The Independent

Weight loss jab ‘could harm those with eating disorders’


A newly approved weight-loss jab should be used with caution as it could be harmful to those vulnerable to eating disorders, doctors have warned. Thousands struggling with obesity could be prescribed a drug called semaglutid­e – sold under the brand name Wegovy – which scientists have described as a “game

changer”, after the National Institute for Health and Care Excellence (NICE) approved its use.

However, eating disorder experts have warned the NHS to proceed with caution in prescribin­g the drug, with one GP accusing NICE of being “absolutely reckless” in approving it.

The drug was approved yesterday for use in adults who have at least one weight-related condition, such as type 2 diabetes, high blood pressure, high-cholestero­l sleep apnoea and heart disease, or a body mass index score of at least 35. It can only be prescribed to those undergoing weight management treatment.

Some scientists and clinicians have praised the decision. However, Edward Emond, head of services at the eating disorders charity Beat, said it was simply a short-term fix.

“Even with it being through prescripti­on, this is presenting a drug as a ‘quick fix’ and is not really looking at the bigger picture on why somebody might be struggling with [weight] ... Generally, this approach is like a restrictiv­e diet, and we know [that going] on a restrictiv­e diet for a significan­t period is one of the biggest risk factors for developing an eating disorder.

“Also, like with many restrictiv­e-eating-based approaches, it might have a temporary change in someone’s weight, and some of the initial evidence on semaglutid­e is showing that people will regain the weight and regain more weight than they’ve lost ... It reinforces the idea that the number on the scale is the only factor in somebody’s worth and wellbeing.”

Mr Emond said there needs to be training for doctors and nurses before they prescribe the drug so that they understand the factors involved in someone’s relationsh­ip with food, such as whether they might be “binge eating” as a coping mechanism.

Semaglutid­e was approved for use in the USA in July 2021 by the Food and Drug Administra­tion for the purposes of weight management. One brand of the drug, Ozempic, designed to treat diabetes, has been touted by various Hollywood celebritie­s as a “miracle” drug.

Mr Emond warned that publicisin­g the drug in that way was dangerous because of the impact it could have on those with eating disorders.

GP Dr Asher Larmie, who describes themselves as a weight-inclusive doctor, claimed that NICE had been “reckless” in its approach to approving the drug as it had only considered data from an earlier trial, and called for more data to be considered.

Dr Larmie said: “My concern is not only that we do not have enough data about the long-term impacts of this drug ... if you’re using this drug for two years, you start to regain weight at the end of year one, if you stay on it or not; if you stop it at any time, you regain weight at an alarmingly high rate ... then after two years, when you stop this drug, you regain weight at a tremendous rate.”

They said that was a concern because rapid weight gain has negative effects on the body, and there is a risk that restrictiv­e dieting could lead to people developing an eating disorder.

Dr Agnes Ayton, chair of the eating disorder faculty at the Royal College of Psychiatri­sts, said: “We are aware that some messaging framing semaglutid­e as a quick-fix weight-loss aid may act as a potential trigger for those living with an eating disorder, and poses a real danger for abuse of the medication by those for whom there is no clinical need to use it.

“With this in mind, we would like to see measures put in place for safeguards regarding high-street availabili­ty of this medication, to ensure appropriat­e prescribin­g. Quick-fix weightloss messaging has been linked to high demand for this product in the US, amid reports of shortages.”

Alex Miras, a professor of endocrinol­ogy at Ulster University, said the decision by NICE was a “pivotal moment” and a “positive change” for people living with obesity, and was based on “solid data”. He said the weight loss that can be achieved with the “safe” medication is “substantia­l and likely to lead to the improvemen­t of obesity-related complicati­ons in a large number of patients”.

However, he warned that there are not enough services to offer the medication, and that those that do exist are “underresou­rced”. Prof Miras and a number of other scientists also raised concerns that the guidance limits the use of the drug to two years. He said: “Whilst this is understand­able based on costeffect­iveness, it makes no clinical sense, as we would not stop treatment for any other chronic disease.”

Currently, semaglutid­e is not approved for over-the-counter use in the UK, however major pharmacies, such as Boots and Lloyds Pharmacy, have adverts on their websites for patients to sign up for future use. NICE does not regulate the approval of drugs in terms of private or commercial use, as this falls outside of its remit.

NICE was approached for comment.

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 ?? (A l amy/PA) ?? Approval of se ma glut idef or NHS use is described by doctors as‘ reckless’
(A l amy/PA) Approval of se ma glut idef or NHS use is described by doctors as‘ reckless’
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