The National Institute for Health and Care Excellence has today (8th March 2023) released a recommendation that the drug semaglutide could be prescribed, under the guidance of healthcare professionals, to those who have the highest risk of ill health due to their weight, such as a BMI over 35 and at least one weight-related illness eg heart disease or type-2 diabetes. These drugs are not licensed for the treatment of obesity in children and adolescents.
Semaglutide (manufactured by Novo Nordisk) and sold under the brand name Wegovy, has been found to produce clinically significant weight loss by all by suppressing appetite, mimicking the hormone GLP-1 – a hormone that slows the movement of food through the intestines – making a person feel full for longer.
The long-term effects, including weight regain and side-effects (which include nausea), are under review, hence the current recommendation is to be placed on the drug for a maximum of 2 years, all whist being placed in a package of care with Specialist Weight Services. There is no evidence of effectiveness if semaglutide is used as a single stand-alone treatment, however these new drugs are an important part of the health care pathway to help manage overweight. Capacity of these services needs to be expanded so everyone can access the care they need.
The Obesity Health Alliance says: This will be tremendous news to those at highest risk who are unable to control their weight due to many complex factors. Obesity is a chronic, relapsing condition with many causes. Drugs alone will not be the answer to the UK’s extremely high levels of excess weight. We need to take action to ensure that as few people as possible reach the stage of needing pharmaceutical or surgical interventions. It is essential that we tackle the root cause of obesity, such as the flood of unhealthy food and drink that is constantly marketed and promoted to us, so we are not treating people and then sending them back into the conditions that made them sick.
“This government can turn the tide on obesity, but to do that they cannot rely on drug treatment alone, and must make it easier, cheaper and more appealing to buy healthier food and drinks, and to help people especially children, reach and maintain healthy weight for life.”
All About Obesity (AAO) welcome the approval of Semaglutide, Founder and someone that lives with obesity, Sarah Le Brocq says ‘Treatments like Wegovy, give people living with obesity, hope, hope that we can successfully manage our condition for the first time and improve our health.’
Simon O’Neill, Director of Care at Diabetes UK, said: “Supporting people to lose weight is key to preventing type 2 diabetes and, for those with a recent diagnosis, to putting the condition into remission. The new NICE guidelines on Wegovy for weight loss are welcome, as they provide another treatment option for some people living with overweight or obesity who could be at risk of developing type 2 diabetes or who already have the condition.
“Drugs such as Wegovy are an important and valid weight management tool for those living with and at risk of type 2 diabetes, and it is our view that people should be supported to find the approach that is most appropriate for them – whether that involves medication, dietary changes or bariatric surgery – with the wraparound support of healthcare professionals.”
Semaglutide is recommended as an option for weight management, including weight loss and weight maintenance, alongside a reduced-calorie diet and increased physical activity in adults, only if:
- it is used for a maximum of 2 years, and within a specialist weight management service providing multidisciplinary management of overweight or obesity (including but not limited to tiers 3 and 4), and
- they have at least 1 weight-related comorbidity and:
- a body mass index (BMI) of at least 35.0 kg/m2, or
- a BMI of 30.0 kg/m2 to 34.9 kg/m2 and meet the criteria for referral to specialist weight management services in NICE’s guideline on obesity: identification, assessment and management.
- Use lower BMI thresholds (usually reduced by 2.5 kg/m2) for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean family backgrounds. (People from some minority ethnic family backgrounds have an equivalent risk from obesity at a lower BMI than people from a White ethnic family background.)
For more information on the Obesity Health Alliance’s recommendations, see our Healthy Weight strategy ‘Turning The Tide‘