Medicines for weight management can be effective when they are combined with dietary and lifestyle changes, and when they are supplied safely and appropriately. Read the sections below to find out more.
There are a variety of medicines available in the UK to help with weight management. These medicines may be sold under different brand names. Examples include:
- Orlistat (for example, Xenical® or Alli®)
- Liraglutide (for example Saxenda®, Nevolat® and BIOLIDE®)
- Semaglutide (for example Ozempic®, Rybelsus® and Wegovy®)
- Tirzepatide (for example Mounjaro®)
Orlistat works by reducing the fat absorbed by the body from food. It is available as a capsule and is licensed for weight management. This means that it has been licensed for this use by the medicines regulator (the Medicines and Healthcare products Regulatory Agency [MHRA]). It is classified as a pharmacy (P) medicine which means it can only be bought from a pharmacy either online or in-store.
Liraglutide, and semaglutide mimic a gut hormone known as glucagon-like peptide-1 and are known as GLP-1 receptor agonists (GLP1-RAs). Tirzepatide is a GLP1-RA that is combined with a GIP analogue (short for glucose-dependent insulinotropic polypeptide). These medicines make people feel fuller and less hungry.
Some of these medicines are available in an injectable form and are licensed for weight loss for example liraglutide (Saxenda®, Nevolat® and BIOLIDE®) and semaglutide (Wegovy®).
Tirzepatide (Mounjaro®) is available in an injectable form and is licensed for both type 2 diabetes and weight loss.
Rybelsus® tablets and Ozempic® injectable pens which contain semaglutide, are licensed to treat type 2 diabetes, but they are also prescribed 'off label' for weight loss (see below for explanation regarding ‘off label’ use).
Medicines containing GLP1-RAs are prescription only medicines (POMs). This means they can only be supplied when they have been prescribed for someone by an appropriate practitioner such as a doctor, a nurse independent prescriber or a pharmacist independent prescriber. This would involve having an appropriate consultation with a prescriber who will jointly make a decision, based on the information provided, about whether it is appropriate to issue a prescription.
No, but it is essential that the type of consultation is appropriate to meet the needs of the person, and it allows the prescriber to get enough information to prescribe weight management treatments safely and appropriately. This could include (but is not limited to):
- not relying solely on an online questionnaire but instead using a method of two-way communication between the person and the prescriber, which allows the person to ask questions and the prescriber to get all the information they need to prescribe safely.
- independently verifying the person’s weight, height and/or body mass index. This helps to increase the reliability of the information that the prescriber receives, supports safer decision making and ensures that the supply is appropriate for the person. By ‘independently’ we mean that the prescriber uses a different way to verify the information provided to them by the person. This could be through a video consultation, in-person, from the person’s clinical records or by contacting another healthcare provider such as the person’s GP.
- carrying out or signposting to appropriate ongoing monitoring.
- advising on what to do if they experience side effects from the medicine.
Prescribers must also consider the person’s wellbeing given that eating disorders, body dysmorphia and mental health issues can play a part in the reason for requesting these medicines.
Prescribing practitioners should make sure that they prescribe in line with legislation and follow good practice guidance.
Prescribers are also responsible for making sure that they have the required training, knowledge, skills and experience to prescribe these medicines safely.
Prescribing ‘off-label’ means prescribing a product to be used for a purpose other than what it has been licensed for by the medicines regulator (the Medicines and Healthcare products Regulatory Agency [MHRA]). This is entirely lawful and can be appropriate in the right circumstances. Pharmacists must adhere to the GPhC Guidance for pharmacist prescribers.
Some medicines containing GLP-1 RAs such as Ozempic® and Rybelsus®, are licensed for the treatment of diabetes, but are sometimes prescribed ‘off label’ for weight management.
A prescriber should explain to the person that they are prescribing an ‘off label’ medicine, and the reasons why.
There is a clear expectation and obligation for pharmacy professionals and prescribers to adhere to national patient safety alerts and guidelines.
Any prescribing or supply incompatible with updated national guidance, such as a patient safety alert would have to be considered in context. Pharmacy owners and pharmacy professionals would need to be able to account for their decision making where these have not been followed.
Our standards for registered pharmacies set out the requirements for the provision of pharmacy services at or from a registered pharmacy. Our inspectors routinely check awareness and knowledge of guidance around medicines for weight management such as Ozempic® as part of assessing whether standards are met.
Where a pharmacy fails to meet our standards, we have statutory powers to take enforcement action in order to protect patients and the public and ensure they receive safe and effective care when using pharmacy services.
When reviewing concerns raised about individuals who prescribe or supply medicines ‘off-label’ and in breach of updated national guidance, we will take into consideration the context and quality of the decision making, including their scope of practice.
We have acted in response to emerging concerns about a small number of pharmacies (both online and bricks and mortar premises) inappropriately supplying medicines that are licensed to treat diabetes but are being used by people for weight-loss. We have taken action, in line with national guidance, to help address shortages of these medicines so they can continue to be accessed by those with diabetes and stop these pharmacies supplying these medicines to potentially vulnerable people.
We’ve also reminded all pharmacies that they need to follow our standards and guidance, and the relevant prescribing guidelines for medicines, at all times.
We’ve shared good and poor practice examples in relation to providing weight loss services that we’ve gathered from our inspections. You can find these in our online newsletter, Regulate.
Fake medicines for weight management, claiming to be Saxenda® or Ozempic® for example have been found in the UK including versions which contain insulin, which can be harmful. We advise against buying medicines online through non-legitimate routes or without a prescription. You should make sure that any private prescriptions are dispensed from a GPhC registered pharmacy.
You can check if the pharmacy you are obtaining medicines from is registered with us by searching our registers.
We have published a guide with other UK health organisations to help people keep safe if they decide to use online services.
You can read more about using online services in our FAQs – Buying medicines online
Find out more about fake weight loss medicines in this MHRA article