Mounjaro Eligibility & Conditions UK 2025

Mounjaro is a prescription-only medication (POM) with specific eligibility criteria set by the MHRA and UK prescribing guidelines. Understanding whether you qualify—and which pathway (NHS or private) suits your circumstances—is essential before pursuing treatment.

📊 BMI Requirements UK

Body Mass Index (BMI) is the primary eligibility criterion for Mounjaro prescription in the UK:

Standard Eligibility:

• BMI ≥30: Qualifies for Mounjaro without additional conditions (classified as obese)
• Example: 5’6″ (168cm) person weighing 84kg+ has BMI 30+

Lower BMI with Comorbidities:

• BMI ≥27: Qualifies IF you have at least one weight-related health condition:
  • Type 2 diabetes or prediabetes
  • Hypertension (high blood pressure)
  • High cholesterol or dyslipidaemia
  • Obstructive sleep apnoea
  • Cardiovascular disease
  • Polycystic ovary syndrome (PCOS)
  • Non-alcoholic fatty liver disease (NAFLD)
• Example: 5’6″ person weighing 76kg (BMI 27.5) with diagnosed Type 2 diabetes qualifies

BMI Below 27:

• Generally NOT eligible for Mounjaro
• Exceptions rare and require specialist endocrinologist assessment
• Using Mounjaro for “cosmetic” weight loss at healthy BMI is off-label and not recommended

🏥 Medical Eligibility Requirements

Age Requirements:

• Minimum: 18 years old (Mounjaro not approved for under-18s in UK)
• Maximum: No upper age limit, but prescribers assess suitability for 75+ patients individually
• Elderly considerations: Slower titration often recommended for 65+ patients

Previous Weight-Loss Attempts:

• Most NHS pathways require documented evidence of previous diet/exercise attempts
• Private prescribers more flexible but still assess lifestyle commitment
• Realistic approach: Mounjaro works best alongside diet/exercise, not as sole intervention

Mental Health Considerations:

• Active eating disorders: Anorexia, bulimia nervosa—typically contraindication (Mounjaro suppresses appetite further)
• Binge eating disorder: Case-by-case; some prescribers consider Mounjaro helpful, others cautious
• Severe depression: Not absolute contraindication, but mental health support recommended alongside treatment
• Body dysmorphia: Thorough assessment required; unrealistic expectations may preclude prescription

🚫 Contraindications (Cannot Use Mounjaro)

Absolute Contraindications:

• Personal or family history of medullary thyroid carcinoma (MTC)
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
• Known hypersensitivity to tirzepatide or any excipients
• Pregnancy or breastfeeding (see separate section below)
• Type 1 diabetes (Mounjaro not approved for T1D; requires insulin)

Relative Contraindications (Use with Caution):

• History of pancreatitis: Increased risk of recurrence; prescriber weighs benefits vs. risks
• Severe gastroparesis: Mounjaro slows gastric emptying further
• Active gallbladder disease: Rapid weight loss can worsen
• Severe kidney disease (eGFR <30): Limited data; careful monitoring required
• Proliferative diabetic retinopathy: Rapid glucose control may temporarily worsen; ophthalmologist monitoring needed

🤰 Pregnancy, Fertility & Contraception

Pregnancy:

• DO NOT use Mounjaro if pregnant (not studied in pregnant women; animal studies show potential risks)
• Stop 2 months before planned conception: Mounjaro has long half-life; allow washout period
• Unplanned pregnancy: Stop Mounjaro immediately and contact GP

Contraception:

• Oral contraceptives: May have reduced effectiveness during first 4 weeks of Mounjaro (slowed gastric absorption)
• Backup contraception recommended: Use condoms or other non-oral methods during first month
• Long-acting methods unaffected: IUDs, implants, injections work normally

Breastfeeding:

• Avoid Mounjaro whilst breastfeeding (unknown if tirzepatide passes into breast milk)
• Post-partum weight loss: Wait until fully finished breastfeeding before starting Mounjaro

Fertility:

• Weight loss from Mounjaro often improves fertility, especially in PCOS patients
• Women with PCOS may resume ovulation—increased pregnancy risk if not using contraception
• Plan contraception carefully if not actively trying to conceive

🏴󠁧󠁢󠁥󠁮󠁧󠁿 NHS vs. Private Prescription Pathways

NHS Pathway:

Current Status (December 2025): Mounjaro NOT routinely available on NHS for weight management alone.

• Type 2 Diabetes: Available on NHS prescription if BMI criteria met and HbA1c indicates need
• Weight Management Only: Very limited availability; postcode lottery (some CCGs offer, most don’t)
• NICE Guidance: Under review; potential future NHS availability for obesity
• Typical NHS Requirements (if available):
  • BMI ≥35 (or ≥30 with comorbidities)
  • Documented previous weight-loss attempts
  • Participation in NHS weight management programme
  • Regular follow-up appointments

Private Prescription Pathway:

Currently Primary Route: Most UK patients access Mounjaro privately (online or in-person clinics).

• Eligibility: Generally BMI ≥30 (or ≥27 with comorbidity)
• Process:
  1. Complete online medical questionnaire OR attend in-person consultation
  2. GP video/phone consultation (15-30 minutes)
  3. Medical history review, BMI calculation, suitability assessment
  4. If approved: prescription issued, medication dispatched
  5. Follow-up consultations: typically every 1-3 months
• Cost: £179-295/month for medication + consultation fees (£20-50) if separate
• Flexibility: More accessible than NHS; faster start; wider prescriber choice

📋 Pre-Treatment Assessment Checklist

Before starting Mounjaro, prescribers typically assess:

Medical History:

• Current medications (interactions check)
• Previous medical conditions (pancreatitis, thyroid issues, kidney disease)
• Family history (medullary thyroid carcinoma, MEN 2)
• Allergies to medications
• Mental health history (eating disorders, body image issues)

Physical Assessment:

• Current weight and height (BMI calculation)
• Blood pressure measurement
• Sometimes: blood tests (HbA1c, kidney function, liver function, lipids)

Lifestyle Assessment:

• Current diet patterns
• Exercise habits
• Previous weight-loss attempts and results
• Weight-loss goals and timeline expectations
• Commitment to lifestyle changes alongside medication

Psychological Assessment:

• Motivation for weight loss
• Realistic expectations (10-20% body weight loss, not 50kg overnight)
• Understanding of side effects and management
• Mental health screening (depression, anxiety, eating disorders)

❓ Eligibility FAQs

Can I get Mounjaro if my BMI is 28?

Only if you have a weight-related health condition (e.g., Type 2 diabetes, hypertension, PCOS). BMI 27+ requires comorbidity; BMI <27 generally not eligible.

Do I need to try other weight-loss methods first?

NHS pathways typically require documented previous attempts. Private prescribers assess individual circumstances—some require evidence of lifestyle efforts, others more flexible if BMI criteria met.

Can I get Mounjaro for “the last 10kg”?

If your BMI is already <30 (or <27 without comorbidity), no. Mounjaro is for obesity treatment, not cosmetic weight refinement at healthy weights.

I have PCOS—does that help me qualify?

Yes. PCOS is recognised weight-related condition. If you have BMI ≥27 + PCOS diagnosis, you meet criteria.

What if I’m taking other medications?

Most medications compatible with Mounjaro. Key interactions: insulin/sulphonylureas (dose adjustment needed), oral contraceptives (backup needed first month), warfarin (INR monitoring). Disclose all medications to prescriber.

Can I switch from Wegovy/Saxenda to Mounjaro?

Yes, many patients switch. Typical process: stop previous GLP-1, wait 1 week, start Mounjaro at 2.5mg (full titration schedule). Discuss with prescriber for personalised plan.

🎯 Key Takeaways: Mounjaro Eligibility

• BMI ≥30 OR BMI ≥27 with comorbidity: Primary eligibility criterion for UK prescription
• Age 18+: Minimum age requirement; no upper limit but individual assessment for elderly
• Contraindications: MTC/MEN 2 family history, pregnancy/breastfeeding, Type 1 diabetes
• NHS limited: Primarily for Type 2 diabetes; weight management availability varies by region
• Private pathway dominant: Most UK patients access Mounjaro privately (faster, wider availability)
• Previous attempts: NHS requires documented lifestyle efforts; private more flexible
• Realistic expectations essential: Prescribers assess understanding of 15-22% average weight loss, not miracles
• Medication review: Disclose all current medications for interactions assessment
• Mental health matters: Active eating disorders or unrealistic expectations may preclude prescription
• Pregnancy planning: Stop Mounjaro 2 months before attempting conception

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