Scientists say anti-obesity drugs such as Wegovy may have to be taken for life

As reported by The Times, scientists have said that people prescribed the new class of anti-obesity drugs should be prepared to take them for the rest of their lives

Describing drugs such as Wegovy as like statins for obesity, they said that despite guidance recommending two years of use, in practice, like statins, they expected that people would need to take them indefinitely.

“The way we explain this to our patients is these are not weight-loss drugs, these are disease-modifying drugs, treatments for the disease of obesity,” Carel Le Roux, professor of metabolic medicine at Ulster University, said. “What happens is when you treat people the disease comes under control. The minute we stop the drug, the disease relapses.

“So one of the most important questions we ask our patients now is are you prepared to take this treatment for the rest of your life? Because if you’re not able to do that, you should not start because then we are probably at risk of doing more harm than good.”

Britain’s National Institute for Health and Care Excellence (Nice) became among the first regulators in the world to approve the use of the treatment for obesity. The drugs, which work by mimicking an appetite-suppressing hormone, can have a dramatic effect on weight.

Studies show the weekly injection enables obese people to lose more than 10% of their weight and keep it off. Doctors are excited by the advance, which provides results comparable to that achieved by bariatric surgery, and also seems to be able to reverse the progression of diabetes.

The drugs are already offered for diabetes in the UK and will be available in specialist weight loss centres imminently. On present clinical evidence though, as well as the ability of NHS services to provide the treatment, Nice has said that the course of treatment can be recommended for only two years.

Barbara McGowan, professor of endocrinology and diabetes at King’s College London, said this time limit was “probably not based on science”. Just as with conventional diets when people stop they put the weight back on, the same appears to be true with weight-loss drugs.

“We all agree that obesity is a chronic disease. We feel that this should not be stopped after two years,” she said. “After two years, you wouldn’t stop a statin, you wouldn’t stop a blood pressure tablet. We know from the clinical trials that when medications are stopped, the weight is regained.”

Studies repeatedly show that dieting alone is largely ineffective as a long-term solution for being overweight. Even expensive intensive programmes, in which people receive counselling and advice on diet and exercise, produce only modest results.

With the rise of obesity in the developed and developing world, public health officials are hopeful that drugs could provide a way to prevent many of the associated complications, which include heart disease and diabetes, and ultimately save health services money.

However, the treatments come with side-effects, which can include dizziness, tiredness, vomiting, headaches and gastrointestinal problems. For some users they are severe enough that they stop taking the drugs. For others, though, they lessen over time.

Professor Le Roux said he expected that as more was learnt about the drugs, and as others came to market, the guidelines for their use would change. “Nice made the right decision at the time, but we hope that they will revise that decision as we get more data [and] also as prices come down,” he said.