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NICE guidance specifies eligibility criteria including BMI thresholds (typically BMI 35 kg/m with weight-related comorbidities, or 30 kg/m with type 2 diabetes), use within specialist weight management services, and treatment duration limits

a Oral semaglutide should be taken on an empty stomach, and patients should wait at least 30 min before eating or drinking or taking other oral medicinal products

If fatigue worsens over weeks rather than improving, or if it's accompanied by muscle weakness, severe headaches, or mood changes, these may signal vitamin deficiencies, thyroid shifts, or other medical issues unrelated to tirzepatide

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