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Analysis

GLP‑1 drug prescriptions for obesity
Who is turning to private weight‑loss treatment?

Published 18 February 2026
Time to read clock icon About 8 mins
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Key points

  • England has high levels of obesity, with rates twice as high in the most deprived areas. Prescriptions for GLP-1 weight-loss drugs have surged over the past 5 years. But NHS availability is constrained leaving the private sector as the main way of accessing treatment.
  • We analysed the characteristics of 113,630 patients of an online weight management provider (Voy), who received a private prescription for a GLP-1 weight-loss drug between November 2024 and October 2025.
  • Private GLP-1 treatments are dominated by women in mid-life. Almost 8 in 10 prescriptions are for women, with the highest uptake among people aged 30 to 49 years, falling sharply after age 60.
  • Affluent areas see far higher rates of prescriptions despite lower obesity prevalence. Per person rates in the most deprived areas are around 32% lower than in the least deprived.
  • After adjusting for the higher rate of obesity in more deprived areas, inequalities in uptake are more pronounced. People living in the least deprived areas are more than twice as likely to access GLP-1 treatments per person living with obesity, compared with those in the most deprived areas.
  • People living in more deprived areas tend to access treatment at a higher body mass index (BMI). In the most deprived areas, around 45% of those using the drugs aged 30 to 49 had a starting BMI of 35 or more, compared with around 30% in the least deprived. This indicates later intervention and a greater accumulated health risk.
  • Given limitations in current NHS provision, these private‑sector patterns risk shaping who benefits first from GLP‑1 treatments. The patterns observed offer insight into where demand is currently concentrated and could help to inform more equitable rollout across the NHS as eligibility expands.
 

Introduction

In 2023–24, almost 65% of adults in England were estimated to be overweight or living with obesity. Not only is obesity common, it is also unequally distributed, with those living in the most deprived areas twice as likely to be obese as those living in the most affluent areas. Obesity increases the risk of serious conditions including type 2 diabetes, coronary heart disease and several types of cancer. Successive government strategies have failed to address the scale of the obesity challenge. As such, there has been no sustained reduction in prevalence over the past decade.

In recent years a new class of weight-loss medications, ‘GLP-1 receptor agonists’ (GLP-1RAs), have been shown to be effective in reducing people’s body weight and improving health outcomes. Two GLP-1 drugs are currently licensed in the UK for weight loss: tirzepatide (available as Mounjaro) and semaglutide (available as Wegovy). They can be prescribed for adults with obesity (BMI ≥30 kg/m²), or adults who are overweight (BMI ≥27 kg/m²) with at least one weight-related comorbidity (eg hypertension, sleep apnoea). 

It is estimated that 2.4 million people in the UK are accessing these medications. But funding and eligibility via the NHS is constrained (see Box 1), meaning the private sector is currently the main way of accessing them. Within the private market, there is not a clear picture of who is accessing treatment. 

This analysis looks at the uptake of private GLP-1 treatments and the demographic and socioeconomic characteristics of those accessing them. It aims to help us understand demand among different groups accessing treatment and the potential impact on inequalities.

Box 1:

As many people are currently unable to access GLP-1 treatments via the NHS, the private sector has emerged as the main way prescriptions are issued, with NHS prescriptions thought to currently account for less than 10% of total prescriptions.  

The National Institute for Health and Care Excellence (NICE), which recommends medications for NHS funding, recommends semaglutide  for weight management only when prescribed by a specialist weight‑management service. Eligibility requires at least one weight‑related comorbidity and either a BMI of ≥35 kg/m², or a BMI of 30–34.9 kg/m² for those who also meet the criteria for referral to specialist weight‑management services. Lower BMI thresholds apply for some minority ethnic groups.

For tirzepatide, eligibility was limited to those with an initial BMI of at least 35 kg/m2 and at least one weight-related comorbidity, with lower thresholds for minority ethnic groups. However, modelling by NHS England indicates that ~3.4 million adults would meet the NICE eligibility criteria for tirzepatide, which led to concerns about the cost and operational feasibility of rollout. NHS England therefore sought phased implementation of tirzepatide via a funding variation. This means that for the first 3 years only around 220,000 patients will be able to access tirzepatide on the NHS – around 6% of the population who would have access per the NICE recommendation for eligibility. To ensure the medications are targeted where they will make the biggest impact, in the initial phase access is limited to cohorts starting with BMI ≥40 (≥37.5 for minority ethnic backgrounds) and four or more qualifying comorbidities (hypertension, dyslipidaemia (high levels of fats in the blood), obstructive sleep apnoea, cardiovascular disease, type 2 diabetes), with later expansion to additional cohorts. 

Despite meeting eligibility criteria, many individuals in early cohorts may not access treatment due to commissioning, funding and capacity constraints. 2 months after rollout, fewer than half of integrated care boards had begun prescribing tirzepatide, and only 9 out of 42 reported sufficient funding to treat 70% of eligible patients. This means that for the initial phase of rollout, many of those who meet NICE eligibility criteria will not be able to access GLP-1 treatments via the NHS.

 

Data and approach

This analysis looks at data from 113,630 people aged 18 years or older who received a private prescription for a GLP-1 treatment via a single online weight management provider – called Voy – between 1 November 2024 and 31 October 2025. The cost of treatment at this provider ranges from £144 to £324 per month depending on type of medication and dose. The monthly subscription includes unlimited access to services, such as nutritionist and clinician support, an AI-powered coach and an app to monitor progress. Across two studies, programme members lost on average 21.5% of body weight over 10 months (semaglutide or tirzepatide) and 24.2% at 12-month completion on tirzepatide.  

Box 2:

Data were analysed by age, sex, BMI at time of first prescription and socioeconomic background based on the 2025 Index of Multiple Deprivation (IMD). Data covered both tirzepatide and semaglutide prescriptions. 

Rates were determined using age, sex and IMD specific denominator populations for England from the 2024 mid-year population estimates and 2025 IMD deciles. Fingertips data on the prevalence of obesity or being overweight in each decile were used to estimate the number of obese or overweight people in each decile across all ages (as age and sex disaggregated data are unavailable).

The analysis uses data from a single provider of GLP-1 prescriptions. There are dozens of private providers of these medications, ranging from providers of comprehensive weight-loss programmes (such as Voy) to online or high-street pharmacies. Each private provider has different price points and levels of support that are offered as part of the prescription. The provider data analysed comes with bundled clinical and digital support, which may increase average prices and favour more affluent consumers. 

The analysis is also cross-sectional and does not consider longitudinal data on how long individuals stay on the medications. Given the high monthly cost of treatment, those in less affluent areas may be more likely to stop medication. As we know, weight loss happens over time, and weight regain is common after stopping medication – this could mean that affordability influences effectiveness of the prescription due to time constraints. 

Estimates of the number of prescriptions for each obese or overweight population are based on the percentage of adults who are obese or overweight from the 2023–24 Active Lives Adult Survey. Many people in these areas who are not obese may have been prescribed a GLP-1 treatment, and many of those who are obese may not have been prescribed a GLP-1 drug. We are unable to account for the relationship between obesity, age, sex and socioeconomic deprivation directly with the data available. 

The data do not distinguish between different weight-loss drugs. Given tirzepatide is more expensive than semaglutide, there may be differences in uptake between different groups. Similarly, the data only looked at uptake of medications and not at differences in outcomes. 

 

Who is being prescribed weight-loss drugs privately?

Patterns by sex and age

Women had substantially higher rates of prescriptions per 100,000 population than men. Women constituted 79.4% (90,262/113,630) of all those being prescribed; men 20.6% (23,368/113,630). Across all ages, women had higher prescription rates on average than men. For those aged 30 to 49 years, there was a ratio of ~3.5:1 women to men being prescribed GLP-1 treatments (578 per 100,000 for women vs 166 per 100,000 for men). 

Clear differences also exist by age. In the provider data, uptake peaked at ages 30 to 49 years, followed by 50 to 59. It then declined after age 60 years, despite high obesity prevalence in older groups. In order, the highest use by age band was 30–39 (27.2%), 40–49 (24.3%), 50–59 (20.4%), 18–29 (16.8%), 60–69 (9.6%) and 70+ (1.6%).

Patterns by socioeconomic deprivation 

Areas with lower levels of socioeconomic deprivation were associated with higher rates of prescriptions, except in the least deprived decile, which saw a slight decrease in prescriptions compared with the second least deprived. 

This gradient corresponds to a 38% lower rate of prescriptions in the most deprived areas than in the 2nd and 3rd least deprived deciles – the deciles with the highest rates – and a 32% lower rate of prescriptions in the most deprived decile than in the least deprived decile.

Figure 1

Obesity is twice as common in the most deprived areas (37.4%) as in the least deprived (19.8%). When we account for this, prescriptions per person living with obesity show a much steeper gradient between the least and most deprived areas. Rates in the least deprived decile of areas are around 120% higher than rates in the most deprived.

Prescriptions per person overweight or obese show less variation across deprivation levels. This is because the prevalence of being overweight or obese differs less across the deprivation gradient (least = 59.4%, most = 71.2%), than for obesity.

Figure 2

BMI differences by deprivation and sex

Our findings point to higher uptake in richer areas, despite having smaller populations of obese people. But some patients who are not obese may take GLP-1 treatments due to other risk factors (eg cardiovascular disease, type 2 diabetes). 

To examine how the distribution of BMI at first prescription changed by sex and area-deprivation level, we look at the 58,000 patients in the dataset aged 30 to 49. A healthy BMI is considered to be in the 18.5–24.9 range, while 25–29.9 is overweight and 30 or higher is considered obese.

In total, 37.1% of prescriptions were for people with a starting BMI of 35 or higher, while 62.9% were for people with a BMI starting below 35 (27–34.9). The data show prescriptions for patients with a BMI of 35 or higher are more common in more deprived areas (most = 46.2%, least = 29.8%), while prescriptions for those with a BMI less than 30 are more common in the least deprived areas (most = 11.1%, least = 15.7%). 

For those purchasing medications who are within the BMI cutoff for NHS eligibility, it is not known whether: they do not meet the full NHS eligibility criteria as they do not have co-morbidities related to obesity; they meet the criteria but cannot access the medications via the NHS due to capacity constraints; or whether they meet the criteria but chose to go through a private provider for other reasons. 

Figure 3

 

What our findings mean

Private uptake of GLP-1 drugs is higher in less deprived areas, despite these areas having lower prevalence of obesity. When private prescription uptake is adjusted for the number of people living with obesity, the inequality becomes more evident: individuals in affluent areas are much more likely to access treatment per obese person than those in deprived areas. In contrast, where people in more deprived areas do purchase GLP-1 treatments, they are more likely to present with a very high BMI (35 or higher), suggesting later intervention and greater accumulated health risk.

The government has ambitions to halve the gap in healthy life expectancy between the most and least deprived areas, currently 19.1 years (for men) and 20.2 years (for women). Modelling has shown that of all the risk factors considered, reduction in BMI would likely lead to the biggest absolute reduction in major illness among those living in the most deprived fifth of areas. This means GLP-1 treatments could contribute to reducing the gap in healthy life expectancy if deployed effectively. But inequalities in private prescribing uptake between different socioeconomic groups are unlikely to help narrow the gap. 

Almost 80% of those prescribed GLP-1 drugs in the provider data are women. This aligns with previous survey research showing that both self-reported use and awareness of GLP-1 treatments is higher among women in the UK. This indicates that even if GLP-1 medications were readily available through the NHS, this gender inequality may continue to exist. Overall, women already experience better health outcomes and live 4 years longer on average than men. A major contributor to this gap is the higher prevalence of ischaemic heart disease among men. Given that GLP-1 treatments have been shown to reduce the risk of major cardiovascular events, unequal uptake could exacerbate existing disparities in cardiovascular risk and mortality. The government’s Men’s Health Strategy prioritises cardiovascular disease prevention and early detection in men, aiming to narrow inequalities in life expectancy and healthy life expectancy over the next decade. The findings of this analysis highlight the need to build in considerations around differential GLP-1 drug access between sexes as part of this strategy. 

Overall, these data provide insight into the population-level demand for GLP-1 treatments not currently being met by the NHS. This could help guide the NHS in designing equitable rollout of these medications. Variation in uptake across socioeconomic groups, observed in private sector prescription data, reflects the effects of constrained NHS access. Although in the short term private providers help bridge these gaps, given more of the eligible population are accessing GLP-1 treatments in more affluent areas, the current usage pattern risks widening health inequalities as uptake increases. This means the health benefits of these medications will disproportionately benefit those already advantaged, while those living in deprived areas, who already carry the highest burden of premature cardiovascular disease and poor health outcomes, lag further behind. Unless NHS availability explicitly counterbalances this skew, the healthy life expectancy gap is likely to persist or even widen, even if there are overall population health gains.

GLP‑1 treatments are an important clinical tool to tackle obesity for many individuals. But for multiple reasons including cost, rebound weight gain and side effects, they cannot substitute systemic prevention strategies. Obesity is driven by structural factors, such as food environments, marketing and socioeconomic conditions that require population-level policy interventions. Pharmacological solutions should complement, rather than displace, government action on structural factors. Focus should stay on tackling the causes of obesity: low-agency, population-level interventions such as taxation, advertising restrictions, reformulation and planning controls that benefit everyone. 

 

Conclusion

This analysis shows clear patterns in who turns to private GLP‑1 treatments when NHS access is limited. Those from more affluent areas are more likely to seek treatment privately, often at lower BMI thresholds. Meanwhile, despite a higher prevalence of obesity, people in more deprived areas tend to access treatment less frequently and at higher BMIs. Women were found to access private GLP-1 treatments much more frequently than men. 

Given the current limitations in NHS provision, these private‑sector patterns could shape who benefits first from GLP‑1 weight-loss drugs. As the NHS continues its rollout of GLP-1 medications, understanding these early signals from private‑sector data will be important for ensuring future provision aligns with clinical need. Ongoing monitoring by deprivation, sex and BMI is warranted as NHS access expands, to see if these patterns are replicated in the public sector and where targeted action may be required. 

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