Skinny jabs risk being used as a cop-out by governments to avoid making hard policy choices to prevent obesity, a leading expert has warned.
Prof Giles Yeo, a geneticist at the University of Cambridge and expert on obesity and the brain control of food intake, said drugs such as semaglutide – the active ingredient in the weight-loss jab Wegovy – were remarkable and worked for a majority of people.
Indeed, Wegovy – which is available on the NHS – can help people to lose more than 10% of their body weight, with drugs such as tirzepatide even more effective. And the drugs are becoming ever more potent in their ability to help people lose weight.
“The effect sizes [in terms of weight loss] of the stuff coming down the line are incredible,” Yeo said, adding that products were in development that would require one injection a month, rather than weekly jabs.
But, Yeo stressed, such medications, known as GLP1 receptor agonists, were designed to treat obesity and its related illnesses, not prevent it.
“Prevention of obesity will require – will require – government policy changes, the hard miles, and I do fear, and this is a true fear, that actually not only our government, but many governments and policymakers, may very well use [these drugs] as a cop-out not to make the hard policy decisions. And that is a real issue,” he said.
Yeo added that prevention remained better than cure.
“The more time you spend in a state of obesity, the worse your health,” he said. “So preventing it means that you’re going to end up being healthier.”
Prevention was also the cheaper approach, he said, noting it avoided costs associated with obesity-related conditions, and those associated with treating obesity.
“The problem is these are long-term costs,” said Yeo, noting that meant they would span many governments. As a result, he said, a long-term plan was needed.
Yeo said among the public health measures that had to be taken by policymakers was to subsidise healthy foods to make them cheaper, so that they became the default choice even when money was limited.
He also stressed the need to crack down on the placement of unhealthy foods in shops.
“I’m not a food nazi, but I do think that if you want to eat something – chocolate, pudding, or whatever – that you walk to the aisle that says chocolate, and you walk to the aisle that says lasagne, you walk to the aisle that says ice-cream, and buy it,” he said, noting that enabled personal agency without people being sold items they were not intending to buy.
Yeo added that, while regulations were also needed on advertising of junk foods, plans for a 9pm watershed were “a load of bollocks now”, given that many people streamed shows as and when they wanted.
He also stressed it was important that action on advertising was non-judgmental, meaning it applied to all foods that met set nutritional criteria – such as having high levels of fat, salt and sugar – regardless of whether the food in question came from a fast-food outlet or fancy restaurant.
Yeo added that while drugs such as semaglutide were effective when it came to treating obesity – and were being trialled in other areas of health, from dementia to addiction – they had their limits.
“They make you feel fuller: you feel fuller, you eat less,” he said. “But what they don’t do is improve your diet.”
That, Yeo said, was a concern if they are used by people who consumed a poor diet.
“All this drug will do is reduce the amount of the poor diet you’re eating, so therefore you will lose weight, but it won’t improve your diet,” he said. “You will be healthier because you’ve lost weight, but nowhere near as healthy as you could have been if you were eating a healthy diet in addition to losing weight.”
Yeo cautioned there could even be unintended effects, given an unhealthy diet might be low in protein and micronutrients, meaning smaller portions might not reach recommended levels. In that case, people who eat less as a result of the jabs could face another problem. “There is a potential danger, if your diet was poor to begin with, that you find yourself in malnutrition,” he said.
Even those who ate healthily while using the drugs could experience unexpected consequences, he said, noting that like quick weight-loss diets, skinny jabs could lead to the loss of muscle mass.
“If you don’t, on top of improving your diet with protein etc, exercise, then you end up losing fat and muscle mass at a rate of 50:50 – and no one signed up to lose muscle mass,” he said.
What’s more, Yeo noted, the drugs worked just as well for someone who was obese as someone who was underweight, while they also altered blood glucose levels and could have side-effects. As a result, Yeo said, monitoring of their use by medical professionals was crucial.
“On top of the fact that [people using the drugs] probably need really robust dietary advice and some kind of exercise plan,” he said.
Ultimately, said Yeo, while such drugs should be embraced as a way to treat obesity, prevention remained crucial.
“We cannot lose sight of the fact that, actually, we still need to improve the environment,” he said.
