By Dr Sonia Adesara, NHS GP and Non-executive director for Health at ukactive.
Weight-loss drugs are not a panacea; we need a comprehensive plan to tackle the obesity crisis.
The obesity crisis in our country is entrenched, complex and getting worse. One in 4 adults is obese, as are 1 in 5 children. And every day in my clinic, I see patients with health conditions related to their weight.
“Weight-loss drugs” are being painted as the panacea to address this, but with every complex problem, there is rarely a “quick fix”.
And promoting these drugs, in the absence of a comprehensive plan to tackle the underlying causes of obesity, will not improve the health of the nation in the long term.
Undeniably, these drugs are beneficial in helping people lose weight, and may also be beneficial in other areas such as addiction.
But I have many reservations.
Firstly, we do not fully understand how these medications work and their long-term impact. In the UK, they have only been used since 2005 for patients who have failed to respond to other diabetes medicines.
There is a dependency issue. We believe weight loss jabs work by mimicking a hormone to tell your brain that you are full. This effect only lasts while you are having the injections. Once you stop the injections, unless your activity levels or diet have changed, you will likely regain the weight. Unless we want large parts of the population to be on weekly injections for life, we have to have a plan to support people to eat better and be more active.
Secondly, these medications are not appropriate for everyone. Despite the rise in use of these medications being a relatively recent phenomenon, I am already seeing many patients with side effects, including severe diarrhoea and vomiting. And, there are more severe known side effects, including gall bladder disease and pancreatitis, which can be life-threatening.
Another worrying side effect is the reported loss of muscle strength and bulk. A study of semaglutide (more commonly known as Ozempic) showed that approximately 40 per cent of the weight loss observed was attributed to muscle loss, rather than fat. More recent studies suggest that this muscle loss may be even more marked with tirzepatide (Mounjaro). This is particularly concerning for people as they age; post-menopausal women lose 5-10% of their muscle mass per decade. If this is not counteracted, this will lead to awful consequences later on in life, including increased frailty and fractures.
Therefore, for every patient I see who is struggling to lose weight. Simply prescribing an injection is not the solution for achieving a healthier, longer life. My patient needs holistic support for sustainable weight loss. This includes dietary advice and support to increase their physical activity – to get them fitter, stronger, healthier for life.
We already have an infrastructure of gyms, pools, and leisure centres to support people. And expertise in the fitness workforce to help ensure people achieve sustainable results and avoid further potential health complications. The Government needs to develop a national programme to support the rollout in communities – fitness and leisure facilities must be integrated to provide support programmes. Our Government has a generational opportunity to invest fully in a comprehensive prevention strategy for the nation’s health.
Advances in medicine have a role to play for people suffering from the severest forms of obesity. Still, the national adoption of weight-loss drugs is no substitute for a comprehensive strategy that encompasses diet support and physical activity.
Given the UK’s health crisis, there is a danger of quick-fix solutions taking priority, so I urge the Government to harness the power of physical activity, which has been proven to prevent more than 20 chronic conditions, including type 2 diabetes, obesity, heart disease, many cancers, anxiety, depression and other mental health conditions.
If the goal is a healthier, stronger, happier nation, then we need to think beyond injections.
This article was originally written for and published on LBC’s Opinion page.
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