Groundbreaking weight-loss injections such as Wegovy and Mounjaro have been celebrated for their remarkable results, but a stark new reality is emerging. Experts now warn that to maintain their benefits, these drugs may need to be taken indefinitely, a prospect that raises serious questions about their cost and accessibility within the UK's healthcare system.
The Sobering Reality of Stopping Treatment
Currently, one in every 50 people in the UK is using these medications, with a staggering 90% paying privately at a cost of between £120 and £250 each month. However, more than half stop within the first year, primarily due to the high expense. Research from the University of Oxford reveals what happens next: on average, people regain all the weight they lost within just 18 months of stopping the medication.
This rebound is alarmingly fast – almost four times quicker than the weight regain seen after traditional diet and exercise programmes end. Crucially, the associated health improvements in blood pressure, cholesterol, and blood sugar levels also vanish, returning to their original baselines. This indicates that the drugs might be required long-term, potentially for life, to sustain any positive outcomes.
NHS Access and the Fairness Question
The rapid weight regain places the NHS's rollout of these treatments under scrutiny. The health service is currently offering them only to people with severe obesity (a BMI over 40) and at least four related health conditions. This strict criteria excludes many who could benefit, effectively limiting access to those who can afford private care.
This issue of fairness is acute because obesity is more prevalent in deprived areas, where people are least able to pay for private prescriptions. While the National Institute for Health and Care Excellence (NICE) initially deemed the jabs cost-effective, its calculations assumed a two-year treatment period with weight regained three years after stopping. The new data, showing a much faster rebound, completely alters those cost-benefit analyses.
Weighing Up the Alternatives
For those not yet qualifying for NHS medication, traditional weight management remains the cornerstone of treatment. Programmes involving total diet replacement can achieve similar initial weight loss to the injections at a far lower cost. Group-based programmes like WW and Slimming World, while resulting in smaller average losses, can be cost-effective and even save the NHS money.
The surge in demand for these jabs underscores a desperate public need for effective weight-loss support. However, until drug patents expire and cheaper, perhaps oral, versions become available years from now, the question of value for money is unresolved. Expanding access to proven, cheaper support programmes could offer a fairer and more sustainable path to improving the nation's health, even if the results are less dramatic than those promised by long-term medication.
The research was conducted by Sam West, Dimitrios Koutoukidis, and Professor Susan Jebb from the University of Oxford.
