The NHS is about to start doling out ‘the King Kong of weight loss drugs’ to obese patients – the scandal, needless to say, is that not enough people will qualify. The drug, Mounjaro, will be limited to people with a Body Mass Index (BMI) of over 35 and who have at least one medical condition resulting from their excess weight. The National Institute for Health and Care Excellence (NICE) has recommended that 220,000 people be given the drug in the next three years – a small fraction of the 25 per cent of the adult population which is obese.
How dare the NHS be so tight-fisted. It is, of course, a human right to be given drugs to save us from having to eat less. You can’t have fat people (sorry, people living with obesity) being forced to exert their will power and act out of a sense of personal responsibility. When you are cut down by a cruel disease like obesity, which could strike any of us at any time, you need the NHS to be there to help. The same logic, after all, was applied to Pre-Exposure Prophylaxis (PrEP), which the NHS now routinely doles out to patients so that they can carry on having unprotected promiscuous sex (even though it is somewhat less than 100 per cent effective and offers no protection against venereal diseases other than HIV/AIDS). You can’t expect people to change their sexual habits in order to limit their risk of disease.
You can’t have fat people being forced to exert their will power and act out of a sense of personal responsibility
There is a weird dislocation between official attitudes to obesity and to Covid 19. With the latter, we were all ordered to change our behaviour overnight, staying at home under pain of stiff fines. With the former, the fashionable view among many in healthcare is to deny any sense of personal responsibility at all.
There is a stark contrast, too, between attitudes towards obesity and smoking. When the link between smoking and lung cancer was discovered, the government health message was uncompromising: smoking will very likely kill you. We will help you to give up, but if you do develop cancer or some other smoking-related illness you will have no one to blame except yourself. There was no doling out of drugs to try to mitigate the harm, so people could carry on smoking with impunity. The message was extraordinarily successful, with smoking rates falling from over 50 per cent of the adult population in the early 1970s to 11.6 per cent now.
With obesity, official policy merely stokes the problem. On the one hand we have campaign groups pushing for it to be recognised as a disease; on the other we have bans on TV adverts for ‘junk food’; ignoring that what makes you fat is how many calories you consume, not the form they come in. And now we have weight loss drugs, which are about to be handed out on an industrial scale in spite of the serious side effects which are beginning to emerge – including, as revealed in a recent study, the risk of losing lean muscle around the heart.
If these drugs lead to some people losing weight, it may be at the cost of making them sicker in other ways – and certainly at the price of weakening the sense of personal responsibility among people who find it difficult to know when they need to stop eating. If we really wanted to tackle obesity we would take advice from the Japanese, where the obesity rate is just 5 per cent. There, employees are weighed once a year by their employers’ medical staff and if found to be overweight they are put on a weight loss programme where they actually have to make an effort. How much easier it is to fool ourselves into thinking there is a miracle drug which can do the job for us.
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