Health
Public health perspective on new weight loss medications
- Oliver T Mytton, associate professor1 2 3,
- Vicky Head, director of public health2,
- Ian Reckless, chief medical officer3
- 1UCL Great Ormond Street Institute of Child Health, London, UK
- 2Milton Keynes City Council, Milton Keynes, UK
- 3Milton Keynes University Hospital, Milton Keynes, UK
- Correspondence to: O Mytton o.mytton{at}ucl.ac.uk
Most countries have seen substantial rises in the prevalence of obesity in recent decades. Effective, acceptable treatments are much needed, and the glucagon-like peptide (GLP-1) agonists semaglutide and tirzepatide, which work by suppressing appetite, may initially seem to fulfil that need.12 In one key trial, semaglutide plus a “lifestyle” intervention for adults (74% women) with obesity (mean body mass index (BMI) 37.9) led to a 12.7 kg (95% confidence interval 11.7 to 13.7) greater weight loss than the lifestyle intervention alone (15.3 kg v 2.6 kg). This weight loss is substantially more than that associated with other pharmaceutical and behavioural options.234
Reliable usage data are lacking, but these drugs seem increasingly popular despite a lack of long term data on safety. Serious reported adverse effects include pancreatitis, bowel obstruction, gastroparesis, pulmonary aspiration during anaesthesia, suicidal ideation, and self-harm; these warrant further investigation.5 For many people with obesity and a high risk of comorbidities, the benefits are likely to outweigh risks, at least in the short term. But will the new weight loss medications work from a public health perspective?
Firstly, relatively …
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