Patients in the Western Isles are being prescribed medicines used for weight loss and diabetes at almost three times the rate of any other health board in Scotland. A new report from the Association of the British Pharmaceutical Industry has uncovered “significant variation” in how health boards across the country dispense newly approved treatments, with the gap most pronounced for GLP-1 medications.
Stark Divide in GLP-1 Prescribing
The analysis, which examined NHS prescribing data from every Scottish health board between September 2020 and August 2025, found that access to GLP-1 drugs showed “substantial geographic variation”. These medicines are widely used to manage type 2 diabetes and were approved for weight management in 2023.
Between June and August 2025, NHS Western Isles recorded the highest prescribing rate at 1,086.54 average units per head of population. NHS Greater Glasgow and Clyde followed at 392.97, while NHS Shetland registered the lowest figure at 100.31.
The report’s authors caution that the figures come with caveats. Island health boards serve small populations, meaning a small number of prescriptions can disproportionately skew the data. The dataset also does not distinguish between prescriptions issued for diabetes and those issued for weight loss.
Still, the disparity is difficult to ignore. Earlier this year, BBC Scotland News disclosed that fewer than half of Scotland’s 14 territorial health boards were prescribing GLP-1s specifically for weight loss, and that fewer than 800 people north of the border had received the injections for that purpose.
Island Board Defends Its Approach
NHS Western Isles is one of six health boards participating in pilot programmes designed to improve access to weight-loss medication. The others are NHS Forth Valley, NHS Borders, NHS Lothian, NHS Lanarkshire, and the State Hospital at Carstairs.
Freedom of information requests submitted by BBC Scotland News showed that the Western Isles has 340 patients on weight-loss medication, the highest number among the boards involved in the pilots.
The health board said it created a “structured pathway” for GLP-1 access before any other Scottish NHS board. It stressed that its prescribing figures reflect early implementation and local clinical need, not simply its participation in a pilot scheme.
“These medicines are prescribed following clinical assessment and form part of a wider dietetic-led programme supporting long-term behaviour change and healthier lifestyles,” a spokesperson said. “Patients are reporting, and we are seeing, significant clinical benefit.”
The Royal College of Physicians has criticised the uneven availability of these treatments, describing restricted access to “safe and cost-effective medicines” as “discriminatory against obese people”. The college has argued that the NHS could save millions by preventing obesity-related illness.
Cardiovascular Medicines Also Show Wide Gaps
The report did not
