Weight-loss medications should not be viewed as short-term fixes by the NHS, say researchers. As these drugs become more widely available, general practitioners (GPs) will need to take a greater role in managing obesity.
A team from the University of Oxford highlighted that while these medicines are very effective at helping patients lose weight, their findings also offer a cautionary message about how the drugs should be used.
Their analysis of clinical trials involving GLP-1 receptor agonists (GLP-1RAs) showed that drugs like semaglutide and tirzepatide caused an average weight loss of 16 kilograms. However, when patients stopped taking the medications, they regained the lost weight within about 1.7 years.
At the European Congress on Obesity, the researchers stressed that the NHS must carefully plan how to use these drugs to get the best results.
Current guidance from NICE (the National Institute for Health and Care Excellence) recommends semaglutide be used for no longer than two years. For tirzepatide, there is no specified limit yet. NICE is reviewing real-world data on how these drugs perform in the NHS.
The study’s conclusion was clear: “Stopping GLP-1RA treatments leads to a return to original weight within two years. This happens faster than after behavioral weight management programs. This suggests these drugs should not be used alone but as part of a broader obesity treatment plan.”
Professor Susan Jebb, lead author and expert in diet and population health at Oxford, told Pulse that these results are not surprising. People often regain weight regardless of the method they use to lose it.
She said GPs will have to become more involved in managing obesity as these medicines become more common.
Currently, an estimated 1.5 million people in the UK are already using weight-loss drugs, mostly via online sources.
NHS England plans a phased rollout starting in June. GPs will first be able to prescribe tirzepatide (brand name Mounjaro) to patients with a body mass index (BMI) of 40 or above who also have four or more serious health conditions like diabetes or high blood pressure.
NICE agreed with NHS England that giving the drugs to everyone eligible at once would overwhelm GPs.
Professor Jebb said there will be a need for specialist weight management centers. These hubs would have teams who understand different treatment options and can guide patients to the best path.
“Some patients might use the NHS Path to Remission program, others GLP-1RAs. But there needs to be a coordinator within the Integrated Care Board (ICB) to manage this process. It cannot be left to individual doctors to decide on their own,” she said.
She added the NHS must accept these treatments will likely be long-term. People buying weight-loss drugs privately should also understand they need to commit for the long haul.
“The cost for the NHS is significant. We must carefully decide who should receive these drugs. It’s important to provide the right treatment for each patient and to do so cost-effectively,” she explained.
Professor Jebb praised the NHS Path to Remission program—also known as the Soups and Shakes diet—as effective and cost-efficient, though she acknowledged not all patients prefer this method.
For those with the most severe obesity, bariatric surgery might be more cost-effective over time, she added.
She warned against using medications as the first and only treatment for everyone.
“The amount of weight people regain after stopping the drugs is quite astonishing,” she said, although more data is needed.
“We need to be honest about this. These drugs are not an easy fix,” Professor Jebb stressed.
One possible approach could be using the drugs intermittently, with patients taking breaks and then restarting as needed.
“In research, clinical practice, and healthcare planning, we must figure out how to support people in the long term,” she said.
Recently, a think tank proposed speeding up the rollout of weight-loss drugs in England. Their idea is to reach millions of working-age adults by working with existing private providers and using a ‘digital first’ approach.
