Is a weight loss jab on the NHS the way to tackle obesity?
As it’s revealed that thousands of obese people will be offered weight loss jabs in a new NHS pilot to try and cut waiting times, we’re joined by Dr Zoe to give us her thoughts, as well as her advice on alternative ways to shed the pounds.
Tell us about this new pilot scheme?
Thousands of obese people will be offered weight-loss jabs in an NHS pilot scheme to assess whether a new generation of appetite-suppressing drugs can cut waiting lists and increase levels of employment.
The weight loss drug Wegovy, also known as Semaglutide, has been approved by the NHS after evidence that it can help people reduce their body weight by 10 per cent or more.
Ministers also hope to include a similar drug — tirzepatide, which could be even more effective - in the scheme.
Ministers, under pressure to get people back to work, are also planning to use the trial to measure whether those who use the drugs stay in work or find new jobs at higher rates than those who do not.
How big of a problem is obesity for the NHS?
The proportion of adults in England who are overweight including obese has risen by 11% since 1993, currently standing at 64%. The costs associated with that increase are expected to top nearly £10 billion by 2050.
This, in turn, has led to increasing rates of obesity-related cancers, such as breast cancer, as well as other life-shortening diseases, including type 2 diabetes.
In 2019/20 there were more than 1 million hospital admissions linked to obesity in England, an increase of 17 per cent on the previous year.
What causes obesity?
Dr Zoe says: "Obesity is finally being recognised as a chronic disease that requires treatment. For decades people have been blamed for poor lifestyle choices, but scientifically, we now know for certain that obesity is usually beyond a person's individual choice and control. And any 'blame' should be attributed elsewhere. What people don't realise is that there are over 100 different potential causes for obesity. The main thing people need to realise is that it is largely down to genetics - something we have absolutely no control over. Other factors are social, even down to postcode, and again people rarely consider this."
So obesity doesn't affect us all equally?
Dr Zoe says: "Children who are born in the poorest parts of london are twice as likely to be obese as those born in the richest areas. Women in the most deprived areas are 17% more likely to be obese than those in the least deprived areas. Men in the most deprived areas are 8% more likely."
How do these new drugs treat obesity?
Semaglutide mimics a weight loss jabs hormone that encourages the body to produce insulin, and helps to control the body's blood sugar. It also 'tricks' the patient into thinking they're not hungry, by not only reducing hunger but also reducing food cravings.
How effective are these jabs?
A 2021 study by the new england journal of medicine found that semaglutide can be a very effective weight loss treatment. The study compared people using semaglutide plus a diet and exercise program with people who made the same lifestyle changes without semaglutide. After 68 weeks, half of the participants using semaglutide lost 15% of their body weight, and nearly a third lost 20%. Participants who incorporated only lifestyle changes lost about 2.4% of their weight. Since then, additional studies have shown similar results.
Are there any side effects?
While its benefits are widely known, the drug can also lead to a variety of side effects. Common side effects include:
Low blood sugar (in people with type 2 diabetes)
Upset stomach, heartburn, burping, gas, bloating
Nausea, vomiting, stomach pain, loss of appetite
Diarrhoea, constipation
Runny nose or sore throat
Stomach flu symptoms
Headache, dizziness, tiredness
What happens when you stop taking the medication?
Dr Zoe says: "They should always be taken along with making healthy lifestyle changes in diet and physical activity. It is also critical that the treatment is provided alongside mental and psychological support, so that people can change their behaviours long term. Otherwise, as soon as you stop the treatment, you will likely put the weight back on."
Do these treatments need to be made more widely available?
Dr Zoe says: "Only 50% of the country have these weight management services, so it's still a lottery whether you'd even be able to be referred to one. So currently it's a relatively small number of people who can access it. GP's aren't able to prescribe it at the moment. So alongside this pilot the government will need to train more dr/nurses in treating obesity, so that it can be prescribed outside of these limited specialist services. And ultimately we need to make sure that these services are available all across the country to the people who need them."
What should people be doing alongside or alternatively to these kinds of treatments?
Dr Zoe says: "There's an argument that for people who have battled lifelong obesity, restrictive dieting programmes may do more harm than good. Our health, whilst absolutely impacted by obesity can be improved in so many other ways, not just weight loss. So for people who are eligible and waiting for an opportunity to access this treatment, remember that there are other ways to improve health-stress management, improved sleep, higher quality food in diet, more water, better relationships."
And you always recommend physical activity for everyone?
Dr Zoe says: "One thing I would recommend for everyone is physical activity (not just for weight loss). If we could bottle up exercise as a drug, I would be prescribing it to every single patient. Instead of fretting about weight, focus on weight loss jabs prescribing it to every single patient. Instead of fretting about weight, focus on the benefits of physical activity.
A brisk ten-minute walk every day cut your chances of an early death by 15 per cent! Regularly being active is one of the best things you can do for your physical and mental health. Studies show it can reduce the risk of developing some long-term health conditions by as much as 40 per cent. Exercise is free and the side-effects include feeling happier, healthier, less stressed and more focused."