Ozempic NHS criteria

[LittleRebelGirl]

Hi,
I'm a bit confused on the criteria to be prescribed Ozempic by the NHS. NICE guidance and NHS guidance seem different.
Before I ask anyone, can I ask her if anyone has been prescribed for bmi over 35 and raised cholesterol. I don't have diabetes or high BP. So would this meet criteria? Am already under tier 3 SWM. I have a dietician app in 3 weeks. She asked me to repeat my bloods last week as my last hba1c was 41. This time it was 39. She didn't mention the cholesterol part though. Last time it was borderline but this time it is raised.
I just want to be prepared. Is it the dietician who can prescribe, or do I need to ask the GP? Sorry for all the questions. Dietician took me by surprise when she mentioned it at the last appt as I'm struggling massively and have put weight on rather than lose it in the last 8 months of being under swms. I can't remember everything that was said so now I don't know what in supposed to do!

GP’s can’t prescribe it for weight loss I’m afraid.

At the moment, patients can only receive Semaglutide on the NHS via Tier 3 weight loss clinics, and then only for 2 years. It cannot be prescribed to patients by GPs, except in the form of Ozempic for patients with Type 2 diabetes
https://www.nbmedical.com/blog/semaglutide-for-obesity-how-does-it-work-whats-the-evidence-and-can-my-patient-have-it#:~:text=At%20the%20moment,%20patients%20can,patients%20with%20Type%202%20diabetes.

So will it be the dietician then? I have a weight management telephone review the day after the dietician. Still waiting for psychologist appt which I think is the crucial missing part of the puzzle for me. In the meanwhile I'd like to try medication - but not Orlistat. I work in community with no toilet access.

@LittleRebelGirl NICE has approved Wegovy for weightloss and Ozempic for D2 treatment. Both are the same drug (Semaglutide) but Wegovy has it's own dosage approval and safety and efficiency data. Wegovy is not yet available in the UK due to supply issues. At present, I think the only drug (of this kind) that is available purely for weightloss is Liraglutide (Saxenda), it's related but not exactly the same and it's a daily injection. Liraglutide is approved for D2 and weighloss again under different names (I think).

Obviously, there's a small overlap with conditions so e.g. it's possible for Ozempic to be prescribed for weightloss, but it would only be with co-mobilities which meant you were practically in the D2 category as well.

NICE make recommendations and recommendations for the NHS, it's up to the NHS to implement the approvals as each trust can resource and source. So a particular area may not follow the NICE guidelines to the letter, some treatments may not be easy to come by in your area because of staffing resources, cost or any other reason. What the NHS can't do except in very rare circumstances is prescribe a treatment that's not been approved by NICE.

https://www.nice.org.uk/search?q=Liraglutide

https://www.nice.org.uk/search?q=semiglutide&ndt=Guidance

I had a telephone appointment with the weight management service at the start of this year and they gave a code for free weight watchers classes. Only people with a BMI 60 or over are considered for other treatments such as weight loss injections. Don’t know if this is UK wide but it seems to be Scotland wide at the moment and she said with the sheer volume of referrals etc they’d had to change their criteria to the BMI 60.

I've been prescribed Ozempic by my GP. I had a BMI of 60. It gone down a bit now. I have very high blood pressure, high cholesterol, thyroid problems, and I'm asthmatic too and my blood sugar is not stable so pre diabetic. My GP said I could go onto Ozempic now and be switched on to Wegovy once it's licensed in the UK. I've been on it for 6 weeks now and lost 7.4kg.

I also have to do a food diary with a Dietician once a month and weigh in with the nurse. I can only keep getting it if I keep losing weight.

If you can't get ozempic I would try saxenda as it is licensed for weight loss.