There has been a significant increase in enquiries from patients about GLP-1 medications used to support weight loss, including Wegovy (Semaglutide) and Mounjaro (Tirzepatide).
Access to these medications on the NHS are very limited and is subject to strict national and local eligibility criteria. As a result, many patients who feel they would benefit from these treatments are not currently eligible to receive them through the NHS.
Please read the information below carefully before contacting the practice.
If you feel you meet the criteria, you can contact us. An appointment with the GP is not necessary at this stage whilst we review your eligibility. If the criteria are not met, we will not be able to arrange a referral for NHS GLP-1 medications.
Route 1. Tier 3 Weight Management services for obesity
In the national weight management system, Tier 3 services are intended for eligible patients who have already taken part in a Tier 2 weight management service.
In Suffolk, ‘Slimming World’ and ‘Xyla Digital weight management are the Tier 2 services that are available for free to eligible patients. Patients can contact their GP Practice to be referred.
Tier 3 weight management usually includes the use of injectable GLP-1 medications, Tirzepatide (Mounjaro) or Semaglutide (Wegovy).
The Oviva Tier 3 weight management service is available to patients who meet the tight criteria published by Norfolk & Waveney Integrated Care Board (ICB) in May 2025. To be eligible, patients must have:
· BMI of ≥35 kg/m² (reduced to 32.5 kg/m² for people from Black, Asian and ethnic minority backgrounds), OR
· BMI between 30-34.9 kg/m² (27.5-32.4 kg/m² for people from Black, Asian and ethnic minority backgrounds) if certain conditions apply (see the full criteria via the link below)
AND one of the following conditions:
- Precancerous or cancerous conditions in which weight loss would improve outcomes or aid access to therapies
- Patients requiring urgent weight loss for organ transplant
- Idiopathic intracranial hypertension (IIH) requiring frequent lumbar punctures and/or with visual compromise
- Patients requiring planned time-sensitive surgery (including bariatric surgery) for reversible, life-limiting conditions and who have severely restricted activities of daily living (ADLs), where high BMI is the primary barrier to having the surgery and weight loss is essential to access treatment
- Weight loss required for assisted conception in women under the care of a fertility service, in cases where weight loss would be beneficial
- Severe obstructive sleep apnoea (OSA), obesity hypoventilation syndrome (OHS) – where the severity has been indicated by an Apnea Hypopnea Index (AHI) of >30A and/or severe asthma
- Proven genetic cause of obesity and not eligible for Setmelanotide.
- An individual who meets the clinical qualification for Phase 2 [see full guidance on the ICB website] but also has a condition such as learning disability (LD) or severe mental illness (SMI)
- Young adults requiring ongoing support, transitioning from paediatric tier 3 obesity services
The full criteria are stated at Tier 3 Weight Management (Interim) – Knowledge NoW
Route 2. GP prescription for obesity (not actually available via GP prescription)
You may have heard that Tirzepatide (Mounjaro) was made available from GP practices nationally in June 2025. This is not true in Norfolk and Waveney. Norfolk & Waveney ICB has not commissioned GP practices to provide this service to patients. However, patients who meet the tight criteria for this service can be instead referred by the practice to the Oviva Tier 3 Weight Management service, as described above.
To qualify, patients must have:
- A BMI of 40 kg/m2 (37.5 kg/m2 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds), AND
- At least 4 of the 5 qualifying health conditions:
- Hypertension (high blood pressure)
- Atherosclerotic cardiovascular disease (ASCVD) such as heart attack, angina, stroke, peripheral vascular disease, heart failure
- Dyslipidaemia (unhealthy lipid / cholesterol levels): Treated with lipid-lowering therapy (e.g. a statin), or with low-density lipoprotein (LDL) ≥ 4.1 mmol/L, or high-density lipoprotein (HDL) <1.0 mmol/L for men or HDL<1.3 mmol/L for women, or triglycerides ≥1.7 mmol/L
- Obstructive Sleep Apnoea (OSA): Established diagnosis of OSA (sleep clinic confirmation via sleep study) and treatment indicated i.e. meets criteria for continuous positive airway pressure (CPAP) or equivalent
- Type 2 diabetes mellitus
Unfortunately, only a very small number of patients, around 2 in 1000, will meet these criteria.
To be clear: you can be referred to the Oviva Tier 3 service if you meet EITHER the criteria set out in ‘Route 1’ or the criteria set out in ‘Route 2’. You do not have to meet both sets of criteria.
Route 3. GP prescription for managing Type 2 diabetes
Tirzepatide can be prescribed in General Practice for treating type 2 diabetes alongside diet and exercise in adults when it is insufficiently controlled only if:
- triple therapy with metformin and 2 other oral antidiabetic drugs is ineffective, not tolerated or contraindicated, and
- they have a body mass index (BMI) of 35 kg/m2 or more (32.5 kg/m2 for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds), and specific psychological or other medical problems associated with obesity, or
- they have a BMI of less than 35 kg/m2, (32.5 kg/m2 for the ethnicities listed above) and:
- insulin therapy would have significant occupational implications, or
- weight loss would benefit other significant obesity-related complications.
If you think you are eligible for Tirzepatide for treating Type 2 diabetes, discuss this with whoever manages your diabetes. If your diabetes is managed by the practice, you can contact your GP about this.