Londoners are being trapped in a “two-tier system” of accessing weight loss drugs due to a slow NHS rollout of obesity treatment in the capital, a City Hall committee has said.
Patients are increasingly buying weight loss drugs privately, including counterfeit and unregulated treatments, due to an inability to quickly get them from their GP or hospital.
It’s estimated that around 500,000 Londoners could be eligible for the medicines, which include well known brands like Mounjaro, but only 3,000 were receiving them on the NHS as of November 2025.
In a new report, the London Assembly Health Committee has warned that without faster public provision, more Londoners will encounter significant health risks from purchasing “skinny jabs” on the black market.
Emma Best, who chairs the committee, said: “Weight loss medicines have the potential to transform the lives of many Londoners living with obesity, but right now access is deeply unequal. While thousands of people are able to buy these treatments privately, only a tiny fraction are receiving them on the NHS.
“We heard powerful evidence from Londoners whose health and confidence have improved because of these medicines – but we also heard real concerns about people being pushed towards unsafe or counterfeit products when they cannot access proper treatment.
“If these drugs are going to play a meaningful role in improving London’s health, the NHS rollout must move faster, patients must receive proper wraparound support, and regulators must crack down on the growing illegal market.”
During a months-long investigation, Assembly Members heard that up to two million people could be using weight loss drugs in the UK, including tens of thousands of Londoners, following a recent surge in popularity.
Clinical trials suggest patients can lose between 10 and 20 per cent of body weight after use and, if prescribed and used appropriately, offer significant health benefits for many Londoners.
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But just 35,000 to 40,000 people in London are expected to receive weight loss medication on the NHS by 2028 of the 500,000 eligible, the committee was told. This has created a “two-tier system” in the capital, where only those who can afford the medication privately are able to access it.
“We understand the pressures the NHS is under, and the challenges involved in making a new medication available in a safe way when demand is so high,” the report said.
“But in order to prevent the growth in these disparities and unequal health outcomes, the NHS is rightly taking steps to accelerate the rollout in London. It will need to go even faster to reach its own targets.”
This will require the “development of clinical pathways and an effective system of wraparound care, which includes advice on dietary and lifestyle change” specifically for weight loss medication.
Failure to provide this will lead to a continuation of the proliferation of purchasing such drugs on the illicit market, the report warned. The committee heard about patients purchasing the medicine in beauty salons, gyms, and on social media, and in extreme cases, in pubs and fish and chip shops.
The committee added that “greater regulation and enforcement” across illegal networks, channels and social media would be required to crack down on the practice. This would include the creation of a dedicated cross-agency taskforce. Evidence suggests that more than 18,000 illegal weight-loss medicines were seized at UK borders between 2024 and mid-2025.
An NHS England London spokesperson said they welcome the report and its recommendations, adding: “We recognise that our ICBs (Integrated Care Boards) are working to implement the NICE guidance within the timeframe that NHS England has agreed, and that should provide 35,000 to 40,000 Londoners with newer weight loss medicines on the NHS by 2028, and we will report annually on progress. We will closely monitor prescribing data and referrals to behavioural support to ensure uptake is equitable, addresses current inequalities of access, and supports sustained behaviour change.
“We are committed to working with ICBs to develop a consistent London-wide clinical pathway and wraparound care offer, and to ensuring patient voices are central to the rollout.
“We are committed to ensuring that every eligible Londoner, regardless of where they live or their financial means, can access these medicines safely and with the right support around them.”
