Britain’s obesity crisis is driven by poverty and bad food. But are weight-loss jabs really the answer?

Celebrities and the elite have flocked to private healthcare companies to get their hands on a drug which promises thinness. People are spending as much as thousands on Ozempic and other weight-loss jabs, even with no medical need for them. And not just in Los Angeles.

Here in Britain, an estimated 1.5 million people use these drugs, 95% of whom have gone private. Only 200,000 people are receiving weight-loss drugs on the NHS.

Yet millions of people across the country are battling with obesity and unable to afford Ozempic or similar drugs, which generally cost between £100 and £350 a month. Just under two thirds of the population are obese or overweight, and poverty is a known driver of this, with healthy food often too expensive or difficult to access.

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The UK government recently promised to expand NHS use of weight-loss drugs. Health secretary Wes Streeting said: “The wealthy talk about how they’ve transformed their health, their confidence, their quality of life. But what about the millions who can’t afford them? 

“That is a return to the days when health was determined by wealth – when some had access to the best care money can buy, while others waited and suffered. And I say: never again.”

But is this truly the solution to Britain’s obesity crisis? Or is it an expensive sticking plaster on a problem which could be prevented in the first place?

“We want people already living with obesity to be supported, but we cannot let the food industry essentially create a future customer base for the pharmaceutical industry,” says Katherine Jenner, executive director of the Obesity Health Alliance. “That’s not the way the country needs to be run. You’re just putting our health into the hands of various industries.”

Rosalind Raine, professor of applied health research at University College London with a background as a public health medicine doctor, agrees. “All that is going to do, if it carries on unabated, is bankrupt us as a nation. It will do nothing to make our population healthy. Children can keep growing up eating unhealthy foods.”

There is evidence that weight-loss drugs may reduce risks of dementia and kidney disease – but research remains limited and the drugs could also come with nasty side effects.

“Some people have nausea,” Jenner explains. “A lot of people find it takes away the enjoyment of food. As you are losing body weight, you lose muscle mass as well. There has to be a controlled way of taking them, and wrap-around support with nutrition and exercise.”

She has heard people have suffered pancreatitis or have had gallbladders removed because of the drugs.

Still, they can be life-changing. Sarah Le Brocq has lived with obesity all her adult life and has endured an endless cycle of diets and fluctuating weight. She even went on a weight-loss TV show, by the end of which she had lost eight stone and completed an Olympic-distance triathlon. But the weight crept up again, even though she continued training.

“I’ve spent my whole life feeling like a failure, frustrated, out of control and like my life’s restricted because of my size,” says the 43-year-old from North Yorkshire. 

A scientist by background with 16 years of experience in pharmaceuticals, Le Brocq founded charity All About Obesity to drive research and advocate for better support and treatment for people with obesity. 

She went on weight-loss drugs two years ago and has since lost seven stone. It has made her feel in control of her body for the first time in her life.

“I can go on an airplane and not have to ask for a seatbelt extension,” Le Brocq says. “I fit into a standard size chair. It’s given me more freedom. It has made me feel more confident in myself. I’ve got more energy. I’ve got a little girl who’s six, and this summer, we went kayaking and paddleboarding. We had such a great active summer.”

Le Brocq pays for Tirzepatide (known by brand name Mounjaro) privately at a cost of £99 a month, but due to price increases, it is going up to £309 a month. She worries about what this might mean in the future as she believes she will have to be on the drug or similar for the rest of her life.

Patients are turning to the black market to obtain drugs which are still in clinical trials. Last month, the Medicines and Healthcare Products Regulatory Agency seized more than 2,000 unlicensed Retatrutide and Tirzepatide pens due to be sent to customers from a facility in Northampton. They also found tens of thousands of empty weight-loss pens ready to be filled.

“I hope we can get it on the NHS one day,” Le Brocq says. She did, however, have her gallbladder removed in January, which she believes was a result of the weight loss rather than the drug.

Research from charity Nesta found that more than 340,000 adults living with severe obesity in England would lose around 20kg of weight as a result of NHS plans to roll out Tirzepatide, amounting to seven million kilograms of weight lost over five years.

However, it will reach just 3% of the 13 million people living with obesity. And the plan may not be sustainable either, as people typically put the weight back on after pausing the drugs.

“They only work for as long as you take them,” Jenner explains. “As soon as you come off them, it seems that you put the weight on as quickly, if not quicker, than if you were doing another more traditional approach.”

It means treatment would have to be long-term, at great costs to the NHS. Nesta estimates that providing weight-loss drugs to all adults living with obesity would cost £42bn over five years, equivalent to about 20% of the Department of Health and Social Care’s annual budget.

Professor Azeem Majeed, head of the Department of Primary Care and Public Health at Imperial College, London, urges the government to consider how it funds access to weight-loss drugs for the poorest sections of society. But he adds that there may be a reduction in prices in future as a result of competition in the market.

Maria Bryant, professor of public health nutrition at the University of York, says: “We have a vast amount of evidence that obesity is not about individual motivation. Rather, obesity is caused by appetite regulation, which is influenced by hundreds of interrelated factors.

“Some people are biologically driven to eat more than others and less likely to feel full. In an environment that is fuelled by cheap, unhealthy, high-energy food, this is extremely challenging. If you are also living with poverty, it’s even worse, as your opportunities to access cheaper, healthier foods are poor – and you are also more likely to be bombarded with advertisements of cheap, unhealthy food.”

Bryant says that weight-loss drugs can be “game-changing” because they influence people’s appetite and make them less inclined to eat, even if surrounded by unhealthy food. They recognise that obesity is a “chronic relapsing condition” impacted by a person’s environment.

But perhaps the government should work to address the environment people are living in first.

Taxation and regulation are proven to have an immediate effect – Raine points to the smoking ban as a successful example. Within the first six months, there was a drop in the number of children with acute respiratory illnesses coming into emergency departments. 

Raine says she would use taxation of unhealthy food to subsidise healthy food, rather than relying on the food industry to voluntarily make their products healthier.

“People are very quick to make statements about how people should live without really understanding how people have to live. It’s not just about reducing poverty. It’s also about enabling people to make healthy choices – and that’s a system-wide issue,” Raine says.

Le Brocq is an advocate for weight-loss drugs because of the transformational impact they have had on her life, but she wants to see changes within the food system too. 

She calls for pressure to be put on food companies to invest in healthy, palatable foods instead of unhealthy options. She also wants the government to ensure that people can access healthy foods regardless of where they live, and she also believes attitudes in society must change.

“We need to talk more about the stigma and the fact that we don’t recognise obesity as a chronic condition. We still treat it as a lifestyle condition, as if people just made bad choices, but we know now that’s not the case,” Le Brocq says.

“We need to be kinder to people and have more empathy for people and actually support them, rather than pointing fingers of blame. I’ve spent my whole life trying to sort myself out because nobody wanted to help me. We need to change that and support people now that there are options available for them.”

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