If you're considering a GLP-1 weight loss medication like Mounjaro or Wegovy, one of the first decisions is whether to try to access it through the NHS or go private. In practice, for most people in the UK right now, private is the more realistic route — but it comes at a significant cost. Here's an honest comparison of both pathways.
At a glance
| NHS | Private | |
|---|---|---|
| Cost | £9.90 per prescription item (England). Free in Scotland, Wales, NI | £130–£300/month depending on medication and dose |
| BMI threshold | Typically BMI ≥35 with comorbidities (Mounjaro Cohort 1 requires BMI ≥40) | Typically BMI ≥30, or ≥27 with comorbidities |
| Waiting time | Weeks to months (or longer for Tier 3 services) | Usually days — often same-week consultations |
| Consultation | GP or specialist weight management team | Online consultation (usually questionnaire + clinical review) |
| Support | Mandatory behavioural support programme (for Mounjaro) | Varies — some providers include coaching, many don't |
| Monitoring | Regular follow-ups with clinical team | Varies widely by provider |
| Duration | Typically max 2 years (Wegovy). Continuation criteria apply | As long as clinically appropriate and you continue paying |
| Medications available | Mounjaro, Wegovy, Saxenda (varies by service) | Mounjaro, Wegovy, Saxenda, Orlistat, Mysimba |
The NHS route
There are two main NHS pathways:
GP prescribing (Mounjaro): Since June 2025, GPs in England can prescribe Mounjaro for patients meeting the strict Cohort 1 criteria (BMI ≥40 with 4+ specific comorbidities). Cohort 2 is expected from June 2026. This is the newest and most direct route, but criteria are very restrictive. See our full Mounjaro NHS guide.1
Tier 3 specialist services (Wegovy, Saxenda, Mounjaro): Referral-based access through hospital or specialist community weight management services. Criteria typically require BMI ≥35 with comorbidities. Waiting times can be very long. See our Wegovy NHS guide.2
Advantages of NHS: Nearly free (just the prescription charge), includes structured clinical support and monitoring, mandatory behavioural programme for Mounjaro.
Disadvantages: Very strict eligibility criteria, long waiting times, limited capacity in many regions, continuation rules that may discontinue treatment if weight loss targets aren't met.
The private route
Most people in the UK currently access GLP-1 medications privately. This typically involves an online consultation with a prescriber (questionnaire about your medical history, height, weight, and health conditions), followed by a clinical review. If approved, medication is posted to your home.
Advantages of private: Much lower BMI threshold (typically 30+), fast access (often same week), wider medication choice, no waiting lists, no NHS stopping rules.
Disadvantages: Expensive (£150–300/month, ongoing), quality of support varies enormously between providers, less clinical oversight than NHS services, no structured behavioural programme in most cases.
What to look for in a private provider
The private weight loss medication market has grown rapidly, and quality varies. Look for:
- GPhC registration: The pharmacy dispensing your medication should be registered with the General Pharmaceutical Council. You can check at pharmacyregulation.org
- Clinical oversight: A qualified prescriber (doctor, nurse prescriber, or pharmacist prescriber) should review your consultation before issuing a prescription
- Follow-up included: Good providers offer regular check-ins and dose adjustment consultations, not just repeat prescriptions
- Transparent pricing: Check total cost including consultation fees, delivery, needles, and any additional charges
- Legitimate medication supply: Medication should come from licensed UK wholesalers. Be wary of very low prices — they may indicate counterfeit or grey-market products
The MHRA has warned about counterfeit weight loss injection pens being sold online. Always use a regulated provider and never buy from unverified sources or social media.
Can I switch from private to NHS?
If you've been buying medication privately and later become eligible for NHS treatment, you can transition. However, NHS eligibility is assessed based on your BMI and conditions at the time of referral into NHS care, not when you started private treatment. If you've already lost significant weight privately, your current BMI may no longer meet the threshold for NHS access.1
Which route is right for you?
If you meet the strict NHS criteria and can wait for access, the NHS route provides comprehensive clinical support at minimal cost. If you don't meet NHS criteria, can't wait, or prefer to start treatment sooner, private access is the practical option — but budget for the ongoing monthly cost and choose a reputable provider.