NHS weight-loss services turning away new patients due to Ozempic demand

Specialist weight-loss services in England are turning patients away with experts suggesting the demand for weight-loss injections may be fuelling the rise in referrals.

One in six integrated care boards (ICBs) in England, which are responsible for planning health services for their local population, have stopped accepting new patients for specialist weight management services as their referral numbers spiral out of control, an investigation by The BMJ has found.

At least seven out of 42 ICBs across the country – covering Manchester, Bristol, Suffolk, Leicester, Essex, and much of Yorkshire – have had to close a specialist (tier 3) weight management service list in their area, with many warning that demand is far exceeding capacity. One obesity service reached its three-year quota of patients in less than 17 weeks.

Experts have said the rise in obesity and the demand for weight-loss injections, such as Ozempic and Wegovy, may be fuelling the increase in referrals, but they blame a lack of consistent government policy for hindering the ability of weight management services to keep up with the growing demand.

Across England, almost two thirds (64 per cent) of adults are estimated to be overweight or obese. But in April 2022, the Government pulled its £100m funding grant for weight management services in England, just a year after it was announced.

Nerys Astbury, associate professor of diet and obesity at the University of Oxford, described the availability of specialist weight management services as “unequal and very limited, or completely absent in some regions”.

She told The BMJ that even where services do exist, “they are over-subscribed, waiting lists have been capped, or budgetary limitations mean services are at risk of being de-commissioned”.

Ozempic is only licensed in the UK for people with diabetes (Photo: David J Phillip/AP)

In some areas, even tightening the access criteria has failed to quell demand. For example, Greater Manchester ICB has had to pause referrals to its service in Bolton, while other localities remain open but are struggling. The ICB is now conducting a review of its entire obesity pathway.

David Buck, senior fellow at The King’s Fund, said the Government has had a “mixed record in the past on supporting health and weight management services, including reducing funding”. He said a “more strategic response” to tackling obesity, including through specialist services, was now needed.

GPs are also feeling the pressure of the obesity crisis. Samuel Parker, a GP and deputy chair of the British Medical Association’s North East Regional Council, is demanding an “increase in funding for UK-based weight management services paid for by an increase in the sugar tax”.

Mr Buck said that the increasing obesity crisis and demand for weight-loss services require the Government to take “bold action” to help people to live healthier lives, particularly as demand for support far exceeds what local services are set up to offer.

He pointed to recent polling by The King’s Fund which indicated strong public support (65 per cent) for restricting the advertising of unhealthy food and drink, and for the Government to require companies to reduce the salt, sugar, and fat in their products (67 per cent support).

“In the long-run, prevention policies, including those to tackle obesity, will be far cheaper than treating the symptoms of ill-health and a new government needs to act decisively,” Mr Buck said.

The investigation comes as leading doctors warned that patients are buying weight loss drugs online without proper “wraparound” care. NHS England medical director Stephen Powis raised the alarm during a national healthcare conference this month over reports of people misusing the drugs as a quick fix to get “beach body ready”.

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Patients should be supported by specialist weight management services if prescribed weight-loss drugs, guidance from the National Institute for Health and Care Excellence (Nice) states.

Ozempic and Wegovy are brand names for the drug semaglutide, which works by mimicking the action of the hormone GLP-1 that is released from the gut after a meal, thereby suppressing the appetite. In England, Wegovy has been approved for weight loss in people who are obese or overweight and Ozempic for people with type 2 diabetes.

Demand for both has soared over the last year leading the World Health Organisation to warn last week that fake versions of the drugs have entered the UK supply chain.

Nick Kaye, chairman of the National Pharmacy Association, said: “Pharmacists are often forced to turn patients away due to being unable to get hold of medication of many different kinds. It’s clear that these growing medicine shortages are heaping pressure on our already stretched local community pharmacy teams.

“Pharmacies want to make sure that those who are in most need of legitimate treatment are prioritised and we are pleased that manufacturing distribution has been recommended to be scaled up.

“We need all politics to commit to tackling medicine shortages as a matter of urgency and deliver a new funding deal that properly support pharmacy to pay for the medicines our patients need.”