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Tirzepatide after intensive lifestyle intervention in adults with overweight or obesity (SURMOUNT-3 [6] (Wadden et al., Nat Med , 2023))

Patients requiring constant administration of stimulant laxatives should be evaluated further

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Eligibility criteria for NHS-funded GLP-1 treatment for weight management include: For semaglutide (Wegovy): BMI 35 kg/m (or 32.5 kg/m for people from South Asian, Chinese, other Asian, Middle Eastern, Black African, or African-Caribbean backgrounds) with at least one weight-related comorbidity For liraglutide (Saxenda): Similar BMI criteria as defined in NICE TA664 Evidence of previous weight management attempts through lifestyle modification Treatment must be initiated within specialist weight management services (Tier 3) Time-limited use as specified in the relevant NICE guidance The referral pathway typically involves: Initial GP consultation: Discuss weight concerns, document BMI and comorbidities, and review previous weight management efforts Tier 2/3 weight management services: Many areas require participation in structured lifestyle programmes before pharmacological intervention Specialist assessment: Referral to specialist weight management services for treatment initiation Ongoing monitoring: Regular review to assess response, tolerability, and continuation criteria Treatment continuation requires achieving the weight loss thresholds specified in the product-specific NICE guidance and SmPCs