New more powerful appetite-suppressing jab has been approved for weight loss on the NHS.
In trials, Mounjaro helped obese people lose a fifth of their weight and the weekly injection is being offered on the NHS to people dangerously obese. However, the jab comes with side effects such as nausea and causes a loss of muscle mass, while experts suspect it will be subject to NHS rationing.
Prof Sir Stephen O’Rahilly, obesity expert at Cambridge University, said: “We are clearly in a new era of obesity management where, for the first time, we can have access to medicines which are effective and, though not without some side effects, largely safe. The genie is out of the bottle. Safe and effective drug treatment for obesity is not going to go away.” The two top-selling appetite-suppressing drugs, Wegovy and Ozempic, are the same drug semaglutide but sold at different doses.
Semaglutide was originally designed to tackle Type 2 diabetes but was repurposed for obesity and trials showed its stronger dose form, branded as Wegovy, could help users lose 15% of their body weight in 68 weeks. The drugs have become popular after celebrities including Sharon Osbourne, Elon Musk and ex-PM Boris Johnson boasted about trying them. They slow digestion and reduce appetite by mimicking a key hormone which regulates hunger called glucagon-like peptide-1 (GLP-1).
Mounjaro, which is made by Eli Lilly, also targets a hormone called GIP to boost its effect on appetite suppression. Trials showed it could help obese people lose 21% of their body weight in 72 weeks. It had previously only been approved by the National Institute for Health and Care Excellence for some people with Type 2 diabetes.
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It received a draft recommendation on the NHS for patients with a body mass index of 35 with at least one obesity-related condition. A four-week supply of pre-filled pen injections of Mounjaro ranges from £92 to £122 for the highest dose.
Prof O’Rahilly said: “In the longer term, these drugs significantly reduce the risks of developing distressing and expensive complications such as Type 2 diabetes, heart attacks and kidney failure, but their cost provides an immediate financial challenge at a time when NHS budgets are tight. I am aware of health authorities that are decommissioning the only local obesity services permitted to prescribe these agents, largely due to the concerns about the immediate expense.
“We must continue to work on making our environment less promoting of obesity but that will take political will and time.” And he added: “Even if we do so, there will still be people who develop obesity because they have a very strong inherent predisposition.”
Many experts believe patients on GLP-1 drugs should stay on them for life as without complete lifestyle changes they are liable to put weight back on if they stop them.