Dr MAX PEMBERTON: Why NHS SHOULDN’T fund fat jabs for millions
- Danish weight-loss jab Wegovy mimics the hormones that make us feel full
- READ MORE: ‘Miracle’ weight loss jab Wegovy launches on the NHS in ‘limited’ supply – but private patients could have to pay up to £300 for a dose
Experts have hailed it as a miracle drug that can eliminate obesity with a few painless injections.
And from what I’ve seen of Wegovy, the Danish weight-loss jab now being rolled out by the NHS, it has the potential to be truly life-changing.
Patients and friends who have paid privately for prescriptions have not only lost substantial amounts of weight, they have kept it off, even after finishing the course of treatment.
What is most remarkable to me is that Wegovy seems to kick-start individuals into adopting a healthier lifestyle because they enjoy being slimmer and fitter.
At the same time, their chances of suffering from life-threatening conditions linked to obesity such as diabetes, high blood pressure and stroke diminish.
Experts have hailed Wegovy as a miracle drug that can eliminate obesity with a few painless injections
Danish weight-loss jab Wegovy works by mimicking the hormones that make us feel full
In short, I’m a huge fan of this new drug, which works by mimicking the hormones that make us feel full.
So why, as a psychiatrist who has worked with obese people for 20 years, am I not shouting from the rooftops for it to be handed out to all on the NHS?
The first answer is simple economics. I yield to no one in my admiration for postwar Labour minister Aneurin ‘Nye’ Bevan and his brilliant idea that we should all pay a manageable amount into the NHS — pooling collective risk — so treatment can be free at the point of delivery.
But Bevan made an elementary and far-reaching error. He believed that as the nation’s health improved, the NHS’s costs would fall.
He failed to anticipate not only a new era of medical science that brought radical new treatments — and spiralling costs — but also a growing elderly population.
The NHS depends on most people taking less out of the system than they put in.
So what happens when well over half of Britons are eligible for a new treatment that could transform their lives for the better?
The 2021 Health Survey revealed that 26 per cent of adults are clinically obese (with a body mass index of more than 30), and a further 38 per cent are overweight.
Dr Max believes that trying to frame obesity as a disease rather than a consequence of behaviour helps no one
Clearly, prescribing this drug to more than 60 per cent of the adult population at a cost of £73.25 to £175.80 a month each would soon bankrupt the NHS.
Not least because some doctors say patients will have to take it for the rest of their lives.
There are those who believe providing the drug free of charge could save the NHS money in the long term.
The health service currently spends around £6 billion on obesity-related treatments each year.
However, with more than 40 million Britons potentially eligible for a drug that costs up to £2,100 each a year, a full rollout would cost an astronomic £84 billion each year.
That’s more than half the entire NHS annual budget for England, currently standing at £160 billion.
Perhaps fortunately then, for the NHS bean-counters, the drug’s manufacturer, Novo Nordisk, has said it’s struggling to keep up with global demand and that supply of Wegovy is likely to be constrained for the foreseeable future.
But there’s another reason why I think the NHS shouldn’t fund the wholesale use of Wegovy.
If Wegovy is handed out free to millions of obese Britons, they won’t tackle the underlying problems that led them to use food as a psychological crutch
I’m convinced that medicalising obesity — trying to frame it as a disease rather than a consequence of behaviour — helps no one.
Of course, people struggling with obesity should be treated with compassion. But obesity is not like cancer: it is something you can do something about.
There are those in medicine who wholeheartedly believe that, like obesity, the behaviours behind drug addiction and alcoholism can be classed as a ‘disease’. But this is counter-productive.
The very idea of a disease removes any sense of responsibility and flies in the face of much of the psychological work I do every day with addicts and obese people to help them make lifestyle changes.
People choose to drink alcohol or inject drugs. Similarly, barring a tiny number of cases, obese people have chosen to consume more calories than their body needs. It is an active decision they make each day.
Pretending otherwise is to rob them of the ability to choose a different path. And this goes to the heart of an even more important issue central to the future of an NHS already creaking at the seams.
What exactly is the NHS for, and where do the limits of its responsibilities lie?
We’ve decided, for example, that except in the rarest of cases, cosmetic breast surgery and nose jobs should be paid for privately, while a drug that can reduce male hair loss is pretty much never prescribed on the NHS.
So the debate about Wegovy has a strong pedigree. It’s telling that Germany’s state-funded health system refuses to pay for the drug. It decided a person’s weight loss is not its business.
I think there’s merit in that decision. Those patients who do seek out Wegovy privately will have taken a decision to do something about their weight —and taking responsibility is key to positive change.
If this new drug is handed out free to millions of obese Britons, they won’t tackle the underlying problems that led them to use food as a psychological crutch.
My hope is that drugs like Wegovy can result in genuine, lifelong benefits for some people.
The key lesson is that obesity itself is not pathological. The real pathology is in our attitude to weight: the idea that we can absolve ourselves of responsibility when it comes to being fat.
LET’S STOP JUDGING SOPHIE
Actress Sophie Turner and singer/songwriter Joe Jonas have split after four years of marriage
At 27 Sophie Turner has split from Joe Jonas after four years of marriage, with the divorce petition stating the relationship is ‘irretrievably broken’.
It seems as though some of the problem is that, while he likes to stay at home, she likes to party.
One of her friends said she regretted ‘missing out’ on her youthful, carefree years after marrying and having children so young.
She’s had a lot of criticism for this, but I wonder if she’d be judged as harshly if she were a man? I think there would be far more sympathy if things were reversed.
What’s more, Joe has received praise for staying at home and looking after their children. Why isn’t this just being seen as his paternal duty?
Why do we think it is so remarkable when a man is doing nothing more extraordinary than looking after his children?
It seems as though the situation has exposed the double standards we apply to men and women when it comes to childcare.
As children go back to school, the debate about when is the right time to give them a mobile phone has been reignited.
Many parents will have given in as their child moves from primary to secondary school. But is this wise, given the atrocious impact that mobile phones and social media can have on young people?
We know they increase the risk of mental health problems and expose children to bullying, exploitation and abuse.
The algorithms that digital companies use are designed to keep people hooked.
I was horrified to read that up to 60 per cent of 11-year-olds have social media accounts (despite an age restriction of 13).
Presumably most use smartphones and gain access to a wealth of damaging or inappropriate content.
I know it can be difficult to say no, but that’s the job of a parent.
A quick shout-out to everyone who, like me, loathes hot weather.
Whenever I write about this I’m inundated with emails and letters from people who say the increased sunlight and heat makes them downright miserable.
If you are one of us then take heart — it is finally going to be over soon. Roll on the rain!
DR MAX PRESCRIBES
Customised prints are a great way to show someone you are thinking about them
We all have those dates that mean something special to us and our friends or family.
What better way to show someone you’re thinking of them or remind them about how important they are to you than with a print featuring your special dates or family name for them to hang on their wall?
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