whats the criteria to prescribe mounjaro on the NHS

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 6 February 2026Updated: 6 February 2026 Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Mounjaro (tirzepatide) prescribing criteria on the NHS focus on its indication for managing overweight and obesity as part of a comprehensive treatment plan including diet and physical activity.

Tirzepatide should be considered for adults with a body mass index (BMI) of 40 kg/m or more, or with a BMI between 35–40 kg/m if they have a significant weight-related health condition, such as type 2 diabetes, hypertension, or severe mobility problems.

Before prescribing, ensure the patient is motivated and understands the importance of lifestyle interventions alongside medication. The prescribing decision should follow a detailed discussion with the patient about the potential benefits and impact on motivation.

Prescribing tirzepatide requires monitoring and support for additional diet, physical activity, and behavioural strategies, and referral to specialist weight management services should be considered to assess eligibility for bariatric surgery if applicable.

Lower BMI thresholds (reduced by 2.5 kg/m) are recommended for people of South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean family backgrounds due to higher cardiometabolic risk at lower BMIs.

Continued prescribing depends on treatment response and adherence, with regular monitoring and reinforcement of behavioural advice. Consider micronutrient supplementation if there are concerns about nutritional adequacy, especially in older or growing individuals.

Additional context: In type 2 diabetes, tirzepatide as a GLP-1 receptor agonist may be considered for patients requiring further glycaemic control, particularly where weight management is an important goal, but prescribing should align with current diabetic management guidelines and individual clinical circumstances.

Prescribing must always be aligned with the Summary of Product Characteristics (SmPC) and local NHS commissioning policies.

References: tirzepatide prescribing criteria are primarily drawn from NICE technology appraisal guidance for tirzepatide and obesity management guidelines ,,.

Educational content only. Always verify information and use clinical judgement.