Can an injection treat obesity?
In 2019/2020 there were over 1 million hospital admissions in the UK where obesity was a factor, an increase of 17% on 2018/2019.
The Health Survey for England 2021 estimated in the same report that 25.9% of adults in England are obese and a further 37.9% are overweight. Around 2 in every 3 patients were female (64%) and this level has stayed static over time.
Obesity is known to cause health problems like diabetes and heart disease, but is also causes problems with maternity, knee joint issues (arthrosis of the knee), gallstones, hip issues (arthrosis of the hip), high blood pressure, stroke, gout and various cancers.
Being obese increased the chances of death from Covid-19.
Other than bariatric surgery, which is not without significant risks, or eating less and moving more, which doesn’t suit everyone,
there is very little in the way of reliable medical treatments for obesity. There is sadly much snake oil available though.
Existing drug treatments for obesity
Drugs such as appetite suppressants (e.g. Saxenda) and ‘fat burners’ such as Xenical, caffeine, guarana and L-cartnitine can have notable side effects too (including needing to poo urgently, pooing more frequently and even having an oily discharge from your rectum).
That’s why one new drug, which has attracted many news headlines in recent months, is generating such interest. Robust clinical trials have shown that the drug, Semaglutide (‘Wegovy’), is indeed highly effective in inducing weight loss. The list of side-effects appears low in comparison to other drugs.
The drug, taken as a weekly injection, stands to transform the lives of millions of people with weight levels that places their health at
The new treatment – a “skinny jab”
Semaglutide, made by Novo Nordisk, a pharmaceutical business specialising in Diabetes treatments, discovered the drug leads to weight loss of about 15% almost by accident. Eli Lilly, an American firm, is also due to have a similar drug on sale later this year.
The new drugs were originally intended to be treatments for diabetics, but the trials noticed the large and sustained weight loss
How Semaglutide works
The drug works by mimicking the release of key hormones which cause a feeling of being full. They effectively turn off the part of the brain that causes the urge to eat.
As well as turning off the part of the brain that triggers urges to eat, drug users have also reported that cravings to consume alcohol are markedly reduced too. The prospect that the drug could also be used as a treatment for alcohol dependency is being taken seriously. Phase 2 trials evaluating it are currently underway at the University of Oklahoma.
What risks are there to using the drug?
Because the type of drugs are new, nobody is sure of the long-term effects of their use. Lower doses of the drug have had some rare
side-effects, such as nausea, vomiting and diarrhoea, although they were observed to be mild. Possible increased associated incidences of thyroid cancer and pancreatitis were observed in animal tests preceding human trials.
The long-term risks are incredibly important to understand because, as is common with many diets, when the treatment is stopped many people put the weight straight back on. That means people may need to take the drug for life (like statins or beta-blockers) to maintain the benefit.
Although competition and innovation are likely to bring the costs of the drugs down, especially as generic versions become available (many years in the future), the drugs are phenomenally expensive (commonly between £75-£300 privately in the UK).
Can I access Semaglutide in the UK?
Yes, the drugs can be accessed privately in the UK and Semaglutide is shortly to become available on the NHS.
The cost, uncertainty of the long-term effects and serious supply issues means the drugs are only available on the NHS where the medical need is greatest. Government estimates suggest around 35,000 people will be eligible for treatment with the drugs.
Those seeking the drug for cosmetic benefit, like Botox, would need to fund the treatment themselves. The government has also recently announced a £40m trial to improve access to the drugs. The aim is to reduce waiting lists by providing the drug to people before they need hospital treatment.
Although the drug is available on private prescription, there have been continued shortages of supply, due to the popularity of the drug.
This means those clinically in need of the drug (e.g. those with type 2 diabetes) often cannot access the treatment. The supply problems are predicted to continue until mid-2024.
There have been calls to cease prescribing the drugs ‘off licence’ (outside their approved usage), which could mean many private prescribers would be restricted in prescribing the drugs. Advice is freely available if the shortages could affect your care.
What does this mean for businesses?
Whilst some private medical insurers may fund the drug as part of a treatment plan in the future, it is very unlikely it would be
reimbursed on most PMI policies. This is because obesity is usually viewed as a chronic condition.
A continued focus on promoting health eating and exercise are likely to be the best strategy for any business wishing to mitigate the effects of obesity on their insurance claims profiles or their day-to-day activities.
Many people are also supporting better food labelling as a cost-effective way to tackle obesity in the UK.