, which signals to the brain when the stomach is full, so the drugs are officially called GLP-1 receptor agonists.
They slow down digestion and increase insulin production, lowering blood sugar, which is why they were first developed to treat type 2 diabetes in which patients’ sugar levels are too high.
Can I get them?
NHS prescriptions of weight loss drugs, mainly Wegovy and an older version called Saxenda (chemical name liraglutide), are controlled through specialist weight loss clinics.
Typically a patient will have to have a body mass index (BMI) of 30 or higher, classifying them as medically obese, and also have a weight-related health condition such as high blood pressure.
GPs generally do not prescribe the drugs for weight loss.
Private prescribers offer the jabs, most commonly Mounjaro, to anyone who is obese (BMI of 30+) or overweight (BMI 25-30) with a weight-related health risk.
Private pharmacies have been rapped for handing them out too easily and video calls or face-to-face appointments are now mandatory to check a patient is being truthful about their size and health.
Are there any risks?
Yes – side effects are common but most are relatively mild.
Around half of people taking the drug experience gut issues, including sickness, bloating, acid reflux, constipation and diarrhoea.
Dr Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the more uncommon side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, gallbladder problems and hypoglycemia.
Evidence has so far been inconclusive about whether the injections are damaging to patients’ mental health.
Figures obtained by The Sun show that, up to January 2025, 85 patient deaths in the UK were suspected to be linked to the medicines.
The future of fat jabs
WHILE the Mounjaro rollout is expected to kick off with a whimper and not a bang, it is hoped it will mark the beginning of a new era in weight loss medicine.
Brits have been getting gradually fatter for decades and no medication or government policy has managed to beat the bulge.
The drugs appear super-effective, reasonably priced and relatively safe, and could help millions slim down after failed diets.
They are expected to reduce the risks of type 2 diabetes, cancer and dementia.
And studies increasingly show they improve health in other ways on top of weight loss, too, reducing the risk of heart attacks and strokes.
NHS medical director, Professor Sir Stephen Powis, believes they could one day be as transformative as cholesterol-lowering statins, which have slashed heart attacks since they were rolled out decades ago.
Prof Powis said: “I think over time it’s highly likely that these drugs will become more widespread.
“I think there will be a combination of increased evidence of positive outcomes and costs dropping, and we will learn better how to deploy them.
“This is very exciting – we’re in the foothills of learning how to use them.”
