Tirzepatide is recommended for treating type 2 diabetes alongside diet and exercise in adults when it is insufficiently controlled only if:

• triple therapy with metformin and 2 other oral antidiabetic drugs is ineffective, not tolerated or contraindicated, and
• they have a body mass index (BMI) of 35 kg/m² or more, and specific psychological or other medical problems associated with obesity, or
• they have a BMI of less than 35 kg/m², and:

• insulin therapy would have significant occupational implications, or
• weight loss would benefit other significant obesity-related complications

Use lower BMI thresholds (usually reduced by 2.5 kg/m²) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds.