NHS rationing means people have to weight the same as a sumo wrestler before they are prescribed weight loss drugs, a top expert has said.
Currently only the dangerously obese are prescribed the jabs which suppress appetite, such as Mounjaro and Wegovy. That is because the powerful drugs require personalised support services to ensure sustained, healthy weight loss – which the NHS does not have capacity to provide for everyone who would benefit from them.
Professor John Deanfield, of University College London, is a leading expert in the drugs which mimic the GLP-1 hormone, and revealed that the average body mass index (BMI) of an NHS fat jab patient is 47 – compared with 46 for an elite sumo wrestler.
Speaking at the world’s biggest heart conference in Munich, Prof Deanfield said: “To put that in context, we just had the world sumo wrestling championship in the UK and the winner had a BMI that was less than the average BMI of the patients we treat with GLP-1s.
“This is crazy. We know that that’s the wrong way to do prevention… It’s like saying that if you’ve got high cholesterol you have to have a heart attack before you deserve to be treated.”
Sumo wrestlers are revered in Japan and have to eat more than 8,000 calories per day, often weighing more than 40 stone so they can push giant opponents out of the ring. They are at greater risk of type 2 diabetes and heart attacks as they age and tend to die 15 to 20 years younger than the average Japanese man.
If provided with the proper support, trials show weight loss jabs and now pills can help obese people lose around a fifth of their body weight and drastically reduce the risk of a host of conditions including Type 2 diabetes, heart disease, cancer and dementia.
Prof Deanfield told delegates at the European Society of Cardiology Congress: “These are genuinely transformative drugs. I suspect there will not be another [like it] in our medical careers.”
Who can get weight loss jabs on the NHS?
The average BMI of someone accessing weight loss drugs via an NHS prescription haas been revealed as 47.
To put that in context, BMI thresholds are 25 to 30 for the overweight, 30 to 35 for obesity class I, 35 to 40 for moderate obesity and over 40 for severe obesity. Someone is classed as morbidly obese if they have a BMI over 40, or over 35 as well as having other weight-related health problems.
Doctors are technically allowed to prescribe jabs for a BMI of 35 or higher, but the NHS is prioritising the most dangerously obese patients first. It is currently forecast to take 12 years to roll out Mounjaro to the 3.4 million people who are technically eligible for it.
About 2.5m Brits are estimated to already be taking weight loss jabs privately, but many have to stop taking them due to problems with cost.
Dr Charlotte Refsum, director of health policy at the Tony Blair Institute for Global Change, said: “Weight loss drugs could transform our approach to obesity, but only if people can actually access them. The NHS needs to shift the question from ‘how can we afford this?’ to ‘how can we afford not to?’.”
The NHS is currently trialling whether remote support, such as via apps, is sufficient to help people on weight loss drugs make the drastic lifestyle changes needed. Without introducing healthy foods and stepping up exercise, such as weight lifting, users risk piling all the weight back on in future, but never regaining lost muscle and bone density.
Dr Leyla Hannbeck, chief executive of the Independent Pharmacies Association, said: “This is a massive missed opportunity for the NHS. Restricting so tightly who can get weight loss jabs is a total false economy for the NHS.
“This would ultimately save the health service a packet as it helps prevent the long-term diseases associated with obesity that are costing the NHS so much. We urge the government to think again and invest now to save later.”
A spokesperson for the National Institute for Health and Care Excellence (NICE) said: “Our guidance recommends Mounjaro for around 3.4 million people in England who are eligible for treatment.
“Because this represents a very large number of people, and to ensure other NHS services are not disproportionately affected, Nice agreed to NHS England’s request for a phased rollout. This means people with the highest clinical need are being prioritised initially.”
An NHS spokesperson said: “Weight loss medicines play a vital role in helping many people lead healthier lives and the NHS remains committed to their rollout, ensuring access for those with the greatest clinical need.
“The NHS also continues to offer a wide range of other free support for people to lose weight, such as the NHS Digital Weight Management Programme, which has already helped hundreds of thousands of people achieve a healthier weight as well as wider lifestyle benefits.”
The Department of Health and Social Care declined to comment.