Pumping the unemployed with weight-loss drugs reflects the Victorian attitude towards the poor Kenan Malik

IIn early 2023, Lars Fruergaard Jørgensen, CEO of the Danish pharmaceutical company Novo Nordisk, and British Vice President Pinder Sahota, met in Whitehall with then Health Minister Steve Barclay, England’s Chief Medical Officer, Prof. Chris Whitty, and several officials from health care and the Ministry of Finance. They discussed the possibilities of a pilot project to improve obesity care in Britain.

According to internal documents obtained by the ObserverNovo Nordisk wanted ‘data from the Department for Work and Pensions’ to ‘help profile those most likely to return to the labor market’. These individuals could then be targeted by Wegovy, the brand name for the company’s weight-loss drug semaglutide.

Simon Capewell, emeritus professor of public health at the University of Liverpool, noted that “targeting people in the interests of the state, for economic reasons, rather than prioritizing the person’s own interests and health” is “unethical” was. He also questioned the scientific “fairness” of a pilot project testing the effectiveness of a drug in helping individuals get back into the job market, but using people who were “already considered borderline cases by the DWP to just go back to work’. It would be “a great piece of marketing for the company.”

That Novo Nordisk study never materialized. However, eighteen months later, a pilot study is launched to test not Wegovy, but Mounjaro, the market name for tirzepatide, an injection for diabetes and weight loss produced by the American pharmaceutical giant Lilly. The government praised Lilly’s presence at last week’s “investment summit” and welcomed the meeting the company’s £279m stake in helping “develop transformative medicines” and “test innovative approaches to treating obesity.” The Mounjaro Process, based in Manchesterwill involve 3,000 people in a five-year study of the “non-clinical outcomes” of the treatment, specifically to see if the drug can help more people return to the workplace. “Our wider waistbands,Health Minister Wes Streeting wrote in an op-ed for the Daily Telegraph‘holding back our economy’.

Politicians are particularly irritated by the increase in the number of people who are economically inactive, largely due to long-term illness. The hope that it will be possible to address this, at least in part, through the use of jabs is tempting, especially at a time when technical, as opposed to political or social, solutions are in vogue.

Drugs such as Wegovy or Mounjaro may well be useful in helping individuals lose weight, although their efficacy is far from certain and their side effects are not well understood. However, this differs significantly from a government strategy to use them as a means of bringing people back into the labor market.

The criticism of the Wegovy study proposed last year could equally apply to the new Mounjaro study – that it treats people based on “their potential economic value, rather than primarily on their needs and their health needs ”, as Dr. Dolly van Tulleken, a researcher. obesity researcher at the University of Cambridge, noted last week. Although many studies show a link between unemployment and obesity, the link is not clear-cut. There is some evidence that obesity reduces job prospects, but it’s not so much obesity causes unemployment because becoming unemployed leads to weight gain.

George Orwell understood why. “A millionaire might like to have breakfast with orange juice and Ryvita cookies; an unemployed man does not,” he noted The road to Wigan pierin which he satirized middle-class sermons about the diets of the working class. “When you’re unemployed, that is, when you’re malnourished, harassed, bored and miserable, you want… something ‘tasty’.” Unemployment “is an endless misery that must be continually alleviated,” and that is why “the physical average in the industrial cities is terribly low.” It is an “endless misery” made worse today by a lack of decent jobs, a lack of social infrastructure, from youth clubs to libraries and pubs, poor transport facilities and shockingly low benefits.

Yet the challenge of unemployment and poverty is still seen as the problem of the individual, of laziness and lifestyle choices. In 1978, Margaret Thatcher told the Catholic Herald that poverty did not exist, and if it did, it was only “because people don’t know how to budget, they don’t know how to spend their income,” and that is the core of a “personality defect.”

It would be easy to dismiss this simply as Thatcherite resentment. But the belief that the responsibility for unemployment and poverty lies with the unemployed and the poor themselves, and that such problems reveal moral rather than political or social shortcomings, has deep historical roots and continues to shape policy to this day .

Then William Beveridge wrote his 1942 report which helped lay the foundations of the post-war welfare state, he described the ‘five great evils’ that plagued society as want, disease, ignorance, misery and idleness. Not ‘unemployment’ or ‘unemployment’ but ‘laziness’.

Even as society turned away from the ethos of the Victorian ‘poor laws’, which saw the cause of poverty and unemployment in the ‘laziness’ and ‘intemperance’ of the poor, to create the modern welfare state and the National Health Service, they are an echo of the old moralistic vision and of the idea of ​​the ‘undeserving poor’. It’s an echo heard in recent decades in New Labor’s crusade against “problem families”, in George Osborne’s division of the nation into “strivers” and “skivers”, in The imposition of Iain Duncan Smith of a benefit cap for parents with more than two children to teach the poor that “children cost money,” which they apparently didn’t know until he came along.

Giving slimming injections to the unemployed fits into this history. Just like Liz Kendall’s proposal last week to “job coaches”visit psychiatric patients in the hospital. And how long will it take before people are sanctioned if they refuse to cooperate? Ten years ago, David Cameron threatened to withdraw benefits from claimants who refused treatment for obesity. It is not difficult to imagine such a plan emerging again. Once the finger is pointed at the individual and unemployment and poverty are seen as moral rather than political issues, coercion is rarely far away.

Unemployment is not a medical condition. Medical treatment may not take place in the DWP’s province. Confusing the medical and the social makes it harder to improve lives in both areas.