Some people with diabetes who live with obesity or overweight might be prescribed weight loss medication.
- Why would someone with diabetes be prescribed weight loss medication?
- Which weight loss medications are available on the NHS?
- Who can take weight loss medication?
- How do I access weight loss medication?
- Do weight loss medications have side effects?
- More information and support
Avoid buying weight loss medications online. These medications should be prescribed and monitored by a healthcare professional. Read our FAQs on GLP-1 agonist shortages for more information.
Why would someone with diabetes be prescribed weight loss medication?
Getting support to lose weight can have both physical and mental benefits.
Losing even 5% of your weight can improve blood pressure and cholesterol levels, and this can have a big impact on your health and reduce your risk of diabetes complications, such as heart disease and stroke.
If you live with obesity, your healthcare team can offer you advice about diet and exercise to help you manage your weight. Your healthcare professional may recommend you take a weight loss medication if you have already tried to lose weight through diet and activity.
You can read our guide to weight loss and diabetes to learn what’s a healthy weight to aim for, and how to lose weight if you need to. Weight loss medications should be taken alongside a healthy diet and regular physical activity.
Which weight loss medications are available on the NHS?
People with type 2 diabetes might be prescribed the following weight loss medications, which are licensed for weight loss on the NHS:
- Xenical – a brand name for orlistat. This is a tablet that you swallow that works by limiting the amount of fat your body absorbs from the food you eat. There are other brands of orlistat that can be bought without prescription from a pharmacy, but they must be taken under the supervision of a pharmacist.
- Wegovy – a brand name for semaglutide. This is an injection that you have once a week. Wegovy can lead to weight loss because it is designed to reduce appetite, so you eat less. It mimics the action of a gut hormone called GLP-1, which is released after eating, and it slows down the movement of food in your body, so you stay full for longer.
- Saxenda – a brand name for liraglutide. This is a type of GLP-1 agonist that is taken as an injection every day. Saxenda also helps to reduce appetite, so you eat less and feel full for longer.
Within the NHS, currently Wegovy and Saxenda can only be prescribed within a specialist weight management service. Xenical can be prescribed by your GP. - Mounjaro – a brand name for tirzepatide, is an injection that you take once a week. Mounjaro is a GLP-1 analogue that is combined with a GIP analogue (short for glucose-dependent insulinotropic polypeptide). Not yet available as a treatment for obesity on the NHS. It is expected to be rolled out on the NHS starting in April 2025.
These drugs are licensed to treat obesity for people living with type 2 diabetes and people without diabetes.
There are other drugs, such as Ozempic, which are used specifically for the treatment of type 2 diabetes but can also lead to weight loss for some people.
Who can take weight loss medication?
You should only be given a prescription for weight loss medications following an assessment by your healthcare team to make sure that you meet the criteria and that you’ll benefit from its use.
This should be an individual assessment that includes how weight loss medication will fit into your current treatment plan and considers any diet or activity programme that you are following, as well as the risk of side effects, the dose you’ll need, and your personal choices.
Normally, weight loss medications will only be prescribed after changes to diet and physical activity have been started and then reviewed by a healthcare professional.
| Drug | Prescription criteria |
|---|---|
| Xenical | Can only be prescribed when you have a Body Mass Index, also called BMI, of 30kg/m² or more, or 28kg/m² or more where you have other medical conditions such as type 2 diabetes or high blood pressure. |
| Saxenda | Can only be prescribed when you have a BMI of 35kg/m² or more, you have prediabetes or type 2 diabetes, and you're at high risk of heart problems such as heart attack and stroke. |
Wegovy | Can only be prescribed when you have a BMI of 30kg/m² and over, and at least one weight-related health condition, such as prediabetes or type 2 diabetes. |
Mounjaro | Can only be prescribed when you have a BMI of 35kg/m² or more (or a BMI of 30kg/m² if you live in Scotland), and have at least one weight-related health condition, such as prediabetes or type 2 diabetes. |
The National Institute for Health and Care Excellence, or NICE for short, recommends that people from Black African, African-Caribbean, Asian, South Asian, Chinese, and Middle Eastern family backgrounds receive weight loss medication at a lower BMI due to their risk from obesity-related health problems.
Who can’t take weight loss medication?
Some medications might not be suitable for some people, which might be because of medical conditions or other reasons:
- If you have kidney disease you might not be able to take weight loss medication, but this will depend on the stage of your kidney disease.
- If you have severe liver disease you might not be able to take weight loss medication.
- You might need to temporarily stop taking weight loss medications if you’re going to have an operation.
- You should not take weight loss medication if you are pregnant of breastfeeding. If you’re planning a pregnancy speak with a healthcare professional if you are using this medication.
There are also reasons why you might not be able to take individual weight loss medications:
- Xenical - You might not be able to take Xenical if you have a problem with your liver called cholestasis or if you have a condition that affects the way you absorb nutrients from food.
- Wegovy - Your doctor will tell you to stop taking Wegovy if you develop diabetic ketoacidosis, also called DKA.
- Saxenda - You might not be able to take Saxenda if you are over 75 years old, or if you have diabetic gastroparesis or inflammatory bowel disease.
- Mounjaro – You might not be able to take Mounjaro if you have delayed gastric emptying.
When you start a new medication always check with your healthcare team that it’s suitable for you to take.
How do I access weight loss medication?
It is important to speak to your GP, nurse or dietitian to discuss weight management options, including weight loss medication, that may be helpful for you.
Orlistat can be prescribed by your GP. Wegovy and Saxenda can only be prescribed through specialist weight management services, known as a tier 3 weight management service.
Mounjaro has been approved for treating obesity on the NHS but is not yet widely available. In England, NHS England are planning to improve weight management support services so that it will be accessible in primary care settings such as GP surgeries.
What are weight management services?
These services use a team of different clinical professionals to support with weight loss.
These teams often included specialist doctors, nurses and dietitians. Once you are referred to a specialised weight management service, you will be able to talk to your team to decide if weight loss medication is right for you.
Currently not all areas of the UK have specialist weight management services. You should speak with your GP or diabetes team to ask what is available in your area and whether it is suitable and available to you.
In June 2023, the Department of Health announced a two-year pilot to tackle obesity, which will explore how Wegovy can be prescribed outside of weight management services.
Diabetes medications and weight loss
Some people find that they lose weight when they use certain diabetes medications.
Weight loss can occur when taking medications such as metformin, Rybelsus or Ozempic, but these medications are not licensed for weight loss.
Do weight loss medications have side effects?
Like all medications, weight loss medications can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone that takes the medication will get them.
The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common then it can affect more than one in ten people, and if a side effect is very rare then it affects fewer than one in 10,000 people.
Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects.
| Drug | Common side effects |
|---|---|
| Xenical | Pain in the tummy and diarrhoea. These normally get better over time. |
| Wegovy | Nausea, constipation and diarrhoea. These normally get better over time. |
| Saxenda | Feeling or being sick, diarrhoea, constipation and headaches. These normally get better over time. |
| Mounjaro | Feeling or being sick, diarrhoea, and constipation. These normally get better over time. |
Risk of low blood sugar
Wegovy, Saxenda and Mounjaro do not often cause blood sugar levels to become too low, also known as hypoglycemia or a hypo, when they’re taken on their own. However, hypos are more common when you take these drugs with other diabetes medications such as insulin or a sulphonylurea.
Your healthcare team may advise reducing the dose of your insulin or sulphonylurea medicine when you start taking weight loss medications to reduce the risk of hypos.
Risk of high blood sugar
If you take Wegovy, Saxenda or Mounjaro and insulin, and your insulin doses are reduced too quickly, it can cause high blood sugar levels, also called hyperglycaemia, and there is an increased risk of diabetic ketoacidosis, also called DKA.
Risk of worsening retinopathy
If you have diabetic eye disease, also called diabetic retinopathy, and you are using insulin then Wegovy might make your retinopathy worse, and it may require treatment.
Tell your doctor if you have diabetic eye disease or if you experience eye problems while taking Wegovy.
These are not all the side effects. You will find a full list of known side effects in the Patient Information Leaflet. This comes in the medication box.
It's important that you take individual advice from your healthcare team before starting weight loss medication and report any side effects to your healthcare professionals, if you have any.
You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.
More information about a drug’s side effects will be contained in the Patient Information Leaflet which comes in the box of the medication.
More information and support
Still have more questions? Or is there anything you're not sure about weight loss medications after reading this page? Contact our helpline on 0345 123 2399.
You can visit the NHS website for more information on weight loss medications.
