The BBCRay, 62, from south London, became one of the first patients to receive weight-loss job Wegovi on the NHS last year and has lost 14kg (just over two stone) in five months.
BBC Panorama joined him as he was prescribed his first dose at Guy’s Hospital in London, where he was told he would likely need lifelong medication to regain the weight. can avoid He said he felt “blessed” to have been given the drug.
But NICE, the NHS spending watchdog, has ruled that each patient can only receive Wegovy for two years. And only a small proportion of the 3.4 million eligible patients in England are accessing the drug.
Professor Naveed Sattar, who is leading the UK government. Obesity Health Care Goals Programsays that if everyone eligible is immediately given the drug “it will just bankrupt the NHS”.
Being overweight is now the norm and almost one in three adults in England is obese – double the rate just 30 years ago.
Obesity can be very bad for your health, and treating the complications it causes is estimated to cost the NHS more than £11bn a year across the UK.
Vigovi and another drug called Monjaro can help patients lose about 15 to 20 percent of their body weight, according to trials.
Such weight loss can have a dramatic impact on health, and can greatly reduce a patient’s risk of many conditions, from diabetes to cancer, joint problems and heart disease.
BBC Panorama has been given exclusive access to the weight management service at London’s Guy’s Hospital, which has started rolling out Vigovi to a small group of patients. have done that meet the criteria – a body mass index (BMI) over 35 and at least one weight-related health complication.
They include care home worker Ray, who weighed 148kg or 23 stone when he started taking Vigovi in July 2024. She struggled with her weight all her life.
Ray needs two operations, but doctors say he needs to lose weight first.
With so many patients meeting the criteria, the hospital is prioritizing people like Ray who need surgery or have multiple health complications related to their weight.
Here, Ray is not only given the drug, which is given by weekly injections under the skin, but also receives face-to-face support from doctors and nutritionists – advice not always given to those who Buy medicine privately online.
They stress that jabs don’t do the trick and that it’s important for patients to change their lifestyle, and eat healthier foods and smaller portions.
Ray was joined at the meeting by his daughter, Sophie, who said it would be “amazing” if he could reach his goal of losing three stone: “I wouldn’t recognize it. It would be like my The pass is brand new.
For now, the drug is available on the NHS in England through specialist services, mostly in hospitals.
But chances of taking medicine are low.
Of more than 130,000 patients eligible for weight-loss drugs in south-east London, Guy’s clinic believes it can only see 3,000.
The weight loss pill that most people know is Ozempic. It has been in high demand and popularized by celebrities from Elon Musk to Sharon Osbourne. In fact, it is for type 2 diabetes.
Vigovi contains the same ingredient, semaglutide, but in different doses.
Semaglutide mimics a gut hormone that sends signals to our brain that we are full. It also slows the passage of food through the stomach.
In trials, Vigovi patients lost an average of 15% body weight when combined with lifestyle and dietary advice.
Experts caution that the drugs should only be taken under proper medical supervision, as like all drugs they have side effects, which not all patients can tolerate.
These are mostly gastrointestinal – such as nausea, vomiting, diarrhea or constipation – but there are potentially serious complications, including pancreatitis.
To help them deal with side effects, patients are started on a low dose of weight loss pills, and increased gradually.
Ray is doing well on the medication, eating smaller portions, and after five months there is a noticeable difference.
At his appointment in Guy just before Christmas, he weighed 134kg, a weight loss of 14kg or just over two stone.
He is happy. “I can’t believe how much weight I’ve lost. Every time my daughters see me, they say I’m shrinking. It’s been a really good journey.”
Ray says he feels “lucky” to have access to drugs through the NHS, especially now he is Willow’s grandfather.
Ray says that despite having several new holes in his belt, his pants are so loose they’re falling off him.
Professor Barbara McGowan, an obesity and diabetes specialist who runs the Weight Management Service at Guy’s, is delighted with the progress of patients like Ray.
She says most clinicians hope NICE’s two-year limit will be scrapped “because obesity is a chronic disease and we need to manage it long-term”.
This is no longer an issue as a second, even more effective drug has been approved by NICE (National Institute for Health and Care Excellence).
Monjaro has been called the “King Kong” of weight loss pills as in one pivotal trial, patients lost an average of 21 percent of their body weight over eight months.
Unlike Vigovi, there are no restrictions on how long NHS patients can stay on the drug.
But the NHS is to bring the drug back within 12 years because of concerns it could overwhelm services.
Over the next three years it is estimated that just 220,000 people in England will benefit, out of the 3.4 million who are eligible.
Professor Sattar, from the University of Glasgow, says it’s a simple matter of economics: “The cost of drugs is still at a level where we can’t afford to treat millions of people in the UK with these drugs. Will just bankrupt the NHS.”
It is estimated that it costs the NHS £3,000 a year to give Mounjaro or Wegovy to a patient.
So if everyone eligible in England received it now, it would be around £10bn a year – half the NHS’s entire drug budget.
Jane, who is 62, hopes Monjaro will help her get her weight and health back on track. She shows me a picture of herself on her phone from a decade ago, when she was apparently much lighter and healthier.
“I was a fitness freak. I went to the gym practically every day. I don’t know what happened, why I fell off the wagon.”
She admits her relationship with food is “terrible”. “I have a lot of food cravings and I tend to act on it,” she says, using a term coined to describe food cravings and preoccupations.
Jane qualifies for Monjaro because she has type 2 diabetes and has been injecting insulin for five years.
They are concerned about side effects, which are similar to Vigovi, but will be carefully monitored at a diabetes clinic in South London affiliated with Guy’s.
Monjaro helps to stabilize blood sugar levels and increase the natural production of insulin in the body.
After just five weeks on the drug, Jane is able to stop her insulin. She’s happy: “I think it’s Monjaro, and willpower too – I have to give myself some credit. I think the medication quiets the noise of eating and I’m not constantly thinking about what I’m going to eat.” will.”
After two months on the medication, Jane is back in the gym, and has lost more than 3kg (half a stone).
She is disappointed with her weight loss, but is determined to lose more pounds as her Monjaro dosage increases.
But Jane and other patients receiving Vigovi and Monjaro on the NHS are in the minority.
Professor Sattar believes that more than nine in 10 patients on weight-loss drugs in the UK are currently paying for them privately.
They point out that obesity rates are highest in areas of social deprivation.
“The people who probably stand to benefit the most, who are from the less affluent and more disadvantaged communities, are simply not able to afford the drug. It’s not fair. It’s just a reality of the economics of the situation. is.”
But Professor Sattar told me that rising levels of obesity could eventually “bankrupt” the NHS.
With smoking levels continuing to decline, they now see overweight and obesity as “a major driver, bar none, of many long-term health conditions.”
Both he and Professor McGowan believe weight-loss jobs have an important role to play and could ultimately bring some vast savings.
Professor McGowan says Ray is a good example: “We treat many complications associated with obesity. Ray has pre-diabetes. We are hoping to go into remission and therefore from this progressive disease. Prevent all complications related.
“It may require joint surgery but achieving weight loss can prevent many complications and ultimately save the NHS a lot of money.”
Professor Sattar says 20 weight-loss drugs could be on the market within 10 years, some of them in pill form. As more effective and cheaper drugs become available, they could generate savings for the NHS, he says.
The UK government also thinks weight-loss drugs could eventually have wider economic benefits.
The five-year trial in Manchester will look at Mounjaro’s wider effects beyond individual health benefits, including whether it helps some people struggling with obesity return to work.
Medicines are no magic bullet for obesity, but after decades of expanding waistlines, they offer hope to millions.
For now, though, the health service doesn’t have the resources to treat all those who qualify. This means – for years to come – only a minority like Ray will have access to the NHS. The rest will have to pay – or go without.
