New diabetes drugs do not tackle the root causes of obesity, experts warn

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The promise of a breakthrough drug to help people lose weight should not be used as an excuse to avoid tackling the root causes of obesity, experts have warned, as concerns grow about the pressure to slim down.

According to recent figures, the percentage of adults in England who are obese rose from 14.9% to 28% between 1993 and 2019, and NHS England data shows that 10,780 hospital admissions in 2019-20 were directly attributable to obesity.

With many finding weight to be kept off through challenging diet and exercise, excitement is growing around diabetes drugs that have been found to help people lose a lot of weight by mimicking hormones that help people feel full after after eating food.

One study involving the drug tirzepatide, along with lifestyle changes, showed that participants lost up to 20% of their body weight in a 72-week trial.

But experts say that while the dramatic impact of these drugs is welcomed, there are concerns that it could detract from action to prevent obesity in the first place.

“Unhealthy food is the biggest cause of death and disability in the world,” said Graham MacGregor, professor of cardiovascular medicine at the Wolfson Institute for Population Health in London.

“The question is, what are you going to do about it? Are you going to let the food industry feed us this garbage and promote it…and then give drugs to stop the effects of all this unhealthy food? Or are you going to try to stop the food industry from doing this?”

MacGregor said prescriptions for blood pressure tablets and statins had risen because of the rise in the number of people with high blood pressure from eating too much salt, and high LDL cholesterol from eating too much saturated fat. .

“I would think this is also inevitable [diabetes] drugs that will [similarly] is widely used, because if you are obese, it is almost impossible to lose weight,” he said. But, he added: “It would have been much better to have prevented this in the first place.”

Although the National Institute for Health and Care Excellence (NICE) in the UK has already approved the use of two diabetes drugs, liraglutide (brand name Saxenda) and the more effective semaglutide (Wegovy), for certain groups of people with obesity, there are obstacles to be violated. their use.

Experts say more work is needed on safety and side effects, and the drugs have drawbacks, including that they are expensive and can only be given by injection.

Natasha Devon, a body image and mental health campaigner, said the advent of drugs would not help ease the already problematic pressure on obese people.

“The public health messages have been overwhelming [obesity] because it’s become ‘any way to lose weight and that’s automatically going to be healthier’ – and that’s not the case and it creates a lot of issues around body image and eating disorders,” she said. “When we’re focusing on what we can change, it should be how we treat our bodies, rather than how our bodies look.”

Devon also questioned whether psychological support and help to change habits would be available to people given the weight loss drugs. “I hope we don’t get to a place like we have with antidepressants where it’s just very surface level. [solution],” she said.

The company that produces the drugs, Novo Nordisk, is yet to supply stocks of Wegovy to the NHS. Novo Nordisk also produces the Ozempic brand of semaglutide, which – although only licensed for diabetes – can be bought through online pharmacies or private healthcare providers.

The shortage of the drug prompted the Department of Health and Social Care to warn doctors in September that no new Ozempic prescriptions should be issued until full supplies were available, raising concerns that those buying it could privately for weight loss risk the availability of the drug. for patients with diabetes.

A spokesperson for the company said: “While Novo Nordisk acknowledges that all licensed prescribers have the discretion to prescribe treatments outside their intended purpose, or approved parameters of use, Novo Nordisk does not endorse this in any way.”

A spokesperson for the Department of Health and Social Care said the government was taking a multifaceted approach to tackling obesity. “We recently announced £20m to trial new obesity treatments and technologies to help save the NHS billions, and we remain committed to introducing restrictions banning food and drink adverts on TV a lot of fat, salt or sugar before 9pm, as well as paid restrictions. for online ads,” they said.

Although controversial calorie labeling for food sold in large businesses and regulations on the promotion of foods high in fat, salt or sugar in large retail locations were introduced in 2022, the government delayed a ban on advertisements for such foods that’s before 9pm, as well as “buy one, get one free” on junk food until 2025.

Related: Obesity ‘epidemic’ leading to 1.2m deaths a year in Europe, says WHO

Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University, said policy changes are needed. “You can’t really help the fact that a lot of you will become obese, because we live in this environment where food is available 24/7 and a lot of the population may not have the money. able to afford the healthiest foods,” he said.

“I think these drugs are a really important weapon in the arsenal to fight the obesity crisis. But I think you have to use it along with changing the whole environment we live in.”

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