I am reaching out with hope and urgency as someone living with cirrhosis, a condition that affects not only my liver but also my entire quality of life. It is a difficult battle, and I am not alone in facing it. Countless others in the UK are similarly struggling, yet a potential beacon of hope remains just out of reach for us, Mounjaro.

Mounjaro (tirzepatide) is currently available on the NHS only under strict eligibility criteria. While these rules may be appropriate for some, they are failing a group of patients who urgently need access: people living with liver disease or cirrhosis who also have a high BMI.

There is growing evidence that GLP-1–based medications like Mounjaro can significantly improve liver health. Studies show benefits in reducing liver fat, inflammation, insulin resistance, and progression of liver damage, particularly for patients with fatty liver disease and obesity-related liver conditions. For many of us, weight is not a cosmetic issue but a critical factor in disease progression and survival.

Delaying access until liver disease worsens or until patients meet narrower criteria is detrimental and avoidable. Cirrhosis already comes with serious complications, including fatigue, pain, increased risk of diabetes, reduced mobility, frequent hospital admissions, and shortened life expectancy. Requiring patients to wait while their condition deteriorates ignores both medical evidence and common sense.

Early access to Mounjaro for patients with both liver disease and a high BMI would:

 • Help slow or reverse liver damage

 • Reduce obesity-related strain on the liver

 • Prevent further complications and hospital admissions

 • Improve quality of life and long-term outcomes

 • Reduce future NHS costs through prevention rather than crisis care

For people with cirrhosis, time matters. Weight loss becomes harder as disease progresses, and the opportunity for meaningful intervention can be lost. Making patients wait is not neutral, it actively causes harm.

We call on the NHS, NICE, and relevant decision-makers to expand access to Mounjaro so that it is available to patients who meet both of the following criteria:

 1. A diagnosed liver disease (including cirrhosis or fatty liver disease)

 2. A high BMI indicating obesity

These two criteria alone should be sufficient. Patients with liver disease should not be excluded from a treatment that could slow progression, improve outcomes, and save lives.

Obesity is one of the few modifiable risk factors in liver disease. Let’s make it one less burden for people already facing a serious, life-altering diagnosis.

People with liver disease cannot afford to wait. Prevention, not delay, should guide NHS policy.

Medical Evidence/Sources
• (European Association for the Study of the Liver – EASL)
• (Armstrong et al., The Lancet*, 2016; Newsome et al.,* New England Journal of Medicine, 2021)
• (Vilar-Gomez et al., Gastroenterology*, 2015)*
• (SURPASS clinical trial programme)