Not such a Game Changer, After all
Weight loss drugs back in the news
Game-changing weight loss drugs have promised to reduce cardiovascular disease, dementia and, recently, even depression. Wes Streeting even thinks they’ll be a game changer for the unemployed.
However, recent data on deaths suggest the game might be changing in the wrong direction: 82 deaths in England were linked to new injectable weight loss drugs. Eighteen deaths were linked to Mounjaro (Tirzetapide), 29 after taking Ozempic or Wegovy (semaglutide), and 35 died after taking Saxenda (liraglutide).
However, the media did not pick up on the amount of underreporting, which is, on average, 94% for adverse events and could be as high as 98% in the yellow card system. Therefore, what the MHRA reports is just the tip of the iceberg.
The Sun reports that an estimated half a million Brits are taking the drugs, with the total expected to double in a year. - So we checked out the prescription numbers at OpenPrescrbing.
We found that Semaglutide )Ozempic) prescriptions peaked at over 145,000 items in July 2024 and fell slightly to 134k per month at the end of December.
In contrast, Tirzetapide (Mounjaro) use has risen steeply, from zero prescriptions in February to nearly 130,000 items in December 2024. Liraglutide use has fallen to near zero.
Based on this data rhe current cost of these drugs works out at roughly £26 million a month (£13.8 million for Tirzetapide) and (£12.2 million for Semaglutide) or £312 million a year.
By the end of next year, the Sun has these costs doubling, adding over £600 million extra costs for the NHS. Throw in government sponsorship, commercial conflicts of interest and over the top celebrity promotion and it won’t be long before these costs hit the billion pound mark.
Yet, the harms of these drugs are predictable.
In the semaglutide pivotla study, one in 15 stopped the drug due to adverse effects, and serious adverse events were reported in one in ten participants.
The BNF has a host of cautions and side effects, and the manufacturer advises women of childbearing potential to use effective contraception during and for at least two months after stopping treatment as they are to be avoided in pregnancy due to toxicity in animal studies. The EU has also investigated reports of suicidal thoughts with the use of semaglutide and liraglutide, and the US FDA received 60 reports of suicidal ideation for patients on semaglutide and 70 on liraglutide.
One issue with weight loss drugs is the laxity of the approval process required for marketing authorisation. The pivotal trial only requires one year of follow-up and a primary outcome that measures changes in body weight in as few as 35% of the participants. Additionally, it only needs to report cardiovascular measures like blood pressure and fasting glucose levels. As a result, the potential harms often become apparent only after the drugs have been approved.
The UK’s Health Secretary, Wes Streeting, said, “The long-term benefits of these drugs could be monumental in our approach to tackling obesity. For many, these weight-loss jabs will be life-changing, help them get back to work, and ease the demands on our NHS.”
If the costs and harms continue to escalate, then monumental they may be.
This post was written by two old geezers who, when it comes to weight loss, believe an ounce of prevention is worth a pound of cure.
I’ve completely stopped my consumption of sugary foods (cakes, biscuits, chocolate etc etc) for four weeks now and lost 6 kilos and a couple of cms off my waist. A side effect of that has been a huge reduction in arthritic pain such that I haven’t need to take any pain killers in that time. Perhaps health agencies could push that strategy as a game changer rather than these jabs.
Unbelievable that we never seem to learn from our mistakes of rushing out "miracle " drugs without proper structured trials. There's no such thing as a free lunch and good health doesn't come in a tablet or injection.