Critical Overview:
The National Institute for Health and Care Excellence (Nice) has recommended the use of semaglutide, a new weight loss drug, on the NHS for people with at least one weight-related condition and a body mass index (BMI) of 35 or above. The drug, which is self-administered using a pen injector, works by suppressing the appetite through mimicking the hormone glucagon-like peptide 1 (GLP-1), leading patients to eat less and lose weight. According to clinical trial evidence, patients on the weekly injections have seen an average weight loss of 12% after one year.
The prevalence of obesity in England is a significant public health concern, with more than one in four people affected. Obesity can lead to severe and potentially life-limiting conditions and costs the NHS and the wider economy billions of pounds annually. The management of overweight and obesity is one of the biggest challenges facing the health service, with nearly two-thirds of adults either overweight or obese.
Access to current drug treatments for obesity is limited to a specific population who have prediabetes and a risk factor for cardiovascular disease, and other drug treatment options available are “poorly tolerated” and “rarely used”. Nice has concluded that there is a large unmet need for many people living with obesity, and that semaglutide would be a welcome new treatment option.
Semaglutide will only be prescribed as part of a specialist weight management service involving input from several professionals, and for a maximum of two years. The drug will be accessible to people from a south Asian, Chinese, and black African or Caribbean background at a lower BMI, after advice from a medic. Experts have previously described the drug as “a gamechanger” and suggested that it could offer people an alternative to weight-loss surgery.
The Approval of Semaglutide:
The approval of semaglutide by Nice represents a significant development in the management of obesity in England. The drug offers a new treatment option for people with obesity and weight-related conditions, who have previously had limited access to drug treatments. The recommendation follows the launch of the government’s anti-obesity strategy in 2020, which included plans for a ban on TV and online adverts for food high in fat, sugar and salt before 9pm, and ending deals such as buy-one-get-one-free on unhealthy food high in salt, sugar and fat.
The drug’s ability to mimic the hormone GLP-1 and suppress appetite, leading to weight loss, offers a promising alternative to weight-loss surgery for those who are not suitable for or who do not want surgery. The drug will be prescribed as part of a specialist weight management service involving input from several professionals, indicating the importance of a multidisciplinary approach to obesity management.
Conclusion:
The approval of semaglutide by Nice offers a significant new treatment option for people with obesity and weight-related conditions in England. The drug’s ability to suppress appetite and lead to weight loss offers a promising alternative to weight-loss surgery for those who are not suitable for or do not want surgery. The specialist weight management service involving input from several professionals highlights the importance of a multidisciplinary approach to obesity management. However, it remains to be seen how the drug will be implemented in practice and whether it will be effective in reducing the prevalence of obesity in England.
