Last week, NHS GPs began prescribing Mounjaro for weight loss for the first time. But for many people reaching out to their doctor, the response is likely to be disappointing – the NHS has made it clear that the drug will only be available to those who meet a strict set of criteria.
The public interest is understandable. Drugs like Ozempic, Wegovy, Mounjaro and other GLP-1 medications are nothing short of revolutionary. I say that from personal experience – they helped me lose over five stone in just a year. And this may only be the beginning. While research is still in its early stages, a growing body of evidence suggests that GLP-1 drugs may be effective in treating a range of other conditions, including addiction and dementia. Some researchers are also exploring their anti-inflammatory properties and potential to reduce the risk of heart attacks, strokes and cognitive decline.
Unsurprisingly, political leaders have seized on the promise of these drugs, hoping they might offer a ‘silver bullet’ (or ‘silver epi-pen’) solution to an overstretched welfare state – one that doesn’t require making politically painful decisions.
On some level, their enthusiasm is warranted. Obesity levels in the UK have surged: from 15% of adults in 1993 to 29% in 2022. Today, nearly two in three adults are overweight, and one in four children. The societal consequences are enormous. According to research by the Tony Blair Institute, the annual cost of obesity to the UK is £98 billion – including £19 billion in NHS spending and £15 billion in lost economic productivity. If a drug could reduce obesity even by a quarter, the impact on both the economy and public services could be transformative.
However, there are good reasons to be cautious.
First, these drugs are currently expensive. A private Mounjaro prescription typically costs £150-£200 per month. Even with NHS bulk discounts, annual costs could exceed £1,000 per patient – though this should fall as patents start to expire in the early 2030s. Since many regain weight after stopping treatment, long-term use will likely be necessary.
That cost doesn’t include the additional costs for the NHS, including regular GP appointments and monitoring. The Chair of the Royal College of GPs has raised concerns, warning that doctors are already under immense pressure and warning about the extra workload. One GP I spoke to joked that they would need to hire an extra pharmacist at their surgery to deal with the extra prescriptions.
There are also ethical considerations. If GLP-1 drugs are found to markedly reduce the risk of dementia and cardiovascular disease, should they not be prescribed more broadly? It’s hard to imagine that public demand wouldn’t push for wider access – potentially adding further strain to NHS resources.
The most profound impact, however, could be demographic. Obesity is linked to shorter life expectancy, with obese individuals living, on average, three years less than those at a healthy weight. If obesity rates fall significantly, we may see hundreds of thousands more people living longer.
This could accelerate an already challenging trend. The UK is experiencing rapid population ageing due to low fertility rates and increased longevity. According to UN projections, by 2050, one in four people in the UK will be over 65, and one in ten over 80. Widespread use of effective weight-loss drugs could dramatically speed up this shift.
That has serious implications for public finances. Last year, the government spent £124bn on state pensions. A sudden increase in the number of people living longer could push the system – already strained by the ‘triple lock’ – to the brink.
Of course, it’s worth adding a key caveat here: long-term predictions about new technologies are notoriously unreliable. I say this as someone who spent much of the early 2000s transferring all my music onto MiniDiscs.
With the enormous investment currently flowing into biotech, it’s not inconceivable that we could see even more radical breakthroughs – perhaps even drugs that slow or halt ageing, making the idea of retirement itself obsolete.
Yet even if these drugs end up costing the state more than they save, that doesn’t mean the government should automatically dismiss the idea of prescribing them more widely. The human benefits are real and should be part of the equation.
From my own experience, losing weight has profoundly improved my life, making everyday activities more accessible and enjoyable. While the cost is high, I’ve found it to be worth every penny – and I’m happy to keep paying for that transformation. Perhaps this could form part of a much needed wider conversation about what we expect the state to provide for us, and more importantly, how much we are willing to pay for it.
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