The majority of patients in London taking weight loss medications are doing so privately, with slow rollouts meaning only a fraction of eligible patients are accessing the drugs on the NHS.
The findings come from a report by the London Assembly’s health committee, which has found a “two-tier system” of weight loss drug accessibility emerging in the UK’s capital. As of November 2025, just 3,000 London residents were accessing weight loss medicines on the NHS. This is a significant gap to the 35,000 to 40,000-figure forecast by 2028. Instead, tens of thousands of patients are estimated to be buying obesity medication privately, owing to a lower threshold of eligibility.
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Exact figures on usage vary, but estimates relayed by Novo Nordisk – manufacturer of Wegovy (semaglutide), a glucagon-like peptide-1 receptor agonist (GLP-1RA) – suggest that up to two million people are using weight loss drugs in the UK. Their use has surged given their efficacy in treating obesity.
In a foreword to the report, Emma Best, the health committee’s chair, said: “[Weight loss drugs] represent a promising new tool in tackling obesity, and often give people the confidence or first step they need to change their lifestyle for the better. However, these medicines are not a silver bullet and access is not always simple.”
Currently, patients seeking GLP-1RAs such as Eli Lilly’s Mounjaro (tirzepatide) – the most prescribed in the UK – on the NHS need to have a body-mass index (BMI) above 40 kg/m² and four or more obesity-related comorbidities. The Assembly’s report, however, suggests that the NHS is still in the early stages of rolling out weight loss drugs, with pilot locations and specialist weight management services the primary channels for access. Patients can also choose their preferred NHS service provider – some patients in London are accessing the medicines this way.
Under the current eligibility criteria, NICE estimates that 220,000 individuals will receive Mounjaro on the NHS nationally by 2028. Given that a large proportion of patients will continue to access drugs like Mounjaro via the private sector, the London Health Committee said that certain provisions need to be taken in order to avoid unequal health outcomes.
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By GlobalDataThese include accelerating the rollout of weight loss medications on the NHS, more ‘wraparound’ care, a review into links between weight loss medication and eating disorders, and patient consultations. Importantly, the committee recommends that a London-wide clinical pathway for weight loss medicines be established by the end of 2026-27, along with a dedicated taskforce to mediate work between the government, health agencies, and pharmacy organisations.
An update to the UK primary care general practitioner (GP) contract for 2026–27 has already provided bonus payments for Mounjaro injections and support for referrals to weight-loss services. Janet Beal, managing analyst of health economics and market access, Europe/CIS at GlobalData, said the new incentive payments “may help to address recent reports of localised restrictions on the availability of this drug for otherwise eligible patients”.
