NHS Obesity Support Service

Important: Access to NHS weight loss medication is limited and not all eligible patients will be offered treatment immediately.

From April 2026, the previous BOB ICB Obesity Locally Commissioned Service (LCS) has ended.

Support for patients living with obesity, including access to NICE approved treatments such as tirzepatide (Mounjaro), is now delivered through the national GP contract.

This service is part of a phased national rollout across England, meaning access is limited and based on clinical need and available capacity.

Who is this service for?

Access to tirzepatide is being introduced gradually across England. Initially, only patients with the highest clinical need are prioritised, and wider access will be expanded over time.
To be eligible, you must meet all of the criteria below:

Meeting these criteria does not guarantee treatment. Patients will be offered treatment based on clinical assessment, the current phase of the national rollout, and service capacity.

• Body Mass Index (BMI)
  Have a body mass index (BMI) that meets the locally agreed criteria for the current phase of primary care access. This generally means a higher BMI combined with multiple weight-related health conditions, adjusted for ethnicity where relevant.
  • Year 1 of the service (2025 to 2026) – BMI of 40 or above, and 4 or more qualifying health conditions listed below (see below)
  • Year 2 of the service (2026 to 2027) – BMI of 35 or above, and 4 or more qualifying health conditions listed below (see below)
  • Year 3 of the service (phased from 2026 onwards)
    You must have either:
    A BMI of 40 or above with 3 qualifying health conditions, or
    A BMI of 35 or above with 4 qualifying health conditions

For some ethnic groups, including South Asian, Chinese, other Asian, Middle Eastern, Black African or African Caribbean backgrounds, a lower BMI threshold applies, usually reduced by 2.5 BMI points.

• Qualifying health conditions are

Health conditions	Definition for Initial Assessment
Atherosclerotic cardiovascular disease (ASCVD)	Established atherosclerotic CVD (ischaemic heart disease, cerebrovascular disease, peripheral vascular disease, heart failure)
Hypertension	Established diagnosis of hypertension and requiring blood pressure lowering therapy
Dyslipidaemia/ High cholesterol or triglycerides	Patients must be currently receiving treatment for high cholesterol or triglycerides. This may include those with raised lipid levels on recent blood tests.
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	Established type 2 diabetes mellitus

Additional Notes:

• Blood test results for cholesterol/triglycerides must be from the last 12 months.
• Patients must be willing to attend regular reviews and commit to a behavioural support programme.
• Patients must not already be on a similar NHS treatment unless transferring with approval.
• Meeting these criteria does not guarantee treatment. All patients must be assessed by a clinician and must agree to take part in regular reviews and NHS behavioural support alongside any medication.

What you should do

You do not need to contact the practice about this service.
Patients will be identified and contacted directly if they are eligible for the current phase of the programme.