Weight loss jabs are not a “quick fix” and the health secretary’s plan to use them to help people get back to work could backfire, experts have warned.
Wes Streeting announced a real-world trial of the medication’s impact on worklessness this week, saying that “widening waistbands” were placing a burden on the NHS. He suggested that as well as bringing benefits to the health service, the jabs could help people get back into employment.
But scientists have said deploying the medications specifically for that purpose would carry serious logistical and ethical problems.
Wegovy, which contains the drug semaglutide, is already being prescribed on the NHS for obesity, however this is not yet the case for Mounjaro, which contains tirzepatide. There have also been concerns about worldwide shortages, although the NHS is thought to have enough.
While the National Institute for Health and Care Excellence (Nice) has said Wegovy should only be prescribed through specialist weight loss services, it has suggested Mounjaro could be prescribed by GPs.
Experts have welcomed the recognition of obesity as a health issue that affects quality of life, and are excited about the potential of these drugs. But they say serious problems could arise should the medications be used to specifically tackle unemployment.
“Streeting is correct in saying that for some people their weight will be a burden to their ability to work, and for people who have significant levels of obesity, it is almost certain that their biology has led them to that weight. Providing people with proven, effective medications to help them lose weight may lead to them being able to enter the workforce,” said Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University. “But this is not a quick-fix solution.”
One major issue, he said, is that access is already hugely problematic. While he said that specialist services are the best approach to maximise results and ensure patient safety, overwhelming demand has already resulted in some trusts pausing all referrals to obesity services.
“The whole system is designed to bottleneck patients through the pipeline and reduce access to specialist services, but alternative provisions through primary care risk the NHS wasting money on partially effective medications and risks patient health,” he added, noting a complete overhaul of the system is needed.
Cork added that, should unemployed people end up being prioritised for the medications, one possibility is that people will quit their jobs, noting patients have been known to put on weight to become eligible for bariatric surgery.
“People will do things to get access to help because they’re desperate,” he said.
Some have also raised ethical concerns should access to weight loss medications be linked to employment potential, not least as people may not be in work because of caring responsibilities.
“In my view, let’s treat everyone who needs to be treated,” said Prof Giles Yeo, an expert in obesity at the University of Cambridge. “If we segment society into whether or not you have economic value, and hence whether or not I would treat you, where does that lead us to?”
Yeo added that it is also important people have the right to refuse medications.
“I think these drugs are effective and powerful, I think they’re a tool which should be used appropriately. I think not enough people are getting it at the moment and they should be, and the people who need to [have them] should be getting them,” he said. “We should not be blackmailing people into taking the drugs if they don’t wish to take it.”
And then there are fears that focusing on weight loss jabs risks distracting from preventing obesity. “People already suffering from obesity need help to manage their weight loss journey,” said Cork. “However, altering the environment which has led to the obesity crisis also needs to happen.”
Yeo agreed. “The drugs treat a disease, they don’t prevent a disease,” he said. “I don’t want [the government] to use [these medications] as an excuse not to make the hard policy decisions.”
Streeting’s comments came alongside the announcement of a new five-year study by Health Innovation Manchester and the pharma company Lilly, which is set to explore whether the drugs can not only bring clinical benefits but also have a health economic impact, including changing participants’ employment status.
“For many people, these jabs will be life-changing, help them get back to work, and ease the demands on our NHS,” he wrote in an opinion piece for the Daily Telegraph this week.
