Getting Saxenda on the NHS (2025): Is It Still Possible?
For a time, Saxenda (liraglutide) was one of the most widely discussed medicines for medical weight management in the UK. It offered a pharmacological option to help regulate appetite alongside lifestyle changes. But in 2025, patients trying to access Saxenda on the NHS are often encountering a confusing situation: it remains approved in certain circumstances, yet access is limited.
The user comments included in this article come from public online forums and reflect individual experiences. They should not be interpreted as typical results or clinical evidence. Responses to treatment can vary, and medical decisions should be made with a qualified healthcare professional.
"My GP told me Saxenda was on the NHS, but then said they couldn’t prescribe it. It’s so confusing." -u/thisislife09
Saxenda’s position within the NHS has changed as newer medicines such as Wegovy (semaglutide) and Mounjaro (tirzepatide) have been introduced. Understanding the current policy helps explain why access can be limited.
The Saxenda Story
When Saxenda was approved by NICE in 2020, it was one of the first GLP-1 medicines recommended for weight management in certain patients with obesity and related health risks. It works by mimicking a hormone that affects appetite and digestion.
"It was the first thing that actually worked for me. I wasn’t constantly hungry anymore." -u/PatientPossibility36
Since then, additional medicines in the same class have become available. NICE guidance has increasingly focused on treatments such as Wegovy and Mounjaro for specific patient groups. As a result, Saxenda is now used less frequently within NHS pathways.
Current NICE guidance allows Saxenda in a specific clinical scenario, generally involving adults with:
- BMI of 35 or higher (with adjustments for some ethnic groups)
- Non-diabetic hyperglycaemia (pre-diabetes)
- High cardiovascular risk
Treatment must normally be started within a specialist weight-management service, rather than directly in general practice.
"I asked my GP about Saxenda last month, but they said they only do Wegovy now. And even that’s a two-year limit." -u/BellaHeroOfTheHorn
Who May Still Be Eligible
Although most NHS weight-management prescribing now focuses on Wegovy or Mounjaro, some patients may still meet the criteria for Saxenda. These typically include individuals with:
- BMI ≥ 35 (adjusted for ethnicity)
- Pre-diabetes, confirmed by HbA1c levels between 42 and 47 mmol/mol
- Elevated cardiovascular risk, such as hypertension or dyslipidaemia
In these cases, a specialist clinician within a weight-management service may consider Saxenda as part of a structured programme that includes lifestyle support.
"They said I wasn’t diabetic enough for Mounjaro and not high-risk enough for Saxenda. It feels like a dead zone." -u/CazzzC
Eligibility decisions depend on clinical assessment, and not all patients referred to specialist services will receive medication.
The Tier 3 Referral Process
Access to Saxenda through the NHS generally requires referral to a Tier 3 weight-management service. These specialist clinics typically include multidisciplinary teams such as doctors, dietitians, psychologists, and specialist nurses.
GPs usually cannot initiate Saxenda themselves but can refer eligible patients for specialist assessment.
Once referred, patients may undergo evaluation of:
- Medical history and current health conditions
- Previous weight-management attempts
- Psychological and lifestyle factors
- Potential treatment options
-u/EstablishmentSad5504
Availability of these services varies across the country, and waiting times can be several months in some areas.
Why GPs Often Cannot Prescribe Saxenda
When a GP says they cannot prescribe Saxenda, this usually reflects NHS prescribing pathways rather than a personal decision.
In many areas, Saxenda must be initiated and supervised by specialist services, and local formularies may restrict prescribing in primary care.
"I showed them the NHS page that says Saxenda is approved, but they said it’s ‘not in our prescribing pathway anymore’." -u/RelativeCall3012
GPs may instead refer patients to specialist services or discuss other treatments recommended in current guidelines.
Regional Differences in Access
Access to weight-management services within the NHS can vary between regions.
"It’s unfair that some postcodes get Saxenda, some get Wegovy, and others just get a gym leaflet." -u/Physical_Orchid3616
Local Integrated Care Boards (ICBs) determine how services are funded and organised in their area. Some regions have established Tier 3 clinics, while others rely on neighbouring services or have longer waiting lists.
This variation can influence which treatments are offered locally.
Why Some Patients Still Prefer Saxenda
Although newer GLP-1 medicines are available, some patients report preferring Saxenda’s daily dosing or finding it easier to tolerate.
"I tried Wegovy and couldn’t handle the nausea. Saxenda was gentler. I wish they’d kept it." -u/FitandForty
Individual responses to medicines vary. In clinical practice, a specialist may sometimes consider Saxenda if other treatments are not suitable or tolerated.
Options if You Are Considering Saxenda
If you believe Saxenda may be appropriate for you, the following steps may help clarify your options:
- Speak with your GP about referral to a Tier 3 weight-management service. These services assess eligibility for specialist treatments.
- Check local NHS pathways. Your GP or local ICB website may outline available services.
- Prepare relevant health information. This may include BMI, HbA1c results, and existing health conditions.
- Discuss alternative treatments if appropriate. A clinician may recommend other therapies depending on your circumstances.
- If considering private treatment, use regulated providers. Medicines should only be supplied by UK-regulated pharmacies following a clinical assessment.
-u/LostInForms
Medicines obtained from unverified sellers or social media can pose safety risks, including counterfeit products.
How Newer Medicines Changed NHS Pathways
The approval of Wegovy and Mounjaro has reshaped NHS obesity treatment pathways.
Wegovy is typically offered within specialist weight-management programmes, usually for a limited treatment period alongside lifestyle support. Mounjaro is being introduced through specialist services and may gradually expand into primary care for selected patient groups.
Because these medicines have demonstrated strong clinical outcomes in trials, they have become a major focus of NHS prescribing strategies.
"They said they’d switched to Mounjaro for most new patients, but Saxenda might still be used if people react badly to the others." -u/HealthyMaybe
Pharmacist Insight
To put the current situation into context, Alessandro Grenci, Superintendent Pharmacist at Medino, explains:
"Saxenda remains an established GLP-1 treatment, but NHS access is now generally limited to specific high-risk patients managed by specialist services. Many NHS pathways now prioritise newer medicines, so patients interested in Saxenda should discuss referral options with their GP."
His comments reflect how prescribing policies evolve as new treatments become available.
Experiences from Patients
Online discussions show a range of experiences, from frustration about waiting times to positive outcomes after specialist referral.
"I’ve been referred three times in two years. Each time they say there’s a waiting list, then I never hear back." -u/WaitingPatient198
Others report eventually receiving support through specialist services.
"After six months I finally got approved. It was a long road, but it’s the first time I’ve felt hope in years." -u/CazzzC
These experiences illustrate how the referral process can differ between individuals and regions.
Future Outlook
Over the next few years, NHS obesity services are expected to expand access to treatments such as Mounjaro and Wegovy for patients at highest clinical risk.
Saxenda may continue to be available in some specialist services, particularly where it remains clinically appropriate or where other medicines are unsuitable.
Conclusion
Saxenda remains an approved medicine for weight management, but access through the NHS is now limited to specific clinical pathways and specialist services.
Patients interested in treatment should speak with their GP about referral options and discuss which therapies may be appropriate for their health needs.
Weight management treatments are typically most effective when combined with structured lifestyle support and ongoing clinical supervision.
