The NHS rollout of Mounjaro started in June but an investigation by the British Medical Journal suggests the jabs are being rationed
Injections dubbed the King Kong of weight loss jabs are only being offered on the NHS in part of the country amid claims its rollout is “not fit for purpose”.
The rollout of Mounjaro was announced by NHS England with much fanfare last year but an investigation by the British Medical Journal (BMJ) has shown the jabs are being rationed. Health authorities calculated 3.4 million people could benefit from the drug so the NHS agreed the injections would be rolled out in phases over a 12-year period.
Some 220,000 patients were supposed to be prescribed it in the first three years but analysis suggests funding for year one clearly only covers 10% of the doses needed so far.
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Information released by regional NHS commissioning bodies under Freedom of Information saw only 18 out of 42 confirm they have started prescribing Mounjaro in line with the rollout plan. Some 28 responded to this question.
Ellen Welch, co-chair of Doctors’ Association UK (DAUK), said: “These figures confirm the fear that the rollout is not fit for purpose. There is a huge discrepancy between national messaging and what patients are actually being delivered on a local level.”
Previous studies showed Mounjaro, officially called tirzepatide, can help people lose 26% of their body weight in 18 months but it needs to come with personalised diet and lifestyle coaching. Exercise is vital so that users do not lose muscle mass as well as fat. Without sufficient lifestyle changes patients can pile the fat back on.
It comes after the Obesity Health Alliance, a coalition of 60 health charities and medical royal colleges, warned the NHS does not have capacity to expand rollout of “life changing” weight loss jabs.
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The vast majority of patients on Mounjaro currently pay for it privately and the Government has said such drugs should be available “to everyone who needs them, not just those who can afford to pay”.
On Wednesday Health Secretary Wes Streeting pledged to do more to prevent people being “priced out” of accessing weight-loss jabs after the manufacturer of Mounjaro said it was putting up prices in the private sector.
Eli Lilly said in August it was putting up the list price of the drug by as much as 170%, which could have meant the cost of the highest dose going up from £122 to £330 per month. However it has since been reported that the highest dose will be sold to suppliers for £247.50.
NHS England started a phased rollout of the drug from June, over a period of up to 12 years, to stop GPs being overwhelmed. Initially only the most seriously obese were eligible – people with a body mass index over 40 and other complicating illnesses such as high blood pressure, obstructive sleep apnoea, cardiovascular disease, and type 2 diabetes.
But the BMJ says few integrated care boards (ICBs) have been allocated enough funding from NHS England for these patients. Responses to its Freedom of Information requests showed only nine of 42 regional boards had the funding needed to cover at least 70% of their eligible patients.
A total of 40 of the 42 ICBs responded to the BMJ’s request.
Four ICBs told the BMJ the NHS funding they had received covered just 25% or less of their eligible patients, with Coventry and Warwickshire faring the worst. That ICB told the BMJ it had received funding to cover just 376 patients, despite identifying 1,795 eligible patients in the first year of rollout.
Dr Jonathan Hazlehurst, consultant endocrinologist and academic clinical lecturer at the University of Birmingham, said the rollout had so far been “significantly underfunded”.
He told the BMJ: “NHS England is talking about treating 220,000 patients in the first three years, but we can see that the initial funding for year one clearly only covers approximately 10% of that.
“If you’re going to have very strict (prescribing) rules, whether they’re right or wrong, you have to fund those very strict rules and have absolute clarity so patients and GPs know where they’re at.”
According to NHS England calculations, around three million patients may be eligible for the jab under current criteria. It has put in place the phased rollout after concerns GPs would be overwhelmed by requests from most of the 3.4 million who will eventually be eligible.
NHS England previously said if all eligible patients turned up for the drug in the first year, and 70% of those were started on treatment, the impact on primary care and general practice would be profound and take up 18% of GP appointments.
Professor Nicola Heslehurst, president of the Association for the Study of Obesity from Newcastle University, said the current commissioning model had set up a “postcode lottery” of access to obesity care.
She said: “The deficit in funding compared with need is another blow for people living with obesity, who deserve evidence-based care to manage their health needs.
“ICBs in more deprived locations will have increased demand for care and need to have the budget required to address obesity inequalities.”
An NHS spokesperson said: “Weight loss drugs have a vital role to play in helping many more people manage their weight and lead healthier lives, and the NHS is developing and rolling out a range of lifestyle support that will be available locally and online to ensure they can be prescribed by GPs as part of holistic care.
“The NHS is fully supporting the phased rollout of tirzepatide for eligible patients, having issued guidance in line with the NICE guidance, and provided funding to local ICBs to support patient care in March 2025. These represent brand new services in primary care that are being established and scaled up over time, starting with those who are in the most need. In the meantime eligible patients can get weight loss support from a range of other services including the NHS Digital Weight Management programme.”
A Department of Health and Social Care spokesman said: “We expect NHS Integrated Care Boards to be making these drugs, which can help tackle the obesity crisis, available as part of the phased rollout, so those with the highest need are able to access them.
“As we shift the focus from treatment to prevention through our 10-Year Health Plan we are determined to bring revolutionary modern treatments to everyone who needs them, not just those who can afford to pay.”