The two main NICE eligibility paths

NICE TA1026 (March 2024) recommends tirzepatide for adults who meet ONE of the following:

• Path A: BMI of 30 or above — this is the standard obesity threshold. No additional condition needed.
• Path B: BMI of 27.5 or above PLUS at least one weight-related condition — the list of qualifying conditions is below.

For people of South Asian, Chinese, Black African or Black Caribbean family origin, NICE applies lower BMI thresholds (BMI 27.5 for the first path, 25 for the second) because of higher metabolic risk at lower body weights.

What counts as a weight-related condition

If your BMI is in the 27.5–29.9 range (or 25–27.4 for the lower-threshold ethnic groups), you need at least ONE of these to be eligible:

• Type 2 diabetes
• Prediabetes / impaired glucose regulation
• Hypertension (high blood pressure)
• Dyslipidaemia (high cholesterol)
• Obstructive sleep apnoea
• Cardiovascular disease
• Non-alcoholic fatty liver disease (NAFLD)
• Polycystic ovary syndrome (PCOS)

Bring evidence of any condition to your free consultation — recent blood pressure readings, blood test results, or correspondence from your GP all help. We can also do a quick BP and BMI check on the day.

Who can't have Mounjaro

The absolute contraindications (from the Mounjaro SmPC) are:

• Personal or family history of medullary thyroid carcinoma — GLP-1/GIP agonists carry a thyroid C-cell tumour signal in rodent studies. Avoid entirely.
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) — same reasoning.
• Known hypersensitivity to tirzepatide or any excipient.
• Pregnancy or planned pregnancy. If you become pregnant on Mounjaro, stop immediately and contact us.
• Breastfeeding. Not licensed.
• Under 18. Not licensed for paediatric use.
• Type 1 diabetes. Mounjaro is not a substitute for insulin.

Cautions — possible but needs careful review

The following situations need a more detailed risk-benefit conversation before we prescribe:

• History of pancreatitis. GLP-1 agonists have a small association with pancreatitis. Generally avoid; case-by-case review.
• Severe gastrointestinal disease (e.g. gastroparesis, IBD flare).
• Severe kidney impairment. Dose adjustments may apply.
• Diabetic retinopathy on insulin. Rapid glucose changes can worsen retinopathy short-term.
• Concurrent insulin therapy. Hypoglycaemia risk needs management.
• Currently on Saxenda, Wegovy, or Ozempic. Can switch but needs guided transition.

How the eligibility check works at Preston Clinic

The free initial consultation is about 20 minutes. We:

• Calculate your BMI from a measured weight and height (we have scales on site)
• Check your blood pressure
• Take a brief medical history — current medications, conditions, family history
• Discuss any weight-related conditions you have or might have
• Review the SmPC criteria against your specifics
• Tell you straight whether we'd prescribe and why

If we don't prescribe, there's no charge — the consultation is free. We'll explain why and what alternative routes might work (NHS Tier 3, behavioural support, other medications). You won't leave empty-handed.

What if you're a borderline case?

If your BMI is 26–27.4 with no weight-related conditions, you're outside NICE criteria. We can't prescribe. But it's worth coming in — sometimes weight measurement at home is inaccurate, blood pressure is higher than people realise, or HbA1c (which you can have tested) reveals prediabetes.

If your BMI is in the 27.5–29.9 range and you suspect you have an undiagnosed weight-related condition, we can arrange a private blood panel (HbA1c, lipids, liver function) to clarify eligibility. Or we can write to your GP recommending tests.