Medical treatments, even those deemed safe and effective, are rarely without any side effects. That is why they should be deployed in strict accordance with expert advice – and, it must be added, why miracle cures are only available from quacks.
So it is with the relatively new weight-loss jabs, which have become understandably popular in recent months, to the point where they’ve gone beyond mere pharmaceutical status and have become fashionable; indeed, in some quarters, a craze. It is time for the authorities to take another look at this phenomenon – and to radically restrict access to them.
However, it is also an opportunity for the Labour government to make inroads into the whole area of childhood obesity, so often the precursor to a lifetime of poor health outcomes and loss of quality of life in middle age and beyond.
For far too long, childhood nutrition has been neglected, with the loss of so many SureStart centres and, until recently, a lack of availability of nutritious free school meals. The excellent report on a new National Food Strategy produced by Henry Dimbleby a few years ago has mostly been left to gather dust on the kitchen shelf.
Similarly, the admirable activism by Marcus Rashford on school meals during the Covid pandemic has sadly come to very little.
Time and again, chances are missed to remedy the root causes of diet-related diseases, from obesity and tooth decay to poor concentration in class and weaker immune systems. “You are what you eat”, as the old adage goes – and in the UK, as in much of the West, we are faced with the terrible paradox that though society as a whole, as measured by GDP, is more prosperous than ever, there are many living in food poverty, in “food deserts” where fresh fruit and vegetables are seldom seen, and hard-pressed parents turn too often to fast food and ready meals.
Food inequalities, indeed, have probably not been as pronounced at any point since the end of the Second World War as they are now, as evidenced in the disparity in life expectancy between the poorest districts and the richest ones – sometimes, as in London, within the same city. Meanwhile, the state school playing fields have long since been sold off, and the Youth Sports Foundation finds that data released by the government shows about half of schools are meeting the UK chief medical officer’s recommendation of at least 60 minutes of physical activity a day. Little surprise, then, that obesity is rising fastest in England among children aged 11 to 15 years.
The answer to this is not to resort to medications. The latest evidence from the Medicines and Healthcare products Regulatory Agency (MHRA) shows that, since the weight-loss jabs were licensed, there have been hundreds of cases of acute and chronic pancreatitis among people taking such medicines. In rare cases, other serious side effects can include gallbladder and kidney problems and depression. The MHRA also found that Mounjaro may make the oral contraceptive pill less effective in some patients.
It’s fair to say that these are unintended and concerning consequences. The evidence from the MHRA’s study also raises some disturbing questions about the approval process and the safeguards on the availability of medicines such as Wegovy and Mounjaro. Any medical intervention requires a careful clinical assessment of risks and benefits, and there is no necessary reason why the current strict NHS criteria are too lax – a series of problematic and life-threatening illnesses must be present before these drugs can be administered, and even then under medical watch. However, the private retail market seems much more laissez-faire, and undesirably so.
Yet pharmaceuticals are not the answer – or at least will not be until a cheap and entirely risk-free jab is invented. Health secretary Wes Streeting and his colleagues must surely now examine the way so many people, including celebrities and politicians who are far from obese or suffering from type 2 diabetes, are obtaining and using these treatments in an almost casual fashion. This abuse creates new problems for themselves and society as a whole by effectively endorsing a miracle cure.
Far better for individuals and society is the long, hard slog of reducing calorific intake and taking more exercise. As has been well observed, the NHS spends so much on the regrettable health consequences of obesity that it would be better called the national sickness service. Even now, with the enlightened and clear-sighted Mr Streeting in charge, there is insufficient effort put into public health and preventative medicine. For someone with borderline obesity and hypertension, a referral from a GP to go to their local leisure centre for a swim and a session on the treadmill is surely preferable to, and cheaper than, injecting them with a drug that may affect their pancreas or have other less serious but still troublesome side effects.
The point bears repeating that this is not just a challenge for the NHS. It’s also a matter for schools, not only in providing nutritious free school meals and healthy food at breakfast clubs, and a new generation of SureStart centres, but in teaching children how to cook – and how much tastier meals with fresh ingredients are compared to the local chicken shop. It might also, given the fiscal crisis, be a time to revisit a “fat tax” on unhealthy food, along the lines of the successful sugary drinks levy.
The vast majority of people don’t need Wegovy, Mounjaro or other similar medications, and, rightly, they can’t get them on the NHS. They certainly should not be allowed to bypass safety rules and waste money on them to look slim, to grow dependent on them, become ill and, looking to long-term usage, develop other, as yet unknown but perhaps dreadful, consequences. Put the jabs away.
