It was Boxing Day 2003, when after seven months on Orlistat, the wonder weight-loss drug of the early noughties, Moira was rushed to hospital. In her late 30s and weighing over 20 stone, Moira had started taking the daily pills that spring. At first, the pounds fell off and she relished her newfound body confidence.
After having shed a stunning eight stone, however, Moira’s family became increasingly concerned about her dramatic weight loss. They persuaded her to ditch the meds, which is when weight leapt back on, and Moira became plagued by severe stomach pains.
Her Boxing Day trip led to emergency surgery to remove her gallbladder, followed by five weeks in hospital. Moira learned from doctors that she almost died. Hers is a cautionary tale.
For Orlistat promised the overweight of the early 2000s the hope that today’s next generation weight loss drugs such as Mounjaro offer to today’s 10 million or so adults classed as “living with obesity” – a safe short-cut to weight loss. Marketed as a wonder drug, it was only some years afterwards that it became apparent the potential side-effects had been dramatically understated.
Having been an overweight child, unable to participate fully in sport, bullied, and mortifyingly self-conscious, I have real sympathy with those struggling with their weight. If you’d told me as a 140lb, 11-year-old that a miracle drug could rid me of my excess baggage, I would probably have swallowed your hand whole.
I accept that there are some for whom weight-loss drugs act as a kickstart into a healthier lifestyle, but I am deeply uneasy about Labour’s plan to have the NHS liberally hand out Mounjaro to the overweight unemployed population – current NHS plans envisage Mounjaro being given to an astonishing 1.6 million people within 12 years – and at considerable taxpayer expense.
The efficacy of these drugs doesn’t seem to be in doubt – patients seem undeniably to lose weight fast. But neither is the long list of known side effects, which includes simple nausea, diarrhoea and vomiting through to serious complications such as kidney failure, severe stomach issues and pancreatitis. In the US, Mounjaro comes with an FDA safety warning that it has caused thyroid tumours in animals. As with any relatively new-to-market drug, optimism for its curative potential should always be tempered by a healthy level of concern not only for its known side-effects but also for what isn’t yet known.
The chequered history of earlier weight loss wonder-drugs gives further reason to be sceptical: a 2016 systematic review carried out by experts at Oxford University identified 25 anti-obesity drugs that had been withdrawn between 1964 and 2009.
Various high profile past users of Ozempic and Mounjaro have spoken out in recent days about the health problems they faced after coming off those meds. The truth is, it seems, that this miracle will only work for as long as you keep on jabbing; if you stop, your body is likely to rebound to a more obese and sickly state than you started with.
How many of those prepared to give these drugs a whirl for a few months would be comfortable thinking they were, in fact, being sold a lifetime subscription to prescription meds? What happens to the economy, not to mention the health service, when people do come off the meds and are bigger and sicker than when they started?
Since Wes Streeting’s announcement, NHS bosses have publicly assisted weight loss drugs should only be used alongside other lifestyle changes. Fine words, but with a quarter of the UK’s adult population completely inactive aren’t we kidding ourselves by thinking a quick jab will, for most, change this habit of a lifetime?
Twenty years on from her Orlistat nightmare and, thanks to regular exercise and an overhaul of her diet, Moira is healthy, happy and, although not ‘thin’, no longer fat, either. I asked her what she thought of this week’s reports; would she be tempted to try one of these new-generation weight loss drugs to shed the last few pounds?
“I wouldn’t touch it with a barge pole,” she replied, before explaining: “They’ve got it all wrong. They’re starting at the end, when we need to start right at the beginning. We need to make people healthier in the first place.”
So what if, instead of dishing out drugs, this interventionist-inclined government invested at scale in innovations proven to reduce obesity: better food and healthy eating lessons for kids, meaningful alternatives to ultra-processed foods, cleverer investment in urban design and sporting facilities to facilitate even mild exercise, and so on.
Instead, this latest Labour policy relies on the promise of a no effort and no regrets cure for obesity. Like the proverbial free lunch, there’s no such thing.
