[unable to retrieve full-text content]
A weight-loss jab loved by celebs and now available on the NHS is not a miracle fix for obesity, leading experts warned today.
Tens of thousands of overweight Brits will be given semaglutide – sold under the brand name Wegovy – after health watchdogs gave the weekly injection the green light, in a move described as a pivotal moment in the country’s battle against the bulge.
Yet questions are already being asked about whether the drug is really a ‘game-changer’.
Trials have shown that users can rapidly pile pounds back on once they stop taking the fat-fighting drug, dubbed ‘Hollywood’s worst-kept secret’ and used by the likes of Elon Musk.
Professor Jane Ogden, a health psychologist at the University of Surrey, said: ‘It’s no magic pill.’
Dr Adam Collins, an associate professor of nutrition, also at the University of Surrey, added: ‘The most concerning aspect of these therapies is their longevity. The drug is very effective when you are taking it, and so far, has been shown to take for several months.
‘Yet the guidelines currently are that this is only advocated for use over two years.
Alex Guevara, 46, (pictured) is a paramedic practitioner from Milton Keynes. He has three children and lives with his wife Christina, 29. He said: ‘When a friend told me about semaglutide I felt I had nothing to lose. I went to a private clinic and paid £250 a month for six months’
Semaglutide, marketed as Wegovy, will be available in pharmacies from the spring
‘So, what happens when you come off of the drug? The answer is, your hunger will return in spades.’
Dr Collins added: ‘With the shackles off your appetite, plus other changes… you are super primed to regain that lost weight.
‘We also know in this scenario people are highly susceptible to overshooting their original weight.
‘In this context, semaglutide is just another, albeit very effective, means of getting people to lose weight.
‘But the trick is not losing weight, that is easy, It is maintaining that weight that is the true challenge. It remains to be seen how the emergence of this new class of drugs can be used to meet this challenge.’
READ MORE: ‘Game-changing’ weight loss jab Wegovy will be rolled out on NHS in weeks… so will YOU be eligible to get Hollywood’s ‘worst-kept secret’?
Professor Jason Halford, from the School of Psychology at the University of Leeds, told BBC Radio 4: ‘I think it’s one of the most powerful pharmaceutical tools to date that we’ve had access to.’
However, he said that the drug needs to be taken in the context of specialist weight management services, which he claimed there are not enough of in the UK, making the treatment hard for many to access.
He added: ‘What we know when you come off the drug at two years, you see rapid weight gain because you’ve no longer got that drug-suppressing appetite systems.’
But Professor Halford added that once data of the drug’s longer-term effects is available, providing it is deemed safe, it may be used for a much longer period by people who struggle to keep weight off.
Semaglutide – sold under the brand name Wegovy – works by hijacking the brain to suppress appetite and reduce calorie intake, resulting in substantial weight loss.
It does this by mimicking the hormone glucagon-like peptide-1 (GLP-1), which is released after eating.
Trials found those on it lost around 12 per cent of their body weight – and slashed their chances of type 2 diabetes by more than half.
Alongside the drug, participants ate 500 calories fewer than they burned each day — so they had a calorie deficit — and were told to exercise for two-and-a-half hours per week.
But one study found that patients then put back on two-thirds of the weight in the next year, once the trial stopped.
The drug is already given at much lower doses to treat patients with type 2 diabetes, under the brand name Ozempic. Private clinics in the UK have given clients Ozempic off-label for just under £200 per month.
TikTok star Remi Bader, who has 2.2million followers on the social media site, was prescribed Ozempic by her doctor in 2020. This drug also contains semaglutide at a lower dose.
She said she put on ‘double the weight’ she lost when she came off the drug because her binge eating got ‘so much worse’.
Ciara Lawless, 40, from Dublin, lost 2st (28lbs/12.7kg) in May 2020 after getting semaglutide injections when she weighed around 12 and a half stone. She said she maintained her weight after coming off the jab through healthy eating and a weekly treat but has since used the jab ‘for help’ when she ‘needs it’
Danielle Breckenridge, 31, (pictured before the weight loss, left, and after, right) says she also lost more than 2st after taking semaglutide injections
Ana McKenna (pictured before and after the drug) told DailyMail.com she plans to stop using Wegovy after reaching her weight loss target
Some patients have told of how they have had to stop taking the drug due to side effects.
Users commonly complain of nausea, constipation and diarrhoea after taking the medication.
It has also been known to make food less appealing, potentially ruining the enjoyment of eating altogether.
Will YOU be eligible for the once-a-week jab?
WHO IS ELIGIBLE?
Wegovy will be available for people who have a BMI of 35 — making them morbidly obese.
Patients must also have at least one weight-related comorbidity, such as type 2 diabetes, to be eligible.
Adults with a BMI between 30 and 35 could also be recommended the drug if they have been referred for specialist help.
HOW TO WORK OUT YOUR BMI
BMI = (weight in kilograms / (height in meters x height in meters))
Under 18.5: Underweight
18.5 – 24.9: Healthy
25 – 29.9: Overweight
30 – 34.9: Obese
35 or greater: Morbidly obese
US comedian and TV host Chelsea Handler revealed she took the drug after being prescribed it by her doctor — but said it made her nauseous.
Some also suffer from acid reflux, fatigue and complain that food tastes different after taking the drug.
It is this side effect that some people credit for further assisting their weight loss — by making their favourite junk foods taste bad.
Thyroid cancer, pancreatitis — when the organ becomes inflamed — and kidney failure are rare but serious side effects.
Patients have also warned of their face appearing gaunt, exhausted and old — a side effect that has been labelled ‘Ozempic face’.
And all the trials so far have seen it dished out alongside strict exercise and calorie-restrictive diets – two proven ways of losing weight.
Doctors have warned that while the drug is an example of ‘very smart science’, it is ‘not a panacea for everyone’, as it doesn’t work for one in five patients.
However, experts welcomed NICE’s recommendation for Wegovy for those with a Body Mass Index (BMI) of 30 and above, as part of a weight-loss programme of diet and exercise.
Tam Fry, from the National Obesity Forum, said this is ‘the weight-loss drug that we’ve been waiting for’ and urged health leaders to ration supplies to those in greatest need.
He said: ‘It’s a game-changer and so successful that Hollywood A-listers are now using it to slim and show off their figures.
‘The real danger is that there may not be enough to go round in the short-term.
‘You should not be using it just to lose a few pounds because that might jeopardise the health of those who really need it, those who have diabetes type 2 and morbid obesity.’
Staci Rice, 40, from Georgia, (pictured) lost 50 pounds in six months while on Wegovy
Ashton Olivia Smith, 33, from Tulsa, Oklahoma, shared before and after photos of her 40lb weight loss on TikTok after taking the drug for nearly a year and a half. The mother-of-four said: ‘If you’re looking for a sign to start Wegovy/Ozempic, HERE IT IS!’
Khalin Grant, 41, from Florida, says she lost 75lbs in seven months while taking weekly injections of Wegovy. Ms Grant says she now fits into smaller dress sizes than when she was in college
The drug has been hailed a miracle cure by some who have taken it.
Alex Guevara, 46, is a paramedic practitioner from Milton Keynes. He has two children from his first marriage, and a third with wife Christina, 29, who’s also a paramedic.
He said by April last year he was touching 20st and his weight left him feeling suicidal.
Mr Guevara started on semaglutide and within a few days said he started feeling less hungry and felt much happier. He quickly lost four stone.
‘I needed something dramatic to break the cycle and stop me hurtling towards type 2 diabetes, cardiovascular diseases and stroke,’ he added. ‘Semaglutide should be available to anyone who needs it.’
Made by Novo Nordisk, it is hoped the jabs – which will initially help around 35,000 people a year – will be available to patients within weeks as part of NHS specialist weight management services.
Adults with a BMI classed as obese and at least one weight-related illness such as pre-diabetes, type 2 diabetes, high blood pressure, cardiovascular disease or high blood pressure, could qualify.
The jabs are self-administered by patients once a week using pre-filled pens, for a minimum of 16 weeks.
They can initially be placed on the drug for a maximum of two years, although regulators say there is scope to increase this if real-world data shows it continues to be an effective weight loss tool.
Around 19million people in England are obese, which costs the NHS more than £6billion a year.
Trials found patients given the weekly jab lost a tenth of their body weight in just 20 weeks – 25 times more than those on a placebo – consuming around 35 per cent fewer calories.
Wegovy works by triggering the body to produce a hormone called glucagon-like peptide-1 that is released naturally from the intestines after meals
A UK study found that people who used Wegovy experienced rapid weight loss, dropping 18% of their weight over 68 weeks. They regained two-thirds of that weight, or 12% of their original body weight in the year after dropping the weekly injections. Experts says the drug needs to be used over a lifetime to keep off the pounds
Top Gear host Jeremy Clarkson (left) revealed he was taking Ozempic, a brand of semaglutide, in a bid to lose weight. When asked in October whether following a healthier diet or hitting the gym was behind his 30lb (13.6kg) weight loss, Elon Musk (right) credited ‘fasting’ and ‘Wegovy’
Comedian and TV host Chelsea Handler (left) revealed she took the drug after being prescribed it by her doctor — but said it made her nauseous. TikTok star Remi Bader (right) revealed that she was prescribed Ozempic by her doctor in 2020 ‘before it was trendy’
Elon Musk (left) credits his spectacular weight loss in 2020 to Wegovy. The tech tycoon looked noticeably slimmer when he first arrived in Twitter HQ after purchasing the company in October (right)
Kim Kardashian is rumoured to have used Wegovy to rapidly lose weight in order to fit in Marilyn Monroe’s famous ‘Happy Birthday Mr President’ dress at the 2022 Met Gala (pictured)
Overweight and obese participants given regular doses also saw their odds of suffering type 2 diabetes fall by up to 61 per cent.
Professor Alex Miras, an endocrinologist and obesity expert at Ulster University in Northern Ireland, said the drug will make a massive difference to people living with obesity.
‘This decision made by NICE is a pivotal moment for the treatment of people living with obesity,’ he said, adding: ‘The weight loss that can be achieved with this safe medication is substantial and likely to lead to the improvement of obesity related complications in a large number of patients.’
It has led celebrities Elon Musk and Jeremy Clarkson to both publicly credit it with helping them to shift the pounds.
Meanwhile, Kim Kardashian was rumoured to have used it to rapidly lose 16lbs (7.3kg) to fit into Marilyn Monroe’s iconic ‘Happy Birthday Mr President’ dress at the 2022 Met Gala.
Helen Knight, director of medicines evaluation at NICE, said: ‘For some people losing weight is a real challenge which is why a medicine like semaglutide is a welcome option.’
Dietitian Dr Duane Mellor, of Aston Medical School at Aston University in Birmingham, said: ‘It is important to remember that semaglutide works alongside and supports healthy lifestyle changes.
‘When people are being offered semaglutide they are also given ongoing support to make changes and maintain these changes with respect to diet and lifestyle.
‘As all individuals initially being offered semaglutide via the NHS will be supported by specialist weight management services, this should include support from a specialist dietitian.’
What are the diet and exercise changes users of the drug need to make?
Wegovy will only be prescribed to people in the UK alongside a weight management programme.
This will involve significant diet and lifestyle changes, to ensure the user’s weight loss continues as planned.
Semaglutide works by suppressing a person’s appetite, encouraging them to eat less.
Participants on trials, who lost around 12 per cent of their body weight, were told to follow a reduced-calorie diet alongside Wegovy, eating 500 fewer than they were burning each day.
The average man needs around 2,500 calories per day to maintain a healthy body weight, while women need around 2,000.
Experts suggest users stick to foods that won’t raise their blood sugar, such as non-starchy vegetables, including beetroot, leeks, broccoli, cauliflower and mushrooms.
Fibre and complex carbs aid gut-health and indigestion, so users are encouraged to eat whole grains, nuts, protein-rich foods and legumes.
In trials, participants were encouraged to complete 150 minutes of physical activity per week, such as walking, alongside using Wegovy.
Additionally, the injection can make a user lose weight very quickly, and with that can come excess, sagging skin.
Some experts suggest regular exercise can combat this by boosting muscle mass and tightening the skin.
And getting into a habit of working out is recommended, to help users keep the weight off when treatment ends.