Why weight loss drugs may not be a panacea for obesity

Sir Keir Starmer and his Health Secretary were praises the potential of the new generation of weight loss drugs.

The treatments – Wegovy and Mounjaro – given as regular injections, mimic a hormone that makes people less hungry.

Not only could they help reduce waistlines, the Prime Minister and Wes Streeting said, they could also be the key to a thriving economy.

It's time to “think differently”, Sir Keir told BBC News after it was announced that a trial by Health Innovation Manchester, an NHS-linked research group, and the pharmaceutical company Eli Lilly would test whether Mounjaro affects obese people could help you get back into the job market.

Obesity is undoubtedly a major burden on healthcare and the economy as a whole.

Obesity-related diseases cost the NHS an estimated £11 billion a year – around 8% of its spending.

Add productivity losses and Research has shown it costs the economy almost £100 billion a year – or 4% of gross domestic product (GDP), a measure of total economic activity in the country.

So it's understandable that there's a lot of hope that these drugs could be the answer.

Finally, the search for a solution to belt expansion has eluded successive governments since the early 1990s.

Attempts have been made to promote healthy lifestyles, improve food labeling, limit advertising and take measures to increase the cost of unhealthy foods, such as sugar taxes – but obesity rates have continued to rise and one in three adults are now obese .

Critics say governments have not gone far enough with these initiatives. At the same time, they point out that public health spending has been cut over the last decade, reducing the effectiveness of healthy lifestyle programs.

And despite the undoubted benefits shown by the weight loss drugs, health experts warn that they should not be viewed as a quick fix.

Firstly, the NHS has severely restricted their use for weight loss – versions of the drugs are also suitable for diabetes.

Wegovy, the brand name for semaglutide, is only available as a weight loss drug for people who are severely obese and have other health problems. And it can only be administered under the supervision of specialist weight loss programs, access to which, like many NHS services, is restricted.

Meanwhile, Mounjaro is not yet used by the NHS as a weight loss agent – despite the official medicines advice body suggesting it.

The criteria appear to be similar, except that they can be made more widely available in the community without the need for specialist oversight.

And how this can be achieved remains to be seen – because patients must continue to adhere to a structured diet and exercise program in addition to the treatment.

GPs fear they do not have the capacity to monitor this – and so various options are still being explored. And the NHS has warned it could be years before Mounjaro is rolled out.

There are also concerns that the drugs could promote a “dependency culture” in which people don't care about healthy eating and exercise – something Streeting himself has admitted.

Secondly, even if the NHS expanded access, it is not clear that drugmakers could keep up.

Shortages of Wegovy and Ozempic, the version of semaglutide used to treat diabetes, have been reported, partly due to a boom in demand in the private market driven by celebrities endorsing their use as a “thin shot.” The result was that many NHS clinics struggled to make them available to all patients who wanted them.

And with the number of people unemployed due to illness rising, it is difficult to tease out the role of obesity.

The number of people unable to work for health reasons has increased since the pandemic and reached 2.8 million last year.

However, data from the Office for National Statistics shows that the most common major contributing factors are mental health problems and musculoskeletal disorders, which affect joints, bones and muscles.

Many will also have weight issues – but managing these issues may only be part of the answer to returning to work.