Published: 2026-02-01 06:03
GLP-1 Medicines: New Government Guidance for Clinicians on Weight Loss and Diabetes
The UK government has issued new guidance for healthcare professionals regarding the prescribing and management of GLP-1 receptor agonist medicines, particularly in the context of both type 2 diabetes and weight management. This update aims to clarify appropriate clinical practice, reinforce patient safety, and address the increasing demand for these medications.
The guidance underscores the critical importance of adhering to licensed indications and established clinical guidelines, such as those from the National Institute for Health and Care Excellence (NICE), when considering GLP-1 medicines for patients.
Understanding GLP-1 Receptor Agonists
Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications that mimic the action of the natural incretin hormone GLP-1. These medicines play a significant role in glucose homeostasis by stimulating insulin secretion in a glucose-dependent manner, suppressing glucagon secretion, slowing gastric emptying, and promoting satiety.
Their established benefits include improving glycaemic control in type 2 diabetes and, for specific agents, facilitating significant weight loss in individuals with obesity or overweight with co-morbidities. This dual action has led to their widespread adoption and increasing interest from both clinicians and patients.
Context for the New Government Guidance
The recent surge in interest and prescribing of GLP-1 medicines, particularly those licensed for weight management, has created a complex landscape for the NHS. Factors contributing to this include:
- Increased Demand: Growing awareness of their efficacy for weight loss has led to a significant rise in patient requests.
- Supply Challenges: This heightened demand has, at times, outstripped global supply, leading to intermittent shortages of certain GLP-1 medicines, impacting patients with type 2 diabetes who rely on them for glycaemic control.
- Off-label Prescribing Concerns: Reports of off-label prescribing for weight loss, sometimes outside of established clinical pathways or without appropriate medical supervision, have raised patient safety concerns.
- Resource Allocation: Ensuring equitable access and appropriate use of these medications within NHS resources is a key consideration.
The government’s guidance seeks to provide a clear framework for clinicians navigating these challenges, prioritising patient safety and the judicious use of medicines.
Key Principles for Prescribing GLP-1 Medicines
The guidance reinforces several fundamental principles that clinicians must adhere to when considering GLP-1 receptor agonists:
- Adherence to Marketing Authorisation: Prescribing must strictly align with the medicine’s marketing authorisation (product licence) and the specific indications for which it has been approved by the Medicines and Healthcare products Regulatory Agency (MHRA).
- NICE Guidance Compliance: Clinicians should follow relevant NICE guidelines for the management of type 2 diabetes and obesity. These guidelines provide evidence-based recommendations on patient selection, initiation, and ongoing management.
- Patient Selection: Careful patient selection is paramount. For weight management, this typically involves individuals with a specific Body Mass Index (BMI) threshold and often co-morbidities, as outlined in NICE guidance. For type 2 diabetes, GLP-1s are considered based on glycaemic control, cardiovascular risk, and other individual patient factors.
- Specialist Supervision: Initiation and ongoing management of GLP-1 medicines, particularly for weight management, often require supervision within specialist weight management services or by clinicians with appropriate expertise. This ensures comprehensive assessment, monitoring, and support.
- Holistic Care: Medication should always be part of a broader, holistic management plan that includes lifestyle interventions (dietary changes, increased physical activity) and behavioural support. GLP-1 medicines are not a standalone solution.
Navigating Supply Constraints and Patient Impact
The guidance acknowledges the ongoing challenges with the supply of certain GLP-1 medicines. It advises clinicians to:
- Prioritise Patients: Ensure that available supplies are prioritised for patients with type 2 diabetes for whom these medicines are clinically indicated and who may have limited alternative treatment options.
- Communicate with Patients: Maintain open and honest communication with patients about potential supply issues and discuss alternative treatment strategies where necessary.
- Avoid New Initiations (where supply is critical): In situations of severe shortage, clinicians may be advised to pause new initiations of GLP-1 medicines, especially for weight management, to safeguard supplies for existing patients with type 2 diabetes.
- Report Shortages: Report any significant supply issues through appropriate channels to help inform national monitoring and response efforts.
This approach aims to mitigate the impact of shortages on the most vulnerable patient groups and ensure continuity of care where possible.
Implications for Primary Care Clinicians
Primary care clinicians, including General Practitioners, play a crucial role in the initial assessment, referral, and ongoing management of patients who may benefit from or are already receiving GLP-1 medicines. The new guidance reinforces the need for:
- Thorough Assessment: Conducting comprehensive patient assessments to determine suitability for GLP-1 therapy, considering all co-morbidities and contraindications.
- Appropriate Referrals: Referring patients to specialist weight management services or diabetes clinics when initiation or ongoing management of GLP-1s is indicated, especially for weight loss where specialist input is often required by NICE.
- Patient Education: Providing clear and accurate information to patients about the benefits, risks, administration, and potential side effects of GLP-1 medicines. This includes managing realistic expectations regarding weight loss outcomes and the importance of lifestyle changes.
- Monitoring and Follow-up: Ensuring robust monitoring for side effects and treatment efficacy, in line with local and national guidelines.
Patient Safety and Ethical Considerations
The government guidance places a strong emphasis on patient safety. Clinicians are reminded of their professional obligations to:
- Prescribe Responsibly: Only prescribe medicines when clinically appropriate and within their scope of practice, adhering to regulatory and ethical standards.
- Manage Expectations: Help patients understand that GLP-1 medicines are not a quick fix and require sustained lifestyle changes for optimal and lasting benefit.
- Address Misinformation: Counter misinformation, particularly from social media or unregulated sources, regarding the use and availability of these medicines.
- Report Adverse Events: Promptly report any suspected adverse drug reactions to the MHRA via the Yellow Card scheme.
The guidance also implicitly touches upon ethical considerations, particularly regarding equitable access and the responsible allocation of resources in a constrained healthcare system.
Conclusion
The new government guidance on GLP-1 medicines serves as a timely reminder for all UK healthcare professionals of the importance of evidence-based, patient-centred care. By reinforcing adherence to marketing authorisations, NICE guidelines, and careful patient selection, the guidance aims to optimise the use of these valuable medicines, safeguard patient safety, and navigate the complexities of increasing demand and supply challenges. Clinicians are encouraged to familiarise themselves with the full guidance to ensure best practice in their prescribing and management decisions.
Source: Gov UK
