1.8 Obesity

Share Print Feedback

Last edited: 24-06-2025

First line drugs

Second line drugs

Specialist drugs

Secondary care drugs

Lipase Inhibitors

Orlistat (TLS Green) - primary care initiation only

GLP-1 (Glucagon- Like Peptide 1) Receptor

The FSRH is advising that individuals use contraception whilst using GLP-1 agonists, with additional advice for those using tirzepatide. The FSRH has also produced a patient information leaflet for clinicians to share with patients.

The BMS has issued advice on the concurrent use of HRT and semaglutide or tirzepatide relating primarily to endometrial protection and a potential risk of reduced absorption of oral progestogens used within HRT regimens.

Liraglutide (Saxenda^®) (TLS Red)

NICE TA664 Liraglutide for managing overweight and obesity

Semaglutide (Wegovy^®) (TLS Red)

NICE TA875 Semaglutide for managing overweight and obesity

Tirzepatide (Mounjaro^®) (TLS Blue)

Tier 3 Specialist Weight Management Services may assess patients for eligibility for tirzepatide in line with NICE TA1026 Tirzepatide for managing overweight and obesity.

From 23^rd June 2025, prescribing of tirzepatide for weight loss in primary care will be introduced in stages over three years in line with prioritised patient cohorts set out in NHS England interim commissioning guidance:

In Year 1 (2025), Practices who have signed up to the relevant BNSSG LES (Weight Management: Tirzepatide prescribing and management in primary care) and who are working to deliver the locally agreed care model can initiate tirzepatide in adults with a BMI of ≥40kg/m2, and four or more weight-related comorbidities (see list below). For people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean backgrounds, reduce BMI threshold by 2.5kg/m2.
Weight-related comorbidities have been defined by NHS England and must be confirmed by a healthcare professional: Type 2 diabetes; Hypertension; Atherosclerotic cardiovascular disease; Obstructive sleep apnoea; Dyslipidaemia. For comprehensive definitions see P8 NHS England interim commissioning guidance
Tirzepatide for weight loss is assigned TLS Blue and considered suitable for prescribing where clinicians have completed additional training as detailed in the BNSSG LES and ONLY where the patient meets the relevant eligibility criteria.
For further information on the implementation of tirzepatide for weight loss see:

BNSSG ICS update June 2025

Weight Management - Tirzepatide (Mounjaro) (Remedy BNSSG ICB)

Tirzepatide FAQs for patients (under review 23/06/2025)

For use of GLP-1s in Type 2 diabetes see formulary Chapter 6.3

Contact Us

Got a question or comment about the Joint Formulary?

Please use the email address below to contact us and we will endeavour to respond within 2 working days.

BNSSG.formulary@nhs.net