The NHS is preparing to make weight-loss injections widely accessible to help manage obesity, a condition affecting millions. These drugs, Wegovy and Mounjaro, are already in use and show promise for individuals struggling with excess weight. However, NHS experts warn that the healthcare system may face significant challenges in meeting the demand for these treatments, which are expected to be available in stages over the coming years.
Mechanism of Action: How Do These Drugs Work?
The two primary weight-loss medications—Wegovy and Mounjaro—work by suppressing appetite. Both are administered as weekly injections, typically via pre-filled pens that patients can use themselves in the upper arm, thigh, or abdomen.
Wegovy, a brand of semaglutide, mimics the natural hormone glucagon-like peptide-1 (GLP-1), which is released after eating and promotes a feeling of fullness.
Mounjaro, which contains tirzepatide, targets not only GLP-1 but also glucose-dependent insulinotropic peptide (GIP). This dual action enhances metabolism and helps regulate energy balance.
Patients usually start with a low dose, gradually increasing until they reach a higher maintenance dose.
Weight Loss Outcomes: How Much Can People Expect to Lose?
Clinical trials show that individuals using these drugs alongside a balanced diet, exercise, and behavioral support can expect significant weight loss. Wegovy users, for example, can lose more than 10% of their body weight within a year of treatment. Mounjaro trials suggest even greater weight loss potential, with some participants shedding up to 20% of their body weight. However, it’s important to note that the weight lost often returns if treatment is discontinued.
NHS Accessibility: Who Can Receive These Medications?
Currently, only Wegovy is available through the NHS in England, Wales, and Scotland. The drug is restricted to adults with obesity (BMI of 35 or higher) and at least one associated health condition, such as high blood pressure. Overweight individuals with cardiovascular disease may also qualify. Treatment is prescribed under the guidance of a weight management specialist, with a maximum duration of two years as part of a comprehensive treatment plan that includes dietary and physical activity changes.
Mounjaro will likely be available on the NHS from March 2025. Initially, it will be restricted to patients with obesity-related health conditions, but wider access may be offered by June 2025. NHS guidelines for this rollout are expected soon, with projections suggesting up to 3.4 million people could eventually be eligible for treatment.
Costs and Private Access: Are These Drugs Available Outside the NHS?
Both Wegovy and Mounjaro are available privately, with prices ranging from £200 to £300 per injection, depending on the dose. However, these treatments should only be purchased from regulated sources. The popularity of weight-loss jabs has led to a rise in black market sales, with unlicensed providers offering the drugs without prescriptions. The BBC uncovered instances of unregulated sales in beauty salons and online platforms, prompting calls for tighter controls.
Side Effects and Safety Considerations
While many patients tolerate the side effects of these drugs, common issues include nausea, vomiting, bloating, constipation, and diarrhea. Some users also report hair loss. Serious side effects, such as gallbladder disease, kidney problems, and depression, have been reported but are rare. Experts caution that misuse of these drugs—especially when sourced from unregulated channels—can lead to severe complications, including pancreatitis.
As a result, doctors emphasize that these treatments should only be used under medical supervision to minimize risks.
What Happens After Discontinuation?
Research indicates that many patients who stop using weight-loss injections regain most or all of the weight they initially lost, as their natural food cravings return. This underscores the importance of using the drugs as part of a broader strategy to improve diet and exercise habits. Health Secretary Wes Streeting has expressed concerns about creating a “dependency culture” around weight-loss drugs, warning that they should be part of a holistic approach to obesity treatment.
Obesity and BMI: Understanding the Condition
Obesity is defined as having excess body fat, with the Body Mass Index (BMI) serving as a primary measurement tool. In the UK, approximately one in four adults is classified as obese, with a BMI of 30 or higher. For those of Asian, Chinese, Middle Eastern, Black African, or African-Caribbean descent, the threshold for obesity is lower, with a BMI of 27.5 or above considered obese.
BMI calculations, while useful, do have limitations, as they do not differentiate between muscle mass and body fat. However, it remains a valuable tool for assessing general health risks associated with weight.
Conclusion: A Step Toward Tackling Obesity?
The introduction of Wegovy and Mounjaro offers promising options for managing obesity, a global health crisis. However, experts caution that these drugs should not be seen as a silver bullet. Their use must be combined with lifestyle changes and careful medical supervision to ensure lasting health benefits. As demand increases, the NHS faces an uphill battle to provide adequate access and support, raising questions about the long-term sustainability of weight-loss drug treatments in the healthcare system.
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