The NHS will limit access to a weight loss jab for 90% of obese patients eligible under current guidelines, citing financial pressures.

The National Institute for Health and Care Excellence (NICE) called this a “difficult decision” aimed at “protecting other essential NHS services,” including critical areas like NHS mental health and NHS diet programs.

NICE has approved Mounjaro (tirzepatide), produced by Eli Lilly, for individuals with a body mass index (BMI) over 35 and at least one weight-related health condition. This covers around 3.4 million people, but only 220,000 patients will be prioritized for treatment over the next three years.

Obesity now affects more than one in four UK adults, with the economic burden estimated at £98 billion annually. Treating obesity-related conditions alone costs the NHS £11.4 billion each year.

Wes Streeting has endorsed pilot programs to determine if these jabs could reduce unemployment linked to health problems. The Health Secretary emphasized that this new class of medication could have a "monumental" impact on reducing obesity and related work absences, noting that obese employees are up to twice as likely to take sick leave.

In response to the rollout plan, NHS England has requested a gradual implementation to allow time for new service setups and staff training, ensuring that both NHS diet and NHS mental health services are integrated into the broader obesity treatment strategy.

NICE maintained that the jabs represent a cost-effective use of NHS resources for individuals meeting the BMI and health condition criteria, but a phased rollout is necessary to manage costs and resources effectively.

But NHS England said time was needed to develop “coordinated and sustainable service models”, train healthcare professionals and to prevent existing services having to be closed down. It asked for the impact on budgets to be taken into account, in giving the NHS extra time to roll out services.

Estimates suggest the limited rollout will cost the NHS around £320 million a year by the third year of rollout.

Nice did not take account of the costs of obesity to the economy.

Earlier this year, a study found that weight-loss jabs had a significant impact on a number of major health conditions, cutting the risk of death from heart attacks and strokes by one fifth.

It was followed by a slew of cardiology papers, which found the jabs could turn back the clock on a host of diseases.

The decision by Nice in final draft guidance means there will be a further review about how best to roll out the jabs to a wider population after three years.

Professor Jonathan Benger, Nice’s chief medical officer, said: “The world will look very different in three years which is why we’ve taken the unprecedented decision to review the way this medicine is delivered to patients then.

“Tirzepatide and other drugs like it, such as semaglutide, will help people living with obesity to lose weight, and as a result will reduce their risk of developing heart disease or having a stroke.

“But tirzepatide is not for everybody, and only those with the highest clinical need will be treated initially. This means many people will have to wait. We have had to make this difficult decision in order to protect other vital NHS services and also to test ways of delivering this new generation of weight loss medications.

“We want to help NHS England carefully manage the roll out of tirzepatide to ensure that other services are not impacted in a disproportionate way.”