Prescribers need to be sure the drugs will be safe and effective (Picture: Getty Images)
For many Brits struggling to lose weight, drugs like Mounjaro and Wegovy have been hailed as game-changers — helping them shed pounds at a speed previously only possible with surgery.
But while demand for the jabs has exploded, some are discovering they can’t actually get them, despite being willing to pay privately or meeting the BMI criteria on paper.
According to digital healthcare platform ZAVA, thousands of Brits are being turned away for GLP-1 jabs due to hidden health reasons.
There’s a whole host of conditions can make the drugs unsuitable — or even dangerous — for patients, from digestive disorders to mental health issues.
And experts are urging people to understand these eligibility rules before pinning their hopes on a prescription.
BMI eligibility criteria
One of the most common reasons people are turned away is because they don’t meet the strict BMI requirements needed to qualify for treatment.
Dr Kathryn Basford at Asda Online Doctor tells Metro that GLP-1 medications are ‘designed to treat obesity as a medical condition’ and are ‘not intended for cosmetic weight loss alone’.
As such, the drugs are usually only prescribed to people who meet specific BMI thresholds, sometimes alongside additional weight-related health conditions.
BMI criteria for a Mounjaro or Wegovy prescription
Mounjaro
Currently, patients need a BMI of at least 35 to 39.9, as well as four or more weight-related health conditions to access this GLP-1 drug on the NHS. From next year, however the requirement changes to a 40+ BMI with three or more health conditions.
Wegovy
To be prescribed Wegovy, the other medication of this type approved on the NHS for weight loss purposes, a BMI of over 35, as well as at least one weight-related comorbidity (such as type 2 diabetes, hypertension or obstructive sleep apnoea) is required.
When it comes to private prescriptions for either jab, you typically need a BMI of 30+, or between 27 and 29.9 alongside a weight-related health issue.
In both cases, however, doctors can refuse a prescription if there are indications the treatment may be unsafe or ineffective.
Pancreatitis
Dr Basford says that, in rare cases, GLP-1 medications ‘have been linked to inflammation of the pancreas’, meaning anyone with a history of pancreatitis may be advised not to take them due to the ‘potential risk of recurrence’.
Digestive or gastrointestinal conditions
‘As these medications slow digestion and influence appetite, people living with conditions such as gastroparesis, severe acid reflux, inflammatory bowel disease, or other significant digestive disorders may find the treatment unsuitable or difficult to tolerate,’ says Dr Basford.
This is a particularly important consideration because nausea, bloating and stomach discomfort are already among the most commonly reported side effects of the injections.
Gallbladder disease or gallstones
According to Dr Basford, ‘both rapid weight loss and the use of GLP-1 medications can increase the likelihood of gallbladder issues’, so anyone with active gallbladder disease may need additional medical assessment before treatment is approved.
BMI is one of the most common reasons for refusal (Picture: Getty Images)
Pregnancy, breastfeeding, or trying to conceive
Neither Wegovy or Mounjaro are considered safe during pregnancy or while breastfeeding.
Dr Basford notes that patients are ‘usually advised to stop treatment well before trying for a baby’ too, due to how weight-loss medications ‘may affect foetal development’.
Other existing medical conditions
From severe liver disease, to kidney problems, to poorly managed diabetes, there are various coniditions that could render the medications unsuitable.
In some cases, treatment may still be possible, but only with ‘closer medical supervision’ or specialist input.
History of eating disorders
Patients with current or previous eating disorders are also unlikely to be approved for treatment.
Dr Basford explains that this is because appetite-suppressing medicationshave the potential to worsen disordered eating behaviours or negatively impact mental wellbeing’ in people with conditions such as anorexia nervosa or bulimia.
Uncontrolled mental health conditions
Similarly, severe or unmanaged mental health conditions may need to be stabilised before treatment can begin — particularly where there are concerns about ‘wellbeing, medication adherence, or safeguarding’.
Doctors may also want to ensure patients fully understand the long-term commitment and potential side effects involved before prescribing the medication.
Severe side effects during previous use
‘If someone has previously taken a GLP-1 medication and experienced severe vomiting, dehydration, or ongoing digestive side effects, clinicians may decide it is not appropriate to restart treatment,’ says Dr Basford.
While mild side effects are common, more serious reactions can sometimes outweigh the benefits of continuing the jabs.
Medication interactions or allergies
Not only can certain medications interact poorly with weight loss injections, some people may be allergic to ingredients used within them.
This is why patients are asked to complete detailed questionnaires and have a full medical review before a prescription can be approved.
A full medical review is required before approval (Picture: Getty Images)
Drug or alcohol misuse concerns
According to Dr Basford, where there are worries about ‘the safe management of prescription medication’ in regards to substance abuse, patients may need extra support or assessment before treatment can go ahead.
Age restrictions
While Wegovy is approved for weight loss in patients aged 12 and over, Mounjaro can only be prescribed to over-18s.
‘Prescribers must follow strict medical guidance around who can safely receive treatment,’ adds Dr Basford.
Unsafe prescribing concerns
Following on from this, the doctor claims patients may be declined a prescription because the the information they provided is ‘incomplete, inconsistent, or suggests the medication may not be being used appropriately’.
She stresses that these checks are ‘an essential part of safe prescribing’, adding that weight-loss injections are ‘powerful prescription medications’ that ‘are not suitable for everyone’.
‘It is relatively common for people to be declined treatment,’ Dr Basford concludes. ‘In many cases, refusal is about protecting a patient’s long-term health and ensuring that the risks of treatment do not outweigh the benefits.’
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