Why the drugs wont work
We are bombarded by clever advertisements, deluged with confusing packaging and cheap, unhealthy convenience food is just a stone’s throw away. Access to affordable ways of keeping active are hugely variable and with unhealthy food three times cheaper than healthy alternatives, there is no doubt in my mind the responsibility lies not with the individual, but with society as a whole.
Prof Jim McManus
ADPH President
Last week, the Government announced a £40m new drugs pilot to tackle obesity, claiming it would reduce pressure on the NHS and help cut waiting lists.
I can confidently say that investing in new treatment, while a welcome lifeline for some individuals, is definitely not the solution to obesity. It is unlikely to be the ‘game-changer’ the Prime Minister hopes for and may well not even produce the much-coveted cuts to waiting lists.
Although the Department of Health and Social Care has recognised the need to take such drugs ‘alongside diet, physical activity and behavioural support’, that is not a given. There are fundamental issues that seem to have been overlooked. Unless considered properly, they will undermine any silver bullet approaches to obesity.
Drugs like Wegovy have limited long-term effectiveness. Studies show patients actually regain two-thirds of their lost weight after stopping treatment.
Since 1946, every generation has been heavier than the last – our places are simply not geared up to maintain a healthy diet or lifestyle.
We are bombarded by clever advertisements, deluged with confusing packaging and cheap, unhealthy convenience food is just a stone’s throw away. Access to affordable ways of keeping active are hugely variable and with unhealthy food three times cheaper than healthy alternatives, there is no doubt in my mind the responsibility lies not with the individual, but with society as a whole.
Even if people could maintain a healthy weight after treatment, is it actually the best use of £40m for our population as a whole?
Researchers at the University of York found that adding one year of healthy life would cost the NHS £13,500. In contrast, that same year can be produced by local public health teams spending just £3,800. Put another way, preventative public health measures are three to four times more cost-effective than treatment.
So, what about the other consequences of poor diet, aside from obesity? People using Wegovy to lose weight, but still eating unhealthily will still get preventable cancers and heart disease and will still place avoidable demand on our health and social care system, impact productivity at work and ultimately, cost lives.
Directors of public health and their teams are already doing things that work. We work with planning departments to stop new fast food outlets springing up near schools, we work with communities to improve understanding of healthy eating habits and we advocate for active travel solutions and affordable recreational facilities.
We also fund existing weight management services, so people who need it get support that has long-lasting health benefits. Healthy weight is not a quick fix.
Instead of investing millions in pilot treatment schemes which will at best work for a small minority, funding should be based on the evidence and investment made in effective, preventative measures that deliver sustainable, cost-effective outcomes for individuals and communities alike.
We have an opportunity and responsibility to fix what is harming our citizens and society and through productive partnerships between local authorities, organisations, businesses and communities. We are making a difference – at a local level.
Short-term strategies like this latest drugs pilot are put in place which won’t fix the problem and the potential to reverse the situation is lost, again. As the Institute for Government concludes, the continued failure to tackle obesity will result in higher taxes and spending and increased inequality.
What we need to help people now – and to future-proof our country – is bold decision- making that puts health at the heart of all policy as we explain in our new Manifesto for a Healthier Nation.
Only by moving away from seeing health as purely medicine and treatment-based will we prevent the huge incidence of largely preventable illness.
Health is wealth and wellbeing, it is freedom and the future and it should be available for everyone.
This article was originally published in the MJ.