Definitive guide to the best fat jab (or pill) for YOU: However much you want to lose, whatever your budget, and even if you’re scared of needles, this is everything you need to know, by LOUISE ATKINSON

News that the first weight-loss pill has just been licensed for sale in the UK caused a palpable buzz of excitement. Promising to replicate some of the benefits of miraculous skinny jabs such as Ozempic and Mounjaro – but without the need for needles – the Wegovy pill is expected to be available in UK pharmacies within weeks.

While British/Swedish pharmaceutical giant AstraZeneca last week revealed it is developing an oral form of the big-hitting injectables, too, it was Danish leader Novo Nordisk that got there first. Online outlets have already started targeting social media with calls to sign up to waiting lists for the highly anticipated semaglutide pill.

Adding to this giddy frisson of excitement is emerging news from research labs showing the startling way these medications appear to offer protection against heart disease, diabetes, dementia, even cancer, while they strip you of troublesome excess fat.

The great question is whether they will one day be prescribed by GPs to everyone – even those who are barely overweight. Already 1.9 million Britons are taking the GLP-1 drugs, according to a recent survey.

The Wegovy pill might be the first oral GLP-1, but it isn’t the most effective form of the drug on the market or in the pipeline. Existing jabs, including injectable Wegovy, beat it for slimming power, while another pill is expected within months that will help consumers drop pounds faster.

Indeed, there are so many new jabs and pills in various stages of development that it’s becoming increasingly hard to find a way through the maze of information.

So what should those of us who want to lose weight be looking for now or expecting soon?

Here’s your expert guide to what you can safely and legally get your hands on this summer, and what’s just around the corner…

If you want to lose more than five stone

Try your GP first. To qualify for ‘free’ jabs on the NHS you need a body mass index (BMI) of 40 and four weight-related health conditions. But be warned, it’s a postcode lottery. Very few NHS GPs are handing out the jabs and most people still have to wait months to be seen by an NHS obesity clinic.

That might change soon. As the drug gets cheaper to supply to the NHS, the eligibility criteria is expected to come down to a BMI of 35, plus one weight-related health condition.

In time, the new pills are also likely to be available on the NHS under the same strict diagnostic criteria, but this may take months or even years since they’ll first need to go through the process of approval by the National Institute for Health and Care and Excellence (NICE).

If you want to lose two to four stone

Private pharmacies are your best option for GLP-1 injections of the semaglutide Wegovy (the cheaper option) or the tirzepatide Mounjaro (the quicker fix) as long as you meet the qualifying criteria and are prepared to pay.

The best advice is to start with Wegovy (from £100 per month for weekly injections) because it works and costs less. You can upgrade to Mounjaro (which starts at around £145 for the lowest dose) if Wegovy doesn’t work for you. Keep the dose low and use the weekly injection to support a healthy high-protein and high-fibre diet and commit to regular strength training.

The added bonus is that Wegovy and Mounjaro are increasingly showing benefits beyond weight loss, including reduced risk of heart attacks and strokes, improved blood sugar control, and emerging evidence of improvements in kidney disease, fatty liver, sleep apnoea, inflammation and possibly addiction, fertility, brain health and certain cancers.

A quick fix if you’re not a fan of the gym

Keep your eye out for retatrutide or ‘reta’. Dubbed the ‘Godzilla’ of weight-loss jabs, it beats Mounjaro for effectiveness and additional bonus health benefits.

Recent trials showed patients lost more than a quarter of their body weight in 18 months – 28.3 per cent – compared to a fifth (20.9 per cent) for Mounjaro.

Like Ozempic and Mounjaro, reta works by mimicking hormones that regulate appetite and slow gastric emptying – but reta is a souped-up version.

If Ozempic works on one receptor and Mounjaro on two, reta acts on three receptors, which gives it the added power to effectively increase energy expenditure and help the body burn more calories. This also helps to preserve muscle as the fat melts away. But at a cost – reta is likely to be charged at a premium to Mounjaro. Expect to pay £350-£500 per month.

However, this magical elixir is still in trials and not expected to be licensed and legally available in the UK before 2027.

If you’re desperate to get your hands on this big-hitter – and don’t want to risk the dupes already available online on the ‘grey market’ – you could sign up to one of the ongoing clinical trials (go to clinicaltrials.gov).

Want to drop half a stone for the summer?

Unless you have a BMI of 30, or 27 with health issues, you won’t legally qualify to get weight-loss medication and you’re likely to find it difficult to persuade one of the many online pharmacies to sell you a GLP-1 syringe pen.

Be aware that online pharmacies are clamping down on fake or forged applications. Increased pressure from the General Pharmaceutical Council, which last year put GLP-1s into a more tightly controlled ‘high-risk medicines’ category, means the focus for regulators has moved beyond issuing guidance to enforcement of the rules.

At one time there was much chatter on forums about using AI-generated images to exaggerate your starting weight, for example. But now you’re likely to need to prove (via phone or video consultation) you meet qualifying criteria, or that you are actively seeking to maintain a certain weight having previously met that criteria.

There are exceptions. If you’ve lost weight on GLP-1s in the past but then stopped them and put some of it back on, many private pharmacies will sell you the jabs under a ‘maintenance programme’ if you can provide proof you legitimately started treatment when you met prescribing criteria.

You’ll also have to agree to be monitored so you don’t become underweight. Your prescription applies so long as your BMI doesn’t drop below 22 (though some pharmacies will agree to continue the course to a BMI of 20-21).

Squirm at the thought of an injection?

Your best non-jab option is oral capsule orlistat. Not a GLP-1 but medication that blocks the absorption of fat, orlistat is cheaper than injectables (about £60 for a month’s supply from private pharmacies under the brand names Xenical or Alli) and safe (it has been used for more than 25 years).

It’s also available on the NHS for eligible patients (with a BMI of 30, or 28 plus one weight-related condition), making it an NHS option for those who don’t meet the strict criteria for GLP-1s.

Studies show it can help support weight loss with people losing 5-10 per cent of body weight over a year when combined with diet and lifestyle changes, compared to around 15 per cent with Wegovy and 20 per cent with Mounjaro. It also lowers cholesterol levels and improves blood sugar control. Its main function appears to be to steer users away from eating fatty foods because it causes excess fat to be excreted from the body. But be warned: the side effects if you don’t cut back on fatty foods include urgent trips to the toilet, flatulence and stomach upset.

If that sounds too grim, some online pharmacies (including weightmedics.co.uk) have started to prescribe a short course of amphetamine-like stimulants in pill form, that help to suppress appetite by reducing hunger signals. These have being doing the rounds since the 1960s but have been reformulated to have a slower-release effect.

If you want a GLP-1 pill and can wait

Then you’re in luck. The approval of the Wegovy pill on Thursday by the Medicines and Healthcare products Regulatory Agency (MHRA) means it’s officially a licensed medicine and pharmacies can start stocking and selling it within weeks.

At present a low-dose semaglutide pill, branded Rybelsus, is only available for type 2 diabetics in the UK, though some pharmacies have been prescribing it ‘off label’ for weight management.

But this new version from Novo Nordisk comes in a higher dose, making it effectively a no-jab version of the injectable Ozempic/Wegovy and most likely at a similar cost.

To qualify for a prescription you still need to prove a BMI over 30 or 27 with a handful of co-morbidities (diabetes, high cholesterol, high blood pressure).

The Wegovy pill isn’t expected to shift the pounds as effectively as jabs, but is likely to be a good weight maintenance option for people coming off them. It might also be sold as a ‘mild’ diet aid to work in conjunction with closely tracked diet and exercise programmes.

If you’re planning on starting next year

It might be worth waiting another six months for an even better pill.

Eli Lilly, which manufactures Mounjaro, has developed orforglipron – a new molecule drug that works on the same GLP-1 receptor pathway as semaglutide, but in a different, more powerful way.

It was licensed in the US for weight loss (as opposed to diabetes) in January this year under the brand name Foundayo, and it is likely to be licensed and available in the UK by early 2027.

Studies show it should be more effective than the Novo Nordisk pill: participants on the highest dose of orforglipron lost 9.2 per cent of body weight compared with 5.3 per cent on the highest approved dose of oral semaglutide.

It has the added advantage that it can be taken with or without food. (The Wegovy pill must be taken as soon as you wake up each morning on an empty stomach, and 30 minutes before any food or drink.)

Further on the horizon are souped-up pills offering the kind of big weight-loss results you see on the jabs.

Both companies are developing next-generation oral obesity drugs that combine GLP-1 with other gut hormones and promise, in the long run, to replace injectables altogether. They should be cheaper, too.

Joining that race is AstraZeneca, the multi-national behind the first Covid jabs, which is developing a daily tablet containing a formulation called elecoglipron. Early studies show it can help people lose 12 per cent of their body weight in eight months, as well as lower blood pressure and inflammation.

Similar to orforglipron, it doesn’t require strict fasting times. But big longer-term trials are still on-going, so you’ll probably have to wait until 2030 to get your hands on it.

If you’re on a very tight budget

The daily weight-loss jab Saxenda feels like the Cinderella of weight-loss medications. The first to hit the market, it’s now rarely prescribed. But the active ingredient in it, liraglutide, is off-patent, meaning you can buy it as Nevolat in high street pharmacies including Asda and Superdrug.

You still need to meet the usual BMI eligibility criteria, but it is cheaper: a monthly pen costs roughly £95.

The drawback? It’s only half as effective as Wegovy (studies show 5-8 per cent weight loss in a year compared to 12-16 per cent with Wegovy) and has a very short duration, which is why it has to be injected daily.

The good news is that what’s happened to Saxenda will happen to Wegovy, too. Legally produced generic semaglutide jabs – Wegovy equivalents – will start to appear from 2031 at a much reduced price. Witness what’s happening in India, where it’s already out of patent and you can buy a month’s worth of semaglutide jabs for just £10.

Tirzepatide (Mounjaro) doesn’t go out of patent until 2036.

And what if money is no object?

Boutique or concierge weight-loss services will charge premium pricing for your jab or pills prescription (£200-£500 per month) with the cushion of extra support in the form of personalised care plans, nutritional coaching, medical consults, advanced diagnostics and app-based tracking.

Alternatively, although you won’t get GLP-1s, a month at VivaMayr health resort in Austria, or Chiva-Som in Thailand, pretty much guarantees significant weight loss. It’ll cost you £15,000, though.