For currently approved GLP-1 receptor agonists available for weight management in the UK, NICE has established specific eligibility criteria: Semaglutide (Wegovy) NICE TA875 recommends semaglutide for adults with: A body mass index (BMI) of 35 kg/m or above with at least one weight-related comorbidity (such as hypertension, dyslipidaemia, obstructive sleep apnoea, or cardiovascular disease), or A BMI of 3034.9 kg/m with at least one weight-related comorbidity, prescribed only in specialist weight management services Evidence of previous unsuccessful weight loss attempts through diet, physical activity, and behavioural interventions Treatment is limited to a maximum of 2 years Liraglutide (Saxenda) NICE TA664 recommends liraglutide for adults with: A BMI of 35 kg/m or above (with or without comorbidities), or A BMI of 3034.9 kg/m with at least one weight-related comorbidity Evidence of previous unsuccessful weight loss attempts Treatment is limited to a maximum of 2 years Both medications must be prescribed as part of a specialist weight management service providing multidisciplinary support, including dietary advice, physical activity programmes, and behavioural interventions
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Safety considerations: The FDA continues to crack down on compounded (non-FDA-approved) semaglutide and tirzepatide products due to serious safety reports tied to misdosing and sterility issues
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Considerations Oral semaglutide must be taken on an empty stomach with water (absorption issues)
