London
CNN
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Weight loss medications such as Wegovy and Ozempic are being hailed worldwide as revolutionary for medicine. In the UK, the government hopes it can also improve public finances, keeping an eye on its use to help the unemployed get back to work and ultimately save money on healthcare.
“For many people, these weight loss jabs will be life-changing, helping them get back to work and easing the demands on our NHS. [National Health Service]”, British Health Minister Wes Streeting recently wrote The Telegraph newspaper.
Streeting added that obesity “places a significant burden on our healthcare system”, costing the NHS £11 billion ($14 billion) a year and forcing people to take an average of four extra sick days a year, damaging the economy.
To counter that, the government is funding a five-year trial of the weight-loss drug Mounjaro, or tirzepatide, in partnership with the drugmaker Eli Lilly, which will collect data on participants’ quality of life and changes in their employment status and cases of illness. day use.
But the proposals have sparked a backlash from health care professionals, who say new pharmaceutical treatments have resulted in a surge in demand that the country’s public health system cannot meet.
Additional measures to prevent obesity in the first place are desperately needed, health experts say.
There’s no doubt about the problem of obesity in Britain – at least 29% of adults in England are obese, as are 15% of children aged between 2 and 15, according to the latest Health Survey for England, which draws data from 2022 used. .
According to government health data, obesity is the second most common cause of preventable death in England, after smoking. It is also a risk factor for type 2 diabetes, cardiovascular disease, dementia, liver disease and several forms of cancer.
British Prime Minister Keir Starmer has said his government needs to “think differently” about how to reduce pressure on the country’s national healthcare system, which is overburdened by staff shortages and funding pressures. Part of that new thinking is exploring weight loss medications.
Still, obesity experts and health care professionals say that because the health care system is already overburdened, medications are difficult to administer at scale and solutions must go much deeper.
“The idea that this is the solution to obesity is a complete fantasy. We still need to prevent as many cases as possible,” said Alfred Slade, head of government affairs at the Obesity Health Alliance, a coalition of organizations working together to reduce the condition in the UK.
The OHA compiled the numbers for existing weight loss medications, such as Wegovy, the brand name for the appetite suppressant semaglutide. The conclusion? It’s almost impossible to make it widely available.
Currently, around 4.1 million overweight people meet the criteria to receive Wegovy through England’s national healthcare system. But fewer than 50,000 people a year will actually receive the treatment due to underfunding of NHS services and staffing levels, even with additional funding in coming years, the alliance said, citing NHS estimates.
“We’re talking about fractions of fractions of fractions of people, even under a very expensive expansion of current access to treatment,” Slade told CNN. “We support these treatments for those for whom they are medically appropriate, but they are not a substitute for the need to prevent as many cases of obesity as possible… nor will they remain a viable population-based solution indefinitely. .”
To improve access, the government is also expanding the use of the drug Mounjaro, or tirzepatide, for obese patients in addition to type 2 diabetes patients. The Ministry of Health claims that up to 250,000 people in greatest need could be helped over the next three years.
The alliance says it is not clear how the government will pay for the drugs, or how it plans to fund ‘wraparound support’ that is essential alongside these prescriptions, such as nutritional advice and physical activity support to ensure patients don’t lose muscle mass. as well as fat.
The government study into the link between weight loss drugs and employment is also raising alarm bells among healthcare experts, who argue that medical necessity should always be the driving factor behind drug prescribing.
“Obesity management services should be available to all who could benefit from them, but where priorities need to be set, this should be done on the basis of clinical need and not the patient’s potential economic output ” wrote Jack Doughty, a senior policy officer at Diabetes UK. in a blog post.
The UK Department of Health has made it clear that the NHS will continue to treat people based on clinical needs and will not prioritize the unemployed.
“This government is committed to tackling this issue urgently and shifting our focus from treatment to prevention as part of our 10-year health plan,” a spokesperson for the Department of Health and Social Care said in a statement to CNN, adding that the government is also working to limit junk food advertising and schoolchildren’s access to fast food.
A major problem with weight-loss drugs is that they “target the symptom, not the cause” of obesity, said Martin White, professor of population research at the University of Cambridge. Experts argue that you should address both.
“You’re ‘medicalizing’ a problem that is actually a social problem,” White told CNN, emphasizing that the rapid rise in obesity rates reflects the rise of processed foods and fast food in society as more and more cheap ingredients such as sugar and fats and salt are creeping into everyone’s diet.
“It’s a population-wide problem, not a small number of individuals,” White said. “We need to think of ways to change the context or environment that causes people to eat so many excess calories.”
One way is to introduce stricter taxes on unhealthy products.
For example, the UK tax on sugary soft drinks has already led to manufacturers reducing the amount of sugar in soft drinks, and research shows that price increases are putting off some consumers. There are increasing calls for taxing food products containing sugar and salt in a similar manner.
Experts are also calling for stricter marketing rules to prevent unhealthy foods from being advertised to children. A watershed law banning junk food advertising before 9pm on TV, streaming services and online will come into force in Britain in October 2025.
Another policy solution is to require healthier food to be served in public sector facilities such as schools, hospitals and prisons. White said this type of intervention could also be applied to the private sector, if offices and corporate caterers need to serve healthier food.
In schools, experts say there are also problems with the implementation of existing healthy food regulations, another area that could benefit from greater scrutiny and investment. For example, a government report calls for more funding to increase access to free and nutritious school meals.
“What we’re seeing more and more is that children are starting to gain weight from a very young age,” White added. “But if you can prevent it very early, the cost savings in health care will be enormous.”
Of course, changing an entire food system is harder than prescribing a drug. But tackling an obesity problem that affects around a third of British adults will require multiple solutions, across all sectors of society.
“There is no such thing as a silver bullet for obesity,” emphasizes the Obesity Health Alliance.