Mounjaro

You may have heard about Mounjaro® (tirzepatide), a new injectable medication that can support weight loss in people living with obesity. This letter explains who is currently eligible to receive this medication in Wales, based on national guidance and Welsh Government policy.

What is Mounjaro®?

Mounjaro® is a weekly injection (tirzepatide) originally developed for type 2 diabetes.

In December 2024, the National Institute for Health and Care Excellence (NICE) approved it as a treatment option for adults with

obesity, to be used alongside a reduced-calorie diet and increased physical activity.

Important: GP Practices in Wales cannot start Mounjaro for weight loss

Currently, GPs in Wales are not allowed to start new prescriptions of Mounjaro® for weight loss. This is a Welsh Government decision.

Only hospital based, specialist weight management services can currently prescribe it for obesity, under the AllWales Weight Management Pathway (AWWMP).

To be considered for Mounjaro® for weight loss, patients must do a self-referral to the hospital specialist weight management service, where a full team (including doctors, dietitians, and behavioural specialists) supports treatment. If you feel you meet the eligibility criteria (see below), you can self-refer to the weight management service, using the following details.

Weight management service – Hywel Dda University Health Board

https://hduhb.nhs.wales/healthcare/services-and-teams/weight-management-service/

Who is eligible to receive Mounjaro® for weight loss?

According to NICE and Welsh Government guidance, Mounjaro® can only be prescribed for weight loss if:

You are 18 years or older, and
You have a BMI of 35 or above (or 32.5 or above if you are from a South Asian, Black African, African-Caribbean or other higher-risk ethnic background), and
You have at least one weight-related health condition, such as:
Type 2 diabetes
High blood pressure (hypertension)
High cholesterol (dyslipidaemia)
Obstructive sleep apnoea
Heart disease

Can Mounjaro® be used for type 2 diabetes?

Yes. Mounjaro® may be prescribed for some people with type 2 diabetes if other treatments have not worked. This decision will be based on your diabetes treatment history and current strict NHS guidance. Not all type 2 diabetes patients are eligible to receive Mounjaro®.

Below is an eligibility checklist we as the GP practice must follow to determine if you can be prescribed Mounjaro®. We are not permitted to prescribe Mounjaro® unless all of the criteria are met.

Eligibility Checklist

Criterion to be Eligible for Mounjaro®

Adult (≥ 18 years)
Type 2 diabetes diagnosis
On metformin and 2 other oral diabetic medications agents (gliflozins, gliptins, gliclazide, pioglitazone), however diabetes remains inadequately controlled
BMI ≥ 35 kg/m² with ≥ 1 obesityrelated problem
Not currently on another GLP1RA (e.g. semaglutide)
Recent retinal screening done and shows no contraindication
Agreement to structured diet/exercise/behavioural programme
Plan for HbA₁c monitoring and safety followup

Contraindication

Mounjaro® cannot be prescribed to patients with the following conditions.

Active retinopathy or maculopathy (eye disease)
Past medical history of pancreatitis

Summary

Purpose	Available from GP?	Who prescribes it?
Weight loss (new starts)	❌ No	Specialist only (hospital clinic)

Type 2 diabetes	✅ Sometimes	GP or specialist (case-by-case)