Ozempic following gestational diabetes

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I've recently been diagnosed with gestational diabetes and am being treated with insulin. My blood sugars are relatively under control now, and I only ever needed insulin at night, not before/after meals.

How likely is it that I could be prescribed Ozempic via the NHS after birth and breastfeeding? I did take it privately for a while and it worked well but it's obviously expensive for a private prescription. I can see it's indicated if you have type 2 but hopefully I won't have type 2 after pregnancy, and I'd rather never get it, for very obvious reasons.

I would love to think it's possible that I'll lose weight without help from the drugs, but realistically I've been overweight or obese my entire adult life and it's not something I can achieve on my own. And yes, I have tried slimming world/no carbs/intermittent fasting etc.

You're looking at about a year away or so, depending on how long you breastfeed for?

Wegovy is only prescribed by the NHS for weight loss if you are on the specialist weight management service, which you need a high BMI to be referred eg over 35 or over 40, and the waiting lists can be long depending on area. They can also be closed to new referrals. You usually have to be on the tier 3 level of support, after going through the previous tiers of support without results which could be months or years.

Mounjaro is going to be rolled out in the summer of 2025, if the NHS follows the announced timetable, but starting with people with BM greater than 35 and a weight related health condition. It may not be available in all areas or to everyone that asks for it.

I would investigate what your local NHS weight management service is, and what the waiting lists are for referrals, and see if you can get on those services if you are eligible. You will probably need to wait until you are not pregnant or breastfeeding though to use those services.

According to the panorama programme on recently "a small number" of obese patients, who had waited 2yrs for the appointments, the ones shown were very overweight and had additional complications - one couldn't walk, all had sleep apnea, it wasn't just they were holding a few lbs.

Having accessed private prescription sites, as mentioned above you have to specify that you are not breastfeeding or have plans to try to conceive.

I don't think the injection is right at this time for you?

I will probably breastfeed so in terms of timing, it wouldn't be until early 2026 I'd want to start the medication, if I breastfeed as long this time as I did last time. It's definitely not something I'd want to take while I'm pregnant, or breastfeeding.

Nobody can really tell you what the prescribing criteria will be in '26, especially given that it's a relatively new drug and they're finding different side effects/long term effects/treatment plans all the time.

At the moment, you'd need to stop breastfeeding, and then be referred to weight management and work your way through the tiers to whichever one your LA uses Ozempic for. Gestational diabetes itself doesn't appear to increase your chances of being prescribed it anywhere in the UK.

Mounjaro produces more weight loss on average than Wegovy/Ozempic, and it is also used to manage blood sugars for diabetics if their blood sugars are not well controlled with other approaches. It might be worth considering privately funding a Mounjaro prescription when you are done with breastfeeding. Or the NHS roll out of Mounjaro might be more developed and you may have more chance of accessing it that way, in 2026 perhaps. Depending on how obese you are and if you have any weight related health conditions at that point.