In recent discussions surrounding weight-loss medications, tennis champion Serena Williams has emerged as a vocal advocate for normalizing their use. She’s committed to breaking the stigma attached to these drugs. They have received significant recent scrutiny, not only for their effectiveness but for the inequities in access that correlate with socioeconomic status. Medications such as Wegovy and Mounjaro have landed under a bright spotlight in the obesity conversation. They hugely compound the health and wealth disparities seen today in our society.
In real terms, weight-loss drugs tend to be in the range of £100-350 per month. The price depends on the dosage and the additional lifestyle support you get. Recent publications have highlighted how impactful these treatments can be in producing tremendous weight loss. In practice, some patients even lose greater than 20% of their weight! Yet the high cost is still a major obstacle for people looking for these alternatives. Over 1.5 million people in the UK are currently on weight-loss medications. More than 90% of them pay privately, exposing a deep and growing chasm in accessibility.
Research underscores the economic implications of obesity, revealing a troubling trend where individuals with higher body mass indexes earn less than their thinner counterparts. Employment discrimination A recent study in the United States found that obese men with bachelor’s degrees earn 5% less than their thinner peers. The gap increases for those with graduate degrees, as they make 14% less. Just as with the previous example, obese women earn 12% and 19% less than their thinner counterparts. For this new data to have the real-world impact needed to address these economic and health disparities exacerbated by obesity, it must be widely used.
In England, the National Health Service (NHS) has begun to give weight-loss drugs as prescriptions. Having launched Wegovy in early 2023, Eli Lilly’s Mounjaro should be right behind. Furthermore, only 18 of the 42 NHS boards have guaranteed signed up for plan rollout. Together, they are now on the frontlines of prescribing these powerful medications. The limited availability raises questions about equity of access, particularly for individuals from deprived areas, where obesity rates are notably high. Over one-third of people in the most disadvantaged regions are classified as obese, compared to lesser rates in more affluent neighborhoods.
Sara, an obese patient who successfully overcame her struggles with dieting to win the war on her obesity, presented her experience. Her GP subsequently referred her to a lifestyle based diet and activity program for ongoing management. Her experience is typical of a systemic problem—with many people encountering barriers to use of proven treatments that work. Martin Fidock, a healthcare professional, noted that recent changes in regional health board policies have raised the body mass index (BMI) threshold for eligibility, making it more challenging for people to receive weight-loss medications.
It’s a lucrative market, and there are more than 160 new weight-loss drugs in clinical development right now. As the industry continues to grow, players like Eli Lilly are coming under fire. Eli Lilly plans to hike Mounjaro’s list price up to 170%. This price increase will compound the challenges for people who already have difficulty affording treatment.
As a result, worries about the drivers of this prescribing behavior have emerged as well. Professor Richard Donnelly pointed out that “some services are desperate to dispense the stuff and don’t care what happens,” while emphasizing that “they’re not there to lose a bit of fat around the tummy.” This call for caution illustrates an urgent need for a more tempered and evidence-based approach to obesity treatments.
Elevator pitches aren’t enough. Stories from celebrities like Whoopi Goldberg talking about their experience with these weight-loss miracle medications. Goldberg stated, “I weighed almost 300 pounds… I was on all this stuff and one of the things that has helped me drop the weight is Mounjaro.” Such testimonials further ingrain the weight-loss drugs in the public consciousness, gaining wider popularity through media embellishment.
Yet as their use among celebrities becomes normalized, we risk further entrenching class disparities. A London-based fashion editor remarked on this phenomenon, saying, “So many fashion people are on it and now they’re very vocal.” The intersection between celebrity endorsement and public perception could influence societal attitudes towards these treatments but may exacerbate existing inequalities.
Public health director Greg Fell warned against the dangers of pouring all efforts into finding pharmacological solutions to obesity. He argued that “by thinking we have a treatment for obesity we lose focus and stop thinking about the more difficult issues around the food industry and regulation,” which are fundamental to understanding the root causes of obesity. Fell expressed worries regarding equity of access: “I do have concerns about equity of access.”
Chief Executive of the Association of Directors of Public Health Katharine Jenner went further, insisting that health was a right, not a privilege restricted to the wealthy. “We cannot allow good health to become a luxury for the wealthiest by limiting access to weight-loss drugs to those who can pay privately,” she stated.
Chris offered a more in-depth look at the nuances involved in addressing obesity in today’s society. He stated, “It would be naïve — or even pious — to claim we can simply solve this. The answer is complex and touches the very fabric of our society,” highlighting the multifaceted nature of obesity and its treatment.
As conversations around weight-loss drugs continue, we need to unpack their medical utility. We’ll need to focus on the broader societal impacts they introduce. How health equity, economic considerations, and the effects on accessibility work together will be an important discussion moving forward as more policies are made to treat obesity.