Access to new weight-loss drugs in the United Kingdom could increasingly depend on a patient's wealth rather than their medical need, experts warned. Strict National Health Service (NHS) criteria for prescribing medications like Mounjaro mean that only a limited number of patients will receive the treatment through public healthcare, while others will need to pay privately.

Researchers from King's College London cautioned that this disparity risks exacerbating existing health inequalities, particularly for groups whose conditions are often missed or under-diagnosed. They are advocating for fairer and more inclusive access to these medications to prevent further widening of gaps in care. The researchers published their concerns in a report released January 4, 2026.

The new weight-loss treatments, while representing a significant advancement in obesity management, have the potential to create a two-tier system, according to the report. Individuals who can afford private healthcare may gain timely access to these drugs, while others, potentially at higher risk, may be left without treatment.

Obesity is a complex chronic disease with significant health implications, increasing the risk of type 2 diabetes, heart disease, certain cancers, and other serious conditions. Medications like Mounjaro, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, have demonstrated substantial weight loss results in clinical trials. These drugs work by mimicking the effects of natural hormones that regulate appetite and blood sugar levels.

However, the NHS's strict eligibility criteria for prescribing these medications often prioritize patients with specific health conditions and a high body mass index (BMI). This leaves out many individuals who may benefit from the treatment but do not meet the stringent requirements.

"The concern is that we're creating a situation where access to potentially life-changing medication is determined by socioeconomic status rather than medical need," said Dr. Sarah Williams, lead author of the report and a health policy expert at King's College London. "This could further disadvantage already vulnerable populations."

The researchers are calling for a comprehensive review of the NHS's prescribing guidelines for obesity medications, emphasizing the need for a more equitable and inclusive approach. They suggest considering factors beyond BMI, such as individual health risks, socioeconomic circumstances, and access to other weight management resources.

The current situation has practical implications for patients struggling with obesity. Those who do not qualify for NHS-funded treatment may face the difficult decision of paying privately for the medication, which can be a significant financial burden. Others may be forced to rely on less effective or less accessible weight management options.

The long-term consequences of unequal access to obesity treatment could be substantial, potentially leading to increased rates of obesity-related diseases and widening health disparities across the UK. Further research is needed to assess the impact of these new medications on different populations and to develop strategies for ensuring equitable access to effective obesity care.