GPs Begin Prescribing Weight Loss Jabs to Obese Patients on NHS

Some people in England can now be prescribed the anti-obesity drug Mounjaro after the NHS rollout of the medication began on Monday.

The repurposed antidiabetic drug, known generically as tirzepatide and made by pharmaceutical giant Eli Lilly, reduces blood sugar levels and slows digestion, effectively suppressing hunger and helping people lose weight.

Family doctors in England can now prescribe the drug to severely overweight people who also suffer from a range of obesity-related health conditions, making it the first of the injectable weight-loss drugs to be accessible directly from GPs.

The initiative is expected to reach about 220,000 people across England over the next three years by targeting those identified as having the “highest clinical needs,” the National Institute for Health and Care Excellence (NICE) said in a December 2024 statement.

Patients previously needed to access it through a referral to a specialist NHS weight loss service or to obtain it privately at a much higher cost than the state prescription price of £9.90.

The drug is delivered through a self-administered weekly injection, which a doctor or nurse will show patients how to use, according to the NHS.

Estimates suggest around 1.5 million people in the UK are currently taking weight-loss medications, known as GLP-1RAs, although many of them would not meet the strict criteria for being prescribed them on the NHS.

Demand for the drug is expected to far outstrip availability on the NHS, with some GPs expressing concern about the additional workload linked to the rollout and cautioning patients not to book appointments requesting the drug unless they meet the criteria.

In the first year of the NHS programme, Mounjaro can be prescribed to people with a body mass index (BMI) of 40 or above who have at least four other health problems linked to obesity, including type 2 diabetes, high blood pressure, heart disease, and obstructive sleep apnoea.

Professor Kamila Hawthorne, chairwoman of the Royal College of GPs, said that the drugs should not be seen as a “silver bullet” solution to the complex problem of obesity.

“While we recognise the potential benefits of weight loss drugs being prescribed in line with NICE guidance, we know many GPs are concerned about the implications of the rollout of weight loss drugs into general practice, both in terms of workload and training to appropriately initiate and manage these treatments,” Hawthorne said.

“The College shares these concerns, which is why we were pleased NHS England suggested a phased roll-out of Mounjaro as a treatment for weight loss; as and when this is escalated, appropriate resourcing for general practice – including access to ‘wraparound’ services – and training for GPs must follow.”

Hawthorne added there must also be a focus on stopping people from becoming overweight in the first place so they do not require medical intervention later.

Demand Continues to Rise

Olivier Picard, chairman of the National Pharmacy Association, said that the NHS will not be able to fulfill the demand for Mounjaro.

“The demand for weight loss jabs continues to rise sharply, and more GPs have been directing patients back to pharmacies after initial inquiries, to access these treatments privately,” Picard said in an emailed statement to The Epoch Times.

“As the NHS is now moving to implement National Institute for Health and Care Excellence (NICE) guidance, and tirzepatide becomes prescribable to more patients, we expect to see prescription volumes increase rapidly. However, NHS provision won’t meet demand straight away, so we fully expect that many people will continue seeking it privately from a pharmacy.”

Picard echoed concerns that the drugs alone will not fix the obesity crisis and said there needs to be a more holistic approach to weight management involving people making permanent lifestyle changes.

“We could end up in a situation where patients are prescribed the medication, lose weight, and then experience rebound weight gain once the course ends—simply because the foundational lifestyle changes weren’t addressed.”

Around 29 percent of the adult population in the UK is classed as obese, according to a 2022 NHS Survey. Obesity-related health problems are estimated to cost the country about £11.4 billion a year, according to the Office for Life Sciences, with total societal costs of about £74 billion.

In an opinion piece for The Telegraph last October, Health Secretary Wes Streeting said anti-obesity jabs could help get some of the long-term sick back to work. At the time, Health Innovation Manchester also announced a partnership with Eli Lilly to begin a five-year trial of Mounjaro to assess the drug’s impact on employment levels.

Streeting told The Press Association, ahead of this week’s rollout, that making the jabs available on the NHS is part of the government’s strategy to focus on the prevention of illness rather than the cure.

“Obesity is now one of the leading causes of ill health, costing the NHS billions. Yet we now have the science, technology, and knowledge to end the obesity epidemic, if we seize this opportunity. Obesity jabs are used by 1.5 million people in the UK, mainly through private prescriptions,” he said.

“This rollout is an important step in making these medicines more widely available, and beginning to shift the focus of healthcare from sickness to prevention, which our forthcoming 10-year plan will deliver.”

Pregnancy Warning

The Medicines and Healthcare products Regulatory Agency (MHRA) issued an alert earlier this month reminding women to use effective contraception while taking “popular medicines for weight loss and diabetes.”

“Effective contraception includes oral (the pill) and non-oral (the implant, coil or condoms) forms of contraception. However, Mounjaro may reduce the effectiveness of oral contraceptives in those who are overweight,” the MHRA stated.

The MHRA recommended that women who use oral contraceptives should use an additional form of contraception for the first four weeks of taking Mounjaro, and for four weeks after each dose increase, as the active ingredients in the contraceptive pill may not be properly absorbed alongside the new medication.

Cancer

Potential side effects of Mounjaro include nausea, vomiting, diarrhea, and constipation, Eli Lilly’s website states. 

Clinical trials showed a link to thyroid cancer in animals, while a charity last week urged caution over the use of weight-loss jabs for people with a history of cancer.

In response to a written question from Reform UK MP Richard Tice last November, Health Minister Karin Smyth said: “A signal of thyroid cancer was not observed in the clinical trials for these medicines at the time of licensing, however it was acknowledged that clinical trials are not usually large or long-enough to observe cancer outcomes.

“Therefore, based on the need for further exploration of the risk about the human relevance, the pharmaceutical companies for all GLP-1RAs have been requested to assess the risk within a collaborative, long-term post-authorisation safety study evaluating medullary thyroid cancer events using United States cancer registries.”

She added that based on current evidence the benefits of the drugs outweigh the potential risks when used for the licensed indications.

“The risk of thyroid cancer with this class of medicines remains under review by the MHRA and all pharmaceutical companies which hold a licence for (the medications),” Smyth said.

Obesity is linked to higher rates of disease, including bowel and colorectal cancers, with research suggesting as many as one in 20 cancer cases are caused by being overweight, according to Cancer Research UK.

A recent study by the American Society of Clinical Oncology found that weight-loss drugs could potentially lower the cancer risk for people with diabetes.

PA Media contributed to this article.