Obesity is undoubtedly a significant problem. In 2023, one-quarter (26.2%) of adults in the UK were estimated to be obese (a body mass index (BMI) of 30 or above). A further 38% are overweight but not obese. Almost three-quarters of those aged 45-74 in England are overweight or obese.

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Now, the UK Health Secretary, Wes Streeting, has given us the answer: the Unemployed will be given weight-loss jabs to ‘get them back to work’.

Instead of tackling the record-high waiting list, the long waits in A&E, and the fact that no one can see their GP, Wes decided that the new class of medication could have a “monumental” impact on obesity and get Britain working.

In the Telegraph, Wes says, “The long-term benefits of these drugs could be monumental in our approach to tackling obesity. For many, these weight-loss jabs will be life-changing, help them get back to work, and ease the demands on our NHS.”

These weight loss drugs have received a marketing push TTE  has never seen before. Often referred to as game changers, they seemingly provide all sorts of benefits beyond weight loss—not only that, but they now get you back to work.

The semaglutide study, published in the NEJM, revealed that participants who received weekly injections over 15 months lost an average of 15% of their body weight. In contrast, the placebo group only lost an average of 2.4%.  One in 15 (7%) stopped the drug due to adverse effects, and serious adverse events were reported in 9.8% of semaglutide participants and 6.4% on placebo (see NICE BNF for cautions and side effects).

The intervention wasn't just the drug; it also involved lifestyle support to help reduce calorie intake and increase physical activity. As the triallists stated, a limitation is that the participants enrolled may represent a subgroup with a greater commitment to weight-loss efforts than the general population. 

By the end of the trial, about 70% of motivated individuals who completed the course of semaglutide lost 10% of their body weight compared to 32% in the placebo group. 

However, what happens when you stop the drug? NICE recommends semaglutide in adults only if used for two years and within a specialist weight management service. The duration of treatment reflects the lack of evidence beyond two years. 

In the NICE guidance, the company included an assumption that three years after stopping semaglutide, you'd be back to where you were, and the weight advantage would be lost. 

So, what do you get for your money? As of July 2024, the number of unemployed people in the UK was about 1.44 million. The list price for a month’s supply of Wegovy is £175.80 for the 2.4mg dose. So if you put 10% of the unemployed on the drug, the cost per month is just over £25 million a month (or £300 million a year), which doesn’t include the cost of consultations and use of NHS resources.

According to Wes's article, "Illness caused by obesity causes people to take an extra four sick days a year on average."  For £300 million, how's that for a game-changer?

This post was written by two old geezers whose understanding of monumental relates to statues.