Are there different qualifications for getting prescribed Wegovy compared to other drugs?

Yes, NICE guidance states that Wegovy can be offered to adults with a BMI over 35 and at least one weight-related condition, or sometimes with a BMI over 30 if criteria are met. Other drugs, like Saxenda or Mysimba, have similar but slightly different BMI thresholds, while diabetes drugs like Trulicity are prescribed on blood sugar criteria instead.

Wegovy and its eligibility rules

In the UK, NICE sets out clear criteria for who can be prescribed Wegovy. It is recommended for adults with a BMI of 35 or more who also have weight-related health problems, such as high blood pressure or sleep apnoea. In some cases, people with a BMI of 30–34.9 may also qualify if they meet specific conditions, including referral to an NHS specialist weight-management service. These rules are designed to ensure that Wegovy is targeted at those most likely to benefit.

Saxenda and Mysimba

Other weight-loss medicines have slightly different thresholds. Saxenda (liraglutide) can be offered to adults with a BMI of 35 or above who have non-diabetic hyperglycaemia and are at high risk of cardiovascular disease. Mysimba (Contrave internationally) is licensed for people with a BMI of 30 or more, or a BMI of 27 or more if they also have a weight-related condition such as type 2 diabetes or high cholesterol. While the numbers overlap with Wegovy’s, the exact conditions for use are not identical.

Trulicity and other diabetes medicines

For drugs like Trulicity (dulaglutide) or Ozempic (semaglutide at lower doses), eligibility is not based on BMI but on blood sugar levels and diabetes control. NICE guidance recommends these medicines for people with type 2 diabetes who are not meeting their glucose targets with first-line treatments such as metformin. Weight loss is a helpful side effect, but it is not the main reason for prescribing them.

Why eligibility rules matter

The qualifications for prescribing are important because they help balance access, safety, and NHS resources. GLP-1 medicines are expensive, so NICE ensures they are directed to the groups with the greatest health need and where the evidence is strongest. For instance, the cardiovascular outcome benefits of semaglutide supported its recommendation in people with obesity, while Saxenda and Mysimba were approved on the basis of more modest weight-loss evidence.

NHS implementation in practice

In England, Wegovy is being rolled out through NHS specialist weight-management services, where eligibility is carefully checked before treatment begins. This approach combines the medicine with lifestyle and behavioural support, which NICE highlights as essential. For Saxenda and Mysimba, NHS use is more limited, and many people access them privately. For diabetes drugs like Trulicity, eligibility checks focus on HbA1c targets, kidney function, and cardiovascular risk.

Why comparisons can be confusing

Because several of these medicines belong to the same GLP-1 family, it is easy to assume their prescribing rules are interchangeable. In reality, each has its own NICE appraisal and set of criteria, reflecting differences in trial evidence, cost-effectiveness, and safety. That’s why clinicians emphasise not just which drug works, but whether a person qualifies for it under NHS or private guidelines.

What the evidence shows overall

Yes, there are different qualifications for getting prescribed Wegovy compared with other drugs. Wegovy is focused on BMI-based eligibility within specialist weight-management services, while Saxenda and Mysimba have similar but slightly different thresholds, and diabetes drugs like Trulicity are offered based on blood sugar control. The distinctions reflect not only the evidence from trials but also the NHS’s priority of directing resources to where they make the most difference.