All about GLP-1 weight-loss injections

The MHRA has updated guidance on the NHS rollout of GLP-1 weight-loss injections, with strict criteria now in place – particularly for Mounjaro (tirzepatide). Unsurprisingly, GP surgeries have seen a surge in phone calls from people eager to access these injections.

There has also been a rise in private prescriptions, which unfortunately increases the risk of misuse and abuse.

Who is eligible?

Weight-loss injections are available through the NHS to people in specific health circumstances (the information below was taken from the NHS at the time of publication.) GPs will be contacting patients who meet the criteria.

To qualify, individuals must:

• Aged 18 or over
• Have a BMI over 40, and
• Have four or more of the following diagnosed conditions:
  • Type 2 diabetes
  • High blood pressure (hypertension)
  • Heart disease (cardiovascular disease)
  • Obstructive sleep apnoea
  • Abnormal blood fats (dyslipidaemia)

Resources for this level of prescription must be allocated appropriately, and eligibility will be at the health professional’s discretion.

Considerations for prescribing

Health professionals will also consider:

Is the patient physically able to make lifestyle changes to reduce weight?

Or are there pre-existing conditions which prevent this, such as mobility issues, rheumatoid arthritis, osteoporosis, Parkinson's, multiple sclerosis, asthma, or COPD? These conditions could prevent even the most committed individual from losing weight, which could then lead to further difficulties associated with weight gain. This may determine the length of time a prescription is given, and whether it is viable or not.

Does the patient have support in place to succeed?

Individuals who have support such as a weight-loss advocate, nutritionist, counsellor, home help, and family support are far more likely to succeed, as there is accountability and education.

Once the weight-loss has been achieved, it is vital that support is given to ensure bounce-back weight gain does not occur or is kept to a minimum.

Eating, lifestyle and side effects

Side effects of the injections may affect the ability to cook; it may affect appetite, or there may have already been poor eating habits. Therefore, it is essential that every single mouthful has high-quality nutritional content so nothing can be taken to chance, no corners cut.

Making sure that individuals are prepared mentally and physically will enable the best from this journey. Otherwise, it's a wasted prescription.

Ask the prescribing professional what support is in place, as ongoing guidance and support will ensure better success.

Reporting side effects

Data collection is vital to building knowledge. If professionals can better predict, then they can better prescribe, so reporting is extremely useful. The yellow card scheme exists so patients can register the side effects.

There is a danger that data will be skewed by limited reporting by private sector prescription users not reporting or GP prescription users not reporting for fear of losing their weight-loss help. This is not the case. Data reporting is essential.

How to eat and live well when on GLP-1 medication

If you have any questions or doubts, it is essential you consult a health professional such as a nutritionist, dietitian, GP, or other professional.

• Use whole foods wherever possible.
• Ensure fibre is introduced by eating whole grains, vegetables and fruit.
• If appetite is affected, try small portions.
• Whole food smoothies can help add essential nutrients.
• Chew your food well.
• Exercise regularly, within any limitations you may have.
• Seek professional advice if you are unsure of the type of exercise.
• Use lean meats and low-fat products.

References:

• Concerns grow as slimming injections tied to more than 100 UK fatalities (Diabetes.co.uk)
• Yellow Card | Making medicines and medical devices safer (yellowcard.mhra.gov.uk)
• Important Information Regarding GP Prescribing of Mounjaro (Tirzepatide) for Weight Management (Arnos Grove Medical Centre)