Tirzepatide for managing overweight and obesity

  • Technology appraisal guidance
  • TA1026
  • Published: 
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A practical guide to using medicines to manage overweight and obesity

Medicine options for weight management in adults

Recommended medicines for weight management and related NICE guidance are shown in table 1. This should be read alongside the NHS England interim commissioning policy for tirzepatide when it is published.

All medicines for weight management should be used alongside a reduced-calorie diet and increased physical activity.

Table 1 NICE-recommended medicine options for weight management in adults
- Tirzepatide Semaglutide Liraglutide Orlistat

For more detail see

NICE's technology appraisal guidance on tirzepatide for managing overweight and obesity (TA1026, December 2024)

NICE's technology appraisal guidance on semaglutide for managing overweight and obesity (TA875, March 2023)

NICE's technology appraisal guidance on liraglutide for managing overweight and obesity (TA664, December 2020)

There is no NICE technology appraisal guidance on orlistat

For adults with

An initial BMI of at least 35 kg/m2 and at least 1 weight-related comorbidity.

At least 1 weight-related comorbidity and:

  • an initial BMI of 35.0 kg/m2 or more,

or

An initial BMI of 35 kg/m2 or more

and

non-diabetic hyperglycaemia

and

a high risk of cardiovascular disease.

A BMI of 30 kg/m2 or more

or

a BMI of 28 kg/m2 or more and associated risk factors. (orlistat summary of product characteristics)

For tirzepatide, semaglutide, and liraglutide, use 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.

Non-diabetic hyperglycaemia is defined as a haemoglobin A1c level of 42 mmol/mol to 47 mmol/mol (6.0% to 6.4%) or a fasting plasma glucose level of 5.5 mmol/litre to 6.9 mmol/litre.

People with type 2 diabetes can also be prescribed tirzepatide if they meet the criteria set out in the recommendations in NICE's technology appraisal guidance on tirzepatide for treating type 2 diabetes. A GLP-1 receptor agonist can also be considered for people with type 2 diabetes following the recommendations in NICE's guideline on type 2 diabetes in adults.

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