Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medicines previously used exclusively for the treatment of type 2 diabetes. In recent years, research has expanded to better understand their use in obesity treatment and has led to the development of newer medicinesincluding the dual action GLP-1/GIP RAs. Clinical trials such as LEAD STEP, SURPASS and SURMOUNT have demonstrated clinically significant weight loss outcomes and more recently the results of the SELECT trial have shown statistically significant reductions in cardiovascular disease morbidity and mortality. The Scottish Medicines Consortium (SMC) has approved liraglutide (Saxenda®), semaglutide (Wegovy®) and tirzepatide (Mounjaro®) for restricted use in NHS in Scotland for weight management.

Engagement with Health Boards, Area Drugs and Therapeutic Committees, weight management specialists, dietitians, pharmacists, nurses and doctors and Scottish Government policy teams, indicated an enthusiasm to develop a ‘Once for Scotland’ clinical consensus to support and facilitate a phased implementation of SMC advice.