NHS Scotland weight loss jabs reach only 705 patients three years after approval

Fewer than 800 people in Scotland have been given NHS Scotland weight loss jabs for obesity, three years after the first one was approved for that use, a BBC investigation has found. Freedom of information replies showed 705 patients treated for weight loss by September 2026, all through small pilot schemes. Most of Scotland's health boards do not routinely prescribe Mounjaro or Wegovy for weight loss at all, while private use has grown far faster. Senior doctors call the gap discriminatory. The Scottish government says each health board decides which medicines it makes available.

What the BBC found

The BBC asked every health board in Scotland whether it prescribes the injections specifically for weight loss. Only a handful said yes, and all of them through pilots that take a small number of patients. The boards named were Forth Valley, Borders, Lothian, Lanarkshire and the Western Isles, along with the State Hospital. Together they had treated 705 people for weight loss by September. The other nine territorial boards said they do not routinely prescribe the drugs for that purpose, though some are working on plans and exceptional cases may get through. Mounjaro was approved for weight loss use in NHS Scotland in 2023 and Wegovy in 2024, according to the BBC. Both drugs have long been used for type 2 diabetes, where access is far wider.

The private market dwarfs those numbers. The BBC cited an estimate from an online pharmacy that at least 300,000 people in Scotland get the drugs privately. That figure comes from a seller, not an official count, so it should be read with care, but even a fraction of it would leave NHS treatment far behind. A third of adults in Scotland are classed as obese, which raises the risk of heart disease, some cancers and diabetes. The result is a two track system: a few hundred people get supervised NHS treatment, and many more pay out of pocket, often through online providers. People on lower incomes are more likely to be obese and less able to pay, which is why doctors say the gap is widening health inequalities.

Inside the Forth Valley pilot

The Forth Valley scheme, run from Falkirk Community Hospital, shows how tight the current rules are. To join, patients needed a BMI of 40 or more and at least four serious medical conditions, or a need for life changing surgery that their weight made unsafe. The clinic treats 48 people, and 18 more receive the drugs through their GP practices. Patients have regular check ups with a pharmacist and a dietitian. The service is not taking new referrals while the pilot runs. Claire Colligan, the board's associate director of pharmacy for primary and community care, said the board wants to expand but must keep the programme manageable. "These drugs are not going away," she told the BBC.

To join, patients needed a BMI of 40 or more and at least four serious medical conditions, or a need for life changing surgery that their weight made unsafe.

One patient in the pilot, a 54 year old woman from Laurieston, was referred by her gynaecologist because she needed surgery that her weight made too risky. She told the BBC she had lost four stone since April, about 13% of her body weight, and that her physical and mental health had improved. She said she had not wanted to buy the drugs privately because she wanted proper support. Her case shows what supervised treatment can offer, but also how few people reach it. Experts quoted by the BBC stressed that weight often returns after the injections stop, and that diet, exercise and follow up are needed to keep it off. The pilot's model of regular review is built around that risk.

Why doctors call it discriminatory

Dr Mark Strachan, a diabetes specialist who spoke to the BBC for its investigation, said it was "unacceptable" that there had been "no meaningful progress" since the BBC first reported low access a year earlier. He argued that the NHS spends heavily on treating the complications of obesity instead of paying for medicines that tackle the cause. He said the drugs are "safe" and "cost-effective" and could be given to the people at highest risk first. He described being able to prescribe them to one patient for diabetes but not to another patient for weight related illness later the same day. In his words, the lack of access was "discriminating against people with obesity."

Strachan also worries about the scale of private use without proper clinical input. "I can't think of many classes of medicines where there are such high levels of private prescriptions," he said, adding that this cuts against the usual norms of safe prescribing in Scotland. Private buyers pay prices set by the maker and the seller, and those prices can move, as when Lilly raised the UK private price of Mounjaro in 2025. People who buy outside a regulated pharmacy face extra risks from fake or unlicensed products. For many patients, though, private supply is the only route available while NHS Scotland weight loss jabs remain limited to pilots.

How Scotland compares with England

England has moved faster, though critics there say it is still too slow. Family doctors in England began prescribing Mounjaro for weight loss in 2025 under a phased plan that starts with the highest risk patients. Even so, a Commons committee said this month that the English plan would reach only about 6% of eligible people in three years, and called the rollout unambitious. Scotland has no single national rollout of that kind. Instead, its boards follow a national consensus statement that recommends bringing the drugs in step by step, by BMI and related illness, with each board deciding on timing. That structure explains why access depends so heavily on where a patient lives.

Public Health Minister Maree Todd said the medicines are one of several effective treatments for obesity, alongside diet and exercise. She repeated that health boards are responsible for deciding how and when to introduce them, guided by the consensus statement on GLP 1 drugs. Earlier warnings from doctors that offering the drugs to everyone eligible would overwhelm NHS budgets help explain the caution. For patients waiting on NHS Scotland weight loss jabs, the practical steps are limited. People who think they might qualify can ask their GP whether their board runs a pilot and what its criteria are. Those who already pay privately should use a regulated pharmacy and tell their GP, so their records reflect the treatment and any side effects can be followed.

Conclusion

NHS Scotland weight loss jabs have reached only 705 patients for obesity since the first approval in 2023, all through small pilots in a minority of health boards. Private use is far larger, and senior doctors say the gap is unfair and widens inequality. The government leaves the pace to each board. Until that changes, most people in Scotland who want these drugs for weight loss will either wait or pay.