Britain's looming 'over-zempic' crisis? Experts warn against overmedicalising obesity amid calls for slimming jabs to be doled out like statins to slash heart attacks and strokes

14/05/2024

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Weight loss jabs like Ozempic shouldn't be handed out 'like Smarties', top experts warned today.

It followed calls to dole out slimming injections to millions of Brits in a bid to slash heart attacks and strokes.

Landmark research found semaglutide, branded as Ozempic and Wegovy, cut the risk of heart attacks or death by a fifth.

Benefits were seen even in patients who did not lose weight, in what cardiologists hailed as a huge breakthrough.

The results, shared at a medical conference in Venice, prompted calls for slimming jabs to be prescribed en masse like cholesterol-busting statins. One expert said the discovery would 'change clinical practice'.

Semaglutide, as well as rival drugs liraglutide and tirzepatide, have been hailed as monumental breakthroughs in the war on obesity. But a spike in demand for the jabs, fuelled by celebrity endorsements, has also seen global stocks run low

In the wake of the study, Rishi Sunak said he was committed to rolling out weight-loss jabs to help fix the nation's health problems. The Prime Minister said doing so could help boost the economy, helping Brits back into work.

But critics said there was growing potential that the mass roll-out of the jabs could lead to an over-medicalisation of obesity, which can be reversed through a healthy diet and exercise.

Experts also warned the long-term side effects remain a mystery, with the injections being probed over cancer fears.

Concerns were also raised that the publicity surrounding the jabs for treating heart disease will contribute to growing inequity in access to the drugs, with the patients who clinically need them most being swept aside by demand.

One expert told MailOnline he expects phones at private clinics connecting the wealthy to the drug to be 'buzzing' in response to last night's news.

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Professor Rameen Shakur, an expert in genomics and precision cardiovascular medicine at University of Brighton, said there still unanswered questions on the study that showed semaglutide's potential cardiovascular benefits.

'We are unclear on the mechanism and biological process by which semaglutide might reduce cardiac mortality per se,' he said.

'I don't think it is commercially realistic to put whole populations on a medical therapy until you know how the biological system works.'

Professor Shakur also warned that the 'potent' drugs were not without risk, with scientists still at an 'early stage' in learning about their long term use, and this should be communicated to patients.

'There remains a risk of pancreatitis and some rare thyroid cancers which is often not stated and this should also be monitored during the course of patient use,' he said.

He also told MailOnline that an overreliance on the drugs risked over-medicalising obesity.

'The potential for medicalisation has now been greatly increased,' he said.

'There are definite means to reduce obesity through exercise and weight loss management that don't require medication.'

But he acknowledged the drugs had their place, and they should be reserved for those who stood to clinically benefit the most from them.

'It's not currently a wise idea to roll them out as if they were Smarties,' he said.

'We need to be more specific on stratifying those patients where we get the most bang for buck, especially in the NHS.

'We know it's particularly effective in diabetics, particularly effective in obese patients, let's start there.'

Wegovy and Ozempic work by triggering the body to produce a hormone called GLP-1 that is released naturally from the intestines after meals

The proportion of Brits overweight or obese has slowly grown over time, rising to two thirds as of 2021, the latest data available. No data was recorded for 2020 the year of the Covid pandemic

Professor Shakur also predicted the latest study will only add to global demand for the drugs, and that private clinics offering prescriptions for the likes of Ozempic, Wegovy and Mounjaro would see a boon in business of the back of it.

'My biggest worry is equity and I don't know how we're going to manage it,' he said.

'The phones will be buzzing in a lot of private clinics.'

Global demand for semaglutide, which was originally designed to help diabetics, as a weight-loss drug has created supply problems for Brits who rely on the medication.

Professor Shakur also highlighted that calls to dish out drugs like Ozempic to millions for heart health benefits don't make sense economically.

Statins, pills that help lower cholesterol in the blood, helping reduce the risk of cardiovascular disease, cost as little as 2p per tab.

Semgalutide costs vary, but privately supplies cost about £200 a shot.

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The NHS in England spend about £9million on GP prescriptions for semaglutide in February this year alone.

Professor Jason Halford, an expert in biological psychology and obesity, also said he had concerns about the over use of weight-loss jabs.

'These are exciting results but we do need a lot more long term data, not only to demonstrate the potential benefits but also understand potential risks,' he said.

'We are also over focusing on one treatment option. We need also to consider other proven approaches to weight management.'

Dr Duane Mellor, of the British Dietetic Association, also said the drugs weren't the only weight-loss treatment.

'Although semaglutide is an effective way for some people to improve their health, including supporting weight loss and now according to this data reduce risk of cardiovascular disease, it does not mean that eating healthy, being physically active and not smoking are at least equally important,' he said.

'Although semaglutide is one tool in the toolkit that can help improve health, it needs to be partner of a holistic approach to improving health.'

Professor Sir Martin Landray, chief executive officer at Protas, a non-for-profit that helps organise clinical trials, said while drugs like semaglutide, which belong to a class of medications called GLP-1 agonists, were 'remarkable' prevention was better than cure.

'We must accelerate the pursuit of non-pharmacological policy efforts to improve diet and reduce the development of obesity in the first place,' he said.

Calls for caution haven't stopped Mr Sunak committing to to rolling out weight-loss jabs to help fix the nation's health problems, however.

After yesterday's 'groundbreaking' research the Prime Minister said its use could help boost the economy.

The Government is now keen to widen out their use for conditions other than obesity and diabetes, once regulators give the go-ahead.

A spokesman for Number 10 said Mr Sunak welcomed the findings.

This chart shows the mortality rate for cardiovascular disease in the under 75s in England (blue bars) which is the number of deaths per 100,000 people as well as sheer number of deaths (red line). Medical breakthroughs and advanced screening techniques helped lower these figures from 2004, but progress began to stall in the early 2010s before reversing in the last few years of data

'This new study is welcome because we know the potential for obesity medicines to help more people both lose weight but as this study suggests also cut wider health conditions,' he said.

'That's why we are committed to the safe introduction of new approved weight loss drugs into the NHS, as well as improving access to existing drugs for those who meet the eligibility criteria.'

Around 8million people in the UK have heart disease, which the British Heart Foundation estimates costs the UK economy £25 billion each year.

Mr Sunak has spoken of his desire to end the 'sick note culture' and help people get back into work.

Speaking at the Policy Exchange on security earlier this week, Mr Sunak acknowledged the huge role the drug – which is approved as Ozempic and Wegovy – could have going forward.

Is the 'Godzilla' weight loss jab REALLY the best? MailOnline's graphic reveals all... and how it truly compares against rivals Ozempic and Mounjaro

He said: 'You can see the opportunity too in healthcare, giving people longer, healthier lives.

'In Denmark, NovoNordisk created the Ozempic drug which is not only helping to tackle chronic disease globally, but singlehandedly grew Denmark's entire economy last year.'

Manufactured by Novo Nordisk, semaglutide is the first in a new generation of anti-obesity drugs which work supress appetite by mimicking the hormone GLP-1.

It was initially used to treat type 2 diabetes under the brand name Ozempic before later being repurposed as the weight loss drug, Wegovy, which is given at a higher dose.

Experts believe the benefits of the drug extend beyond weight loss, with trials ongoing into illnesses including Parkinson's and kidney disease.

The landmark SELECT trial, the results of which were announced in Venice, involved 17,604 adults diagnosed with heart problems who were overweight or obese from 41 countries, who took semaglutide medication over three years.

Given once weekly at the same dose as Wegovy, the jab was found to have the same heart health benefits to patients, regardless of their weight.

The group who took it, rather than a placebo, had a 20 per cent lower risk of heart attack, stroke or death from heart disease, and typically lost around 10 per cent of their body weight.

This effect was seen regardless of weight loss, suggesting the drugs target an underlying biological mechanism such as inflammation, which is linked to chronic diseases including cancer.

However, the 'miracle' weight-loss jabs are not without side effects.

These range from the simply embarrassing, such as flatulence, to cases of suicidal thoughts among patients taking the jabs, which work trick the body into feeling full and slowing digestion.