Millions more Britons could be offered free 'miracle' weight loss injections by the NHS

Millions more Britons could be offered free weight loss injections by the NHS under proposals to overhaul the BMI system.

Currently, “miracle” weight loss treatments – which work by making you feel fuller and less hungry – are offered to people with a BMI of 30 or more.

Proposals to overhaul the BMI system for diagnosing obesity could see millions more Britons offered weight-loss injections

According to current BMI guidelines, a person is considered obese when they reach a BMI of 30.

But experts said people who are not technically classified as obese may still need drugs like Wegovy or Mounjaro.

They argued that factors such as abdominal fat accumulation should also be a factor in identifying obesity and prescribing fat-loss injections.

Abdominal fat or visceral fat as it is called is different from the soft layer of fat that sits just a layer under your skin.

Instead, it sits under the abdominal wall and envelops the liver, intestines, and other organs.

Although visceral fat makes up only a small proportion of body fat, it plays a key role in many health problems, linked to a higher risk of heart disease, dementia and even some cancers.

But because of current BMI guidelines, people with excess abdominal fat may still not be considered obese — and thus miss out on treatments that could benefit them.

Write in the journal Natural medicineA coalition of experts from the European Association for the Study of Obesity (EASO) said: “In many settings, the diagnosis of obesity is still based solely on body mass index (BMI) cut-offs and does not reflect the role of adipose tissue distribution and function in disease severity.

“Furthermore, the indications for the use of the different therapeutic approaches currently available for the management of obesity remain mainly based on anthropometric measurements, rather than on a more complete clinical assessment of the individual.”

Anthropometry is the practice of taking measurements of the human body.

The study’s authors called for a review of how we diagnose obesity – and therefore the requirement to reach a BMI of 30 or more to be able to administer anti-obesity drugs.

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“In current practice, strict application of these evidence-based criteria precludes the use of anti-obesity medications or metabolic and bariatric procedures in patients with a high burden of obesity-related disease but low BMI values,” they explained.

Experts have suggested that weight-loss drugs should be offered to people with a BMI greater than 25 and a waist-to-height ratio (WHtR) greater than 0.5, as well as a weight-related health complication such as high blood pressure or diabetes.

Abdominal fat is most accurately measured using an MRI, but WHtR – your waist circumference divided by your height – is often used.

The larger your waist, the higher your waist-to-height ratio, and a ratio greater than 0.5 suggests you have excess fat around your belly and are at increased risk for health problems.

“The basis for this change is the recognition that BMI alone is not sufficient as a diagnostic criterion and that body fat distribution has a substantial effect on health,” the obesity experts wrote.

“More specifically, abdominal fat accumulation is associated with an increased risk of developing cardiometabolic complications and is a stronger determinant of disease development than BMI, even in individuals with BMI levels below the standard cutoff values for the diagnosis of obesity (BMI of 30).”

If these criteria were implemented in the UK to diagnose obesity, it would mean millions more Britons would be eligible for weight loss injections.

The 29 EASO experts behind the new obesity framework included specialists in endocrinology, nutrition, internal medicine, bariatric surgery and primary care.

Overall, 79% of experts agreed that anti-obesity drugs should be considered in patients with a BMI greater than 25 and a WHtR of 0.5 or greater.

The authors also called on pharmaceutical companies to use their new BMI diagnostic framework in clinical trials of obesity treatments.

“This statement can also be seen as a call to pharmaceutical companies and regulatory authorities to use inclusion criteria more in line with the clinical stage of obesity and less with traditional BMI thresholds when designing. future “clinical trials with anti-obesity drugs,” they wrote.

This is not the first time that the BMI system for diagnosing obesity has been questioned.

Italian scientists have found that lowering the BMI threshold for obesity to 27 could give a more accurate picture of who is affected.

Meanwhile, researchers have found that a simple “rope test” is more accurate at detecting excess fat in children and adolescents than BMI.

In other weight-loss vaccine news, drugs like Wegovy may reduce a person’s risk of developing 10 types of cancer, a new study has suggested.

Everything You Need to Know About Fat Injections

Weight loss injections are a hot media topic right now, with hundreds of success stories of people losing weight.

In March 2023, the NHS announced it would make Wegovy, a drug made by Danish company Novo Nordisk, available on prescription to thousands of obese Britons.

It contains semaglutide, a drug that has reportedly helped reality TV star Kim Kardashian and Twitter boss Elon Musk lose weight.

Wegovy, which helped a third of people reduce their weight by 20% in trials, is now available in pharmacies including Boots.

How do they work?

The injections work by suppressing your appetite, causing you to eat less and therefore lose weight.

To do this, semaglutide mimics the role of a natural hormone called GLP-1.

GLP-1 is part of the signaling pathway that tells your body you’ve eaten and prepares it to use the energy from your food.

Dr Zoe Watson, London GP and founder of wellgoodwellbeing.com, said: “Your body naturally produces an appetite-regulating hormone called glucagon-like peptide-1.

“These injections work by regulating your appetite, which can cause you to eat fewer calories and lose weight.”

Aren’t they diabetes medications?

Semaglutide, Wegovy’s active drug, was originally sold under the name Ozempic specifically for diabetic patients.

But people started to notice that it helped suppress their appetite, stopping them from eating as much and helping them lose weight.

Novo Nordisk then developed Wegovy, which contains the same chemical but in higher doses specifically to promote weight loss.

Wegovy is not prescribed for diabetic patients.

Can I have them?

Wegovy is available on prescription for obese adults undergoing specialist weight loss treatment.

The NHS currently also offers a similar medicine called Saxenda or liraglutide.

These two services are only available for Level 3 and 4 weight management services, meaning you must be referred to expert-led weight management clinics.

GPs also cannot prescribe them themselves, Dr Watson said.

Injections should be taken as part of an overall program to help with lifestyle changes and psychological support to get the best effect from the prescribed medication.

Although its use has been approved, the supply of Wegovy to the NHS has been postponed indefinitely due to an increase in global demand.

In the United States, supply has also been cut in half due to high demand.

Are there any risks?

Like all medicines, vaccines are not without side effects.

Nearly half of people taking this medicine experience intestinal problems, including nausea, bloating, acid reflux, constipation and diarrhea.

Dr Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the rarer side effects is severe acute pancreatitis, which is extremely painful and affects one in 500 people.”

Other uncommon side effects include altered taste, kidney problems, allergic reactions, thyroid tumors, gallbladder problems, and low blood sugar.

What other options are there?

Mounjaro (brand name of tirzepatide) also hit the market in early 2024.

Like Wegovy, tirzepatide comes from a drug originally designed to treat diabetes.

The weekly injection helped overweight people lose more than 2 pounds in 18 months.

It is available to order with an online prescription from pharmacies including Superdrug and LloydsPharmacy Online Doctor.

Its operation is similar to that of Wegovy and Saxenda, but it is more efficient.

Dr Mitra Dutt of LloydsPharmacy says: “In clinical trials, 96% of people were able to lose more than 5% of their body fat with Mounjaro. In similar trials, 84% of people lost more than 5% of their body weight with Wegovy and 60% with Saxenda.

“Mounjaro works by activating two hormone receptors (GIP and GLP-1), which increase insulin production, improve insulin sensitivity and help reduce food intake.”