I'm ineligible for weight loss drugs: can I ask a second opinion?

Ready to take the next step? See if you're eligible for expert-led weight loss support.

Have you been told you're ineligible for weight loss drugs? Learn about your options and your rights, including asking for a second opinion on the NHS.

Prescription-only GLP-1 weight loss medications, including Wegovy (semaglutide) and Mounjaro (tirzepatide), are becoming increasingly popular in the UK. By one estimate, around 1.6 million British adults were using or had recently used a GLP-1 drug for weight loss in early 2025.¹

It's easy to guess why these treatments are so popular: they're effective. To take Mounjaro as an example, users typically lose 21% of their starting body weight when taking the drug alongside diet and exercise changes.²

However, many find that accessing the treatments is still a challenge. In some parts of the UK, Wegovy and Mounjaro are available on NHS prescription – but with strict eligibility criteria.

These criteria exist to keep patients safe and prioritise NHS resources for those who could benefit most. However, it does mean that many patients – some of whom could benefit from the treatments, in theory – are told they don't qualify in practice.

That raises the question: can you ask for a second opinion if your GP tells you that you're ineligible for Wegovy or Mounjaro?

The short answer is yes – you're free to ask for a second opinion on the NHS. However, it's not a legal right, and your doctor doesn't have to agree if they think it's inappropriate.

Let's unpack this. We'll look at the eligibility criteria for Wegovy and Mounjaro, why you might be told you're ineligible, and your options if that happens.

Who is eligible for Wegovy and Mounjaro in the UK?

There are different eligibility criteria for Wegovy and Mounjaro in the UK, depending on whether you choose the NHS or a private route.

These are both based on your body mass index (BMI) – a measure of body fat. Doctors will also consider whether you have existing weight-related health conditions, as well as your ethnic background. That's because certain ethnicities are at a higher risk of weight-related complications.

(Note: these criteria apply to NHS patients in England.)

Wegovy NHS criteria³	Mounjaro NHS criteria³	Private criteria (Wegovy or Mounjaro)
You must have a BMI of 35 or more, OR	You must have a BMI of 40 or more AND at least 4 weight-related health conditions.	You must have a BMI of 30 or more, OR
➡️ 32.5+ if you come from certain ethnic backgrounds	If you come from one of several high-risk ethnic backgrounds, you may qualify at a lower BMI.	➡️ 27.5+ if you come from certain ethnic backgrounds
➡️ 30+ if you meet other criteria for specialist weight management services		➡️ 27+ if you have a weight-related health condition
➡️ 27.5+ if both of the above apply		➡️ 25.5+ if both of the above apply

It's important to note that meeting these criteria doesn't guarantee you'll receive treatment. There are other factors to consider, such as your medical history and medications you're currently taking. Plus, the treatments aren't yet available on the NHS in all parts of the UK.

Why might you be told you're not eligible?

There are several reasons why your doctor might say you're ineligible for Wegovy or Mounjaro. These include:

Being below the BMI threshold
Not having qualifying health conditions (if you go down the NHS route)
Not yet being referred to tier 3 weight management services (this is required for NHS treatment – GPs can't prescribe the medications directly)
The treatments not yet being available on the NHS in your area
Other clinical concerns (such as previous health conditions or currently prescribed medication)

However, being declined doesn't always mean that treatment is impossible. Depending on the route you take, there may still be options available to you.

What are my options if I'm told I'm not eligible?

Ask for a second opinion on the NHS

Doctors in the UK are regulated by the General Medical Council (GMC). The GMC says that doctors must:⁴

Recognise your right to choose whether to accept their advice
Respect your right to seek a second opinion

However, while the NHS encourages people to seek a second opinion if they have doubts, no UK law says you're entitled to one. It's considered a right, but not a legal right.⁵

In practice, however, most doctors will be understanding and willing to support you.

If you're unsure why you're ineligible, a good first step is to ask your GP to explain. Their explanation might help clarify the situation and their choices.

If you're still unhappy, tell your GP why. You can then:

Ask to see another GP at the same practice.
Ask for a referral to another NHS specialist.
Ask about alternative providers that can provide NHS treatment. This is a right under Any Qualified Provider – a framework that allows non-NHS providers to offer NHS services.

Ask for a second opinion privately

If you're ineligible for treatment on the NHS, you can still approach a private healthcare service for a clinical assessment.

Asking for a second opinion privately doesn't guarantee approval. Far from it – a private clinician will still assess safety and suitability just as carefully as an NHS doctor.

However, it does mean:

You'll get an independent review of your eligibility from a qualified clinician.
You'll face less strict criteria for approval (a BMI of 30+ as a general cutoff point).
You won't need a referral to tier 3 weight management services.
You may be able to receive treatment more quickly (if your local NHS services are facing delays).
If you're eligible, you can access treatments even if they're not available on the NHS in your area. Many private weight loss services offer remote treatment online.

Of course, unlike NHS treatments, private healthcare is not free. However, if you can afford it, it could be a viable option – especially if you narrowly miss the NHS criteria for treatment.

Semapen is an online provider of Mounjaro and Wegovy on private prescription, as well as the SemaHealth drug-free meal replacement programme. Our programmes are designed and led by UK experts and include step-by-step support to help you lose weight safely and sustainably. You can find out if you're eligible today by taking our quick online consultation.

Sources

1. Jackson, S.E. et al. (2026) "Prevalence of use and interest in using glucagon-like peptide-1 receptor agonists for weight loss: a population study in Great Britain" BMC Medicine, 24(1) https://doi.org/10.1186/s12916-025-04528-7

2. Jastreboff, A.M. et al. (2022) "Tirzepatide Once Weekly for the Treatment of Obesity" The New England Journal of Medicine, 387(3) https://doi.org/10.1056/NEJMoa2206038

3. NHS (2023) Treatment: Obesity. Retrieved from https://www.nhs.uk/conditions/obesity/treatment/

4. Healthwatch (2025) Getting a second opinion about your care. Retrieved from https://www.healthwatch.co.uk/advice-and-information/2025-09-29/getting-second-opinion-about-your-care

5. The Patients Association (n.d.) Getting a second opinion. Retrieved from https://www.patients-association.org.uk/getting-a-second-opinion

This article was reviewed and approved by Lujain Alhassan, Bariatric Nutritionist, on 3 April 2026.

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