AIBU to question GP incentives for prescribing weight-loss drugs?

[NinaNinComPoop]

And to ask what other prescribed medication awards GPs with financial incentives?

Beginning in April 2026, GPs in England will receive financial incentives, averaging £3,000 a year, to increase the prescription of weight-loss drugs, specifically Mounjaro (tirzepatide), to eligible patients. This move is part of a government initiative to accelerate the NHS rollout of these treatments to manage obesity, with up to £25 million in ring-fenced funding.
BBC +2
Key Aspects of the New Initiative:

• Targeted Incentives: The bonus is intended to encourage GP practices to prescribe Mounjaro to those with the greatest clinical need, rather than just those who can afford private prescriptions.
• Eligibility Restrictions: Despite the push, access remains restricted to specific groups. Initially, this includes patients with a BMI of 40 or higher (or 37.5 for certain ethnic groups) who also have at least four weight-related conditions. The eligibility threshold is expected to drop in 2026/27.
• Concerns over Implementation: While aimed at improving access, some GP leaders and experts have voiced concerns that the incentives may not overcome the "stark divide" in access and could strain GP workloads.
• Alternative Care Models: Amidst the focus on medication, some GPs are also expanding "social prescribing" to improve mental and physical health through non-clinical activities like community projects, which can in some cases reduce the need for medication.
• BBC +5

The move follows a broader push to make weight-loss treatments "to the many, not the few," aiming to reduce the long-term health burdens on the NHS.

Absolutely terrible. How dare Measles, Mumps, Rubella, Polio, Diptheria, Tetanus and all those other diseases be prevented in poor people's children? After all, what is Africa without millions of dead babies?

But you're quite happy that people in a wealthy country get medication to not die of obesity related disease (at least significantly due to the fact that they or their parents didn't die of the infectious diseases due to free vaccinations as children).

That’s right, but ANY drug can have adverse effects on SOME people. It’s up to the individual to weigh it up.

Yet it will undoubtedly make us already slim and fit people have to wait even longer for an appointment. Last time I booked a gp appointment it was 6 weeks.

Eat less, it's quite simple.

If eating less was that simple we wouldn’t have an obesity epidemic. We’re in an obesogenic environment.

Absolutely. I've reduced my BMI from 47.2 to 27.6 in just under a year. I was class II obese, but had no medical conditions so wouldn't have been eligible. Seems mad to have waited until I did have before I could have taken action.

Why do you think obese people will
be taking up appointments that 'slim and healthy' people can't get ? If they are slim and fit they won't need an appointment!

I imagine they mean so they can be prescribed. Although it's illogical as if people get 'slim and healthy' they'll statistically need less appts in the future.

Is there some sort of tag team going on on here, “it’s your turn to start the negative weight loss injection thread” where the jealous and resentful all get together. Sigh.

op, no one is asking you to take the meds. And for GPs,and those eligible of course they need to be paid for the extra work.

you are writing like someone’s going to get you in half Nelson and force you down the gp surgery and give you an injection to stop you being fat.

i can assure you that’s not the case. No one cares enough sadly.

Opppsite is true, if you can stop people being fat they use less nhs resources. Applying critical thought it’s important 😂

I try not to get annoyed by people writing crap on the internet but it’s really starting to piss me off.

If I found myself with the urge to vent because I was annoyed that people were getting a medicine which helps them live healthier, happier, longer lives, I would 1) be too ashamed/embarrassed to express my views and b) be examining my own feelings/values/life to try to understand why people improving their lives was getting to me so much.

I, a big fat fatty, got a same day appointment today 😙

Goodness me. I know AI likes to please the user but I've never read such a load of biased twaddle in my life!

It’s because being slim is seen as aspirational and few people like being fat.

Women are perceived as more conventionally attractive when slim, and some women watch and are jealous, deeply jealous, or resentful, as they think it’s being done with too much ease whilst they struggle.

and so we see thread after thread of women posting negative stuff on here, women who aren’t on the meds, which is just incredibly odd as not one person will stop taking them due to it, but every day another one of them has their resentment bubble over and another daft thread is started.

Well, you are demonstrating @BoarBrush‘s point aren’t you? I imagine the receptionist asked “Are you a fat fatty?”, you replied in the affirmative and they said “We can slot you in today then madam.” If you’d said you were a skinny thinny it would have been a six week wait for you 🙄

Oh yes, I phoned up and said “I am a big fat 27 stone and I deserve to be seen right the instant!”

(i jest, of course)

You've just demonstrated you don't understand it at all.

We haven't been allowed to prescribe WLIs in primary care purely for weight loss. The guidelines are clear and prescriptive, and personal views don't come into it.

Regarding the OP, what a pile of tripe. God forbid we are paid to deliver something we're commissioned to do... patients starting WLIs need multiple appointments, follow ups and monitoring. It's written into the service specification. This will largely be delivered by nurses who will funnily enough need to be paid to do the hours to provide these appointments.

Even BMI 40+ but no other weight related issues yet would help a lot more people. That was me when I started - BMI of 43, so into the 'this could kill you' catagory, but that wasn't bad enough for a NHS prescription. I completely understand that they can't prescribe to everyone who just fancies it, but it's incredibly restrictive still. And of course had a prescription have been possible I'd have got one of those big fat fatty same day appointments, which would have been excellent.

Personally I think it should be anyone who’s obese, but I say it because I want them prescribed!

Yes and I saw something a while ago, the actual numbers getting it on the nhs are minuscule.

the nhs have made 220 thousand people eligible, the amount getting it are a tiny percentage of that , a couple of thousand max, as doctors are saying they haven’t been given the go ahead by their health authority and no funding.

22 million are eligible under the mhra presciption guidelines. The nhs was supposed to be increasing past the initial 220 k, this year, and have not even come close to that first number. In fact when the nhs announced it last year, most surgeries put a recorded message on saying we can’t prescribe. And they have just let the situation lay there like that until now.

so now we have 2 and a half million people in the uk on them privately . That 2.5 million reduces the amount who will need them on the nhs, and also reduces the pressure on the nhs, because these people will be healthier and consume less nhs resources, freeing them up for others.

im a micro example, I was seeing my gp monthly, sometimes more, due to high blood pressure, I’ve not had to see a doctor for over a year. I don’t need the blood pressure meds any more, my gp took me off.

if I had not went on mounjaro then it is likely my health situation would have deteriorated further, it was my gp who recommended them, and was appalled she wasn’t allowed to prescribe. Fortunately I could afford them, discussed with my family and took them and hav had amazing results on them. I immediatly felt better, and my stomach started shrinking back, my energy levels up, and my bp started dropping.

its sad we are in this situation, where big pharma can profit in this manner, and restrict the market, but thats where we are. And people need to stop watching those on them living their best lives, with their jealous or resentful eyes and get control of themselves.

it’s fine not to want them. No one will make you. But this repeated negative threads isn’t stopping anyone. Nor is it fooling anyone.

Oh I hear you, but I guess it's the same problem they have with potentially game changing cancer drugs etc - the money isn't there to prescribe everything to everyone who'd benefit. I'm genuinely happy for the small number of people who can get it through the NHS while I'm also bemused that with a BMI of 43 and pre-diabetes I was 'too healthy' for it that way 😂

Ultimately, these medications will save the NHS a huge amount of money.

Firstly, you are no more entitled to an appointment than anybody else.

Secondly, it will ultimately free up appointments as obesity and all its related complications becomes less of an issue.

There are no losers here.

Your response is only surprising for not appearing near the beginning of the thread. If only it were as easy as the "eat less, move more" mantra that is always trotted out on these threads. There are a myriad of reasons for people to be overweight and not all involve the amount of food on someone's plate. Certain drugs can make people put on weight as can various medical conditions. Even when people are overweight because they have eaten too many of the "wrong" foods, there are often reasons behind it. Many people comfort eat because it really can help them to feel better when in a difficult situation. The psychology behind obesity is not to be underestimated. I think the guidelines are good, although perhaps the criteria could be lowered to a BMI above 30 with comorbidities. The medical costs of illnesses caused by obesity will be drastically cut as people lose weight and the cost of the injections will be seen as much cheaper in the long run. They are also a much better option than weight loss surgery. For those people, mostly people who have never had a weight problem, who think that such interventions are somehow cheating, it must be remembered that they are tools, not a quick fix. The obese person still has to put in a lot of hard work. And, no, although I could certainly lose a bit more weight, I don't qualify for the injections, whether on the NHS or privately but I have no problems with other people using them.

We? Are you saying you're a GP? In which case you must know that GPs have been allowed to prescribe WLI.

@MoneyJo not a GP but no, we’re not allowed to prescribe PURELY FOR WEIGHT LOSS WITHOUT QUALIFYING COMORBIDITIES. (And even then in my locality we have to refer to tier 3 services for initiation).

We can prescribe for diabetes and have been able to do so for years.