A leading expert has warned that skinny jabs could be used by governments as a subterfuge to avoid tough policy choices to prevent obesity.
Professor Giles Yeo, a geneticist at the University of Cambridge and an expert on obesity and the brain’s control of food intake, said drugs such as semaglutide – the active ingredient in the weight-loss jab Wegovy – were notable and helped the majority of people people worked.
Wegovy – which is available on the NHS – can indeed help people lose more than 10% of their body weightwith medications such as tirzepatide even more effective. And the drugs are becoming increasingly powerful in their ability to help people lose weight.
“The effect sizes (in terms of weight loss) of the things coming to market are incredible,” Yeo said, adding that there were products in development that required one injection per month, rather than weekly injections.
But, Yeo points out, such drugs, known as GLP1 receptor agonists, are designed to treat obesity and its related diseases, not prevent them.
“Prevention of Obesity Required – shall require – changes in public policy, the hard miles, and I fear, and this is a real fear, that not only our government, but many governments and policy makers may very well use (these drugs) as a subterfuge to not make the hard policy decisions . And that is a real problem,” he says.
Yeo added that prevention remains better than cure.
“The more time you spend in a state of obesity, the worse your health,” he said. “So preventing it means you will ultimately be healthier.”
Prevention was also the cheaper approach, he said, noting that it avoided the costs associated with obesity-related conditions and the costs associated with treating obesity.
“The problem is that these are long-term costs,” Yeo said, noting that this meant they would cover many governments. Therefore, according to him, a long-term plan was necessary.
Yeo said one of the public health measures that needed to be taken by policymakers was to subsidize healthy food to make it cheaper so that it became the default choice even when money was limited.
He also stressed the need to crack down on the placement of unhealthy food in stores.
“I’m not a food Nazi, but I do think that if you want to eat something – chocolate, pudding or whatever – you walk to the aisle where there is chocolate, and you walk to the aisle where there is lasagna, you walk to the aisle where ice cream, and buy it,” he said, noting that this allowed for personal choice without selling people things they had no intention of buying.
Yeo added that while regulations were also needed on junk food advertising, the plans for a 9pm watershed “were now a load of nonsense” as many people streamed shows as and when they wanted.
He also stressed that it is important that action on advertising is non-judgmental, meaning that it applies to all foods that meet set nutritional criteria – such as high fat, salt and sugar content – regardless of whether the food is in issue comes from a Lenten season. -food outlet or chic restaurant.
Yeo added that while drugs such as semaglutide were effective when it came to treating obesity – and were being trialled in other areas of healthcare, from dementia to addiction – they had their limits.
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“They make you feel fuller: you feel fuller, you eat less,” he said. “But what they don’t do is improve your diet.”
That, Yeo said, was a problem when they were used by people on poor diets.
“All this drug will do is reduce the amount of the bad diet you eat, so you will lose weight, but it will not improve your diet,” he said. “You will be healthier because you have lost weight, but not nearly as healthy as you could be if you ate healthy in addition to losing weight.”
Yeo warned that there may even be unintended effects, as an unhealthy diet is low in protein and micronutrients, meaning smaller portions may not reach recommended levels. In that case, people who eat less as a result of the injections may face another problem. “If your diet was already poor, there is a potential danger of becoming malnourished,” he said.
Even those who ate healthily while taking the drugs could experience unexpected consequences, he said, noting that lean shots, like quick weight-loss diets, can lead to loss of muscle mass.
“If you don’t do that, in addition to improving your diet with protein etc., and also exercising, you end up losing fat and muscle mass in a 50:50 ratio – and no one has signed up to lose muscle mass,” said he.
Moreover, Yeo noted, the drugs worked just as well on someone who was obese as on someone who was underweight, while also altering blood sugar levels and could have side effects. As a result, Yeo said, monitoring its use by medical professionals was critical.
“On top of the fact that (people taking the drugs) probably need really robust nutritional counseling and some kind of exercise plan,” he said.
While such drugs should be embraced as a way to treat obesity, Yeo said, prevention ultimately remained crucial.
“We should not lose sight of the fact that we still need to improve the environment,” he said.