Tirzepatide use for obesity

NICE issued guidance on the use of tirzepatide (Mounjaro) in type 2 diabetes in 2023 and followed this in 2024 with: ‘Tirzepatide for managing overweight and obesity’.Tirzepatide is recommended as an option for managing overweight and obesity, alongside a reduced-calorie diet and increased physical activity, in adults with an initial body mass index (BMI) of at least 35 kg/m2 and at least one weight-related comorbidity. NICE advises using lower BMI thresholds (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, as some ethnicities are at an equivalent risk of the consequences of obesity as a lower BMI than people from White ethnicities. Different models of community-based services and digital technologies are being developed by NHS England for the use of tirzepatide over the next three years as part of a phased rollout. Initially, it is proposed that people would be eligible to receive  tirzepatide if they have a BMI of more than 40 kg/ m2 and at least three of the specified weight-related health problems:

• Hypertension
• Dyslipidaemia
• Obstructive sleep apnoea
• Cardiovascular disease. 

The medicine would be part of a wraparound package including diet and exercise support, could be offered in either primary or secondary care, with a multidisciplinary team.