According to a 2021 survey, approximately 25.9% of the UK’s population is obese, and while an unknown percentage of this group is unemployed, the government seems determined to intervene. Diabetic injections like Wegovy and Ozempic have gained popularity internationally for their success in facilitating rapid weight loss.
The Prime Minister’s announcement suggests that by providing these injections through the NHS, the affected population would be able to gain access to formal employment and re-enter the workforce, effectively boosting the country’s economy.
Experts and advocacy groups have urged the government to focus on addressing the underlying issues that exist within the public health sector. Without an overhaul, they warn, innovative solutions such as this will not have the desired effect.
Industry Experts Respond to the Announcement
Experts working within the British public health system, the National Health Service (NHS), were among the first groups to voice their concern. Chief among their concerns is the capacity to deliver, as the NHS is an already overwhelmed system. Additionally, there’s the issue of unequal access to healthcare services. The Obesity Health Alliance (OHA) elaborates on this.
Expressing concern, they penned a letter to Wes Streeting, the Secretary of State for Health and Social Care. The OHA is a consortium of healthcare charities and medical royal colleges, and included in their letter is a report that highlights a number of inequities; chief among them is the long wait times for specialist support. In some instances, patients wait as long as five years. Concerningly, the letter also states that some services have closed their waiting lists, as they’re unable to meet the demand.
The OHA wants to see equitable access to obesity treatments, including weight loss injections. There have been reports of global stock shortages, and currently, in the UK, the injections can only be offered through specialist weight-management services on the NHS. Some patients go private, but many others miss out, warns the OHA.
Burdened System and Equitable Roll Out
In their report, the OHA calculates that approximately four million people would qualify for the proposed government treatment. However, at the current capacity of the NHS, they expect that less than 50,000 patients will receive assistance by 2028.
Katharine Jenner, the OHA’s director, also warned against hailing weight loss jabs like Wegovy and Mounjaro as silver bullets. “Even if you are taking the jabs, you still need to have extra care and support around it. You still need to be doing exercise and have dietary advice as well, and that’s not currently there. There is also concern about who is getting access to this drug. We need to make sure that we are prioritizing access based on greatest clinical need and not based on any other factors.”
There is still a huge stigma attached to obesity within healthcare in the UK. Katharine highlighted the plights of patients turning to the OHA after having been turned away from the public health system due to their excess weight. This, she says, raises questions about the right to access treatment.
“They’re having to seek private treatment, and they’re not getting the care and support package that they’d be expecting to get if you had any other sort of condition,” she said. “We need to have a review of existing NHS services to identify cases of really good best practice and identify those challenges that exist all over the place.”
The frontrunner for NHS adoption is the drug Mounjaro. For its impressive trial results, it is colloquially referred to as the “King Kong” of the weight loss jabs. The drug is currently pending approval by the NHS. Experts predict that its availability through the NHS is likely to put additional strain on the public health system.
The OHA is not against the government proposal. Rather, they hope to see this solution rolled out in an equitable and sustainable manner. According to the OHA’s Government Affairs Lead, Alfie Slade, “The new weight loss drugs represent a breakthrough in treatment, giving hope to the millions of people struggling to manage their weight, but they also expose the weaknesses in our current obesity services. Without urgent government intervention, we will fail to meet the needs of millions of patients, leading to greater health inequalities.”
A Holistic Approach to Managed Care for Obesity
Doctors have added their voices to those raising concerns about the use of diabetic drugs as a weight loss solution. While the benefits are clear, they caution users against solely relying on medications like Wegovy and Mounjaro. A synthetic version of a naturally occurring hunger inhibiting hormone, these medications are by no means a “quick fix”, doctors warn.
They advise patients and healthcare practitioners to incorporate exercise and healthy eating in their treatment plans. One of the dangers of solely relying on weight loss drugs is that patients can put on weight once they stop taking the injections. And, of course, there’s the other side of the coin of benefits: Side effects.
According to the OHA, a holistic approach to managed care for obesity should include:
A review of existing obesity care services offered by the NHS. Healthcare practitioners are encouraged to identify current challenges and examine the case for expansion of treatment.
Assist NHS clinicians in assessing patients to establish patient priority for access to weight loss medications, in the face of increased demand for these jabs.
Access to comprehensive obesity treatment services through integrated care systems. This can mitigate the gaps caused by the “postcode lottery system” currently in place.
To effectively address obesity, a mix of interventions is required. While weight loss injections are revolutionary in enabling rapid weight loss, the NHS should also focus on prevention campaigns that can help at-risk individuals avoid so-called “killer conditions” like diabetes, heart attacks, and strokes.
Obesity on the National Agenda
Despite the numerous warnings and cautions from various healthcare practitioners, experts have equally welcomed the government’s decision to prioritize obesity. This is a healthcare issue that deeply impacts quality of life, and these weight loss injections offer new hope.
According to a spokesperson from the Department of Health and Social Care, obesity “costs the NHS more than £11bn a year, and it also places a significant burden on our economy. With obesity-related illness causing people to take more days off sick, obesity drugs can be part of the solution.”
Experts have cautioned the government in rationalizing this initiative as merely an economic issue. Drugs like Wegovy and Mounjaro cannot simply be used as a tool for economic empowerment (by tackling unemployment).
This bleeds into the issue of access, where a potential issue is that provision of service may be limited to the unemployed. This, in conjunction with the previously mentioned issues of an overwhelmed system, can create a bottleneck, effectively reducing access to specialist care.
The other consideration is that if the unemployed are a priority for the government, those ineligible are likely to quit their jobs to gain access to care. This wouldn’t be an anomaly. Bariatric surgery offers another option for overweight and obese people to live a healthy life, but is also subject to eligibility criteria. In some cases, patients who do not meet the weight requirement will try to intentionally gain weight to access the surgery.
According to Dr Simon Cook, a senior lecturer in physiology at the Anglia Ruskin University, “People will do things to get access to help because they’re desperate.”
Conclusion
The UK’s Prime Minister, Sir Keir Starmer, recently announced that weight loss injections are a viable solution to the issue of obesity in the country. He envisions a future scenario where hundreds of thousands of unemployed people are able to return to the workforce with the help of these “wonder drugs”, boosting the economy in the long term.
The biggest issues flagged by healthcare workers and subject-matter experts is the strain on the NHS, the public healthcare system. Specialist service providers are already overwhelmed, with patients waiting as long as five years for assistance; in other cases, wait lists have closed completely.
Healthcare practitioners and advocacy groups have also raised concerns about access to care. Inequality remains an issue, and organizations like the OHA urge the government to be proactive in resolving these baseline issues, in order for this program to be effective.
Lastly, they highlight the need for a holistic approach and caution against hailing weight loss jabs as a silver bullet. Patients will still need to maintain a healthy lifestyle and adopt healthy eating habits for long-lasting change and results.
While healthcare workers aren’t entirely against the suggestion, it would require a concerted government effort to overhaul the NHS and address the foundational challenges for this program to achieve its goal: A healthy population that can contribute to Britain’s workforce and economy.
