We cannot treat our way out of the obesity crisis, England’s top doctor warns

Weight loss jabs are not a “holy grail” and will not solve the obesity crisis on their own, England’s top doctor has said.

Professor Sir Stephen Powis said the nation “cannot treat its way out of the obesity crisis”.

The NHS England’s national medical director also cautioned over the “over medicalisation” of children when asked about the prospect of the jabs being made available to young people.

“I personally wouldn’t want to medicalise children or young people, but that’s not to say that they might not have a role in some instances,” he said.

In a speech about the prevention of ill health at The King’s Fund, Sir Stephen said that new weight-loss jabs will play an “important part” but “are not on their own going to be the solution”.

Sir Stephen said managing obesity “is not just about pills” and also includes healthy lifestyles including eating properly and getting enough exercise.

He said: “I have no doubt that those drugs will be a revolutionary part of the approach that we need to tackle obesity.

“In the months and years that come, they are going to be a very welcome addition to the everyday treatment options that we have available within the NHS to manage obesity.

“These drugs are part of the approach to weight management, but they are not going to be the sole approach … they are not on their own going to be the solution.

“So, they will absolutely have a place and that is why we are intent on ensuring that we roll them out, and roll them out to those who will benefit from them the most to start with.”

Speaking to journalists, Sir Stephen added: “These new treatments will be transformative on the NHS, but we must also recognise as a country that we cannot simply treat our way out of the obesity crisis – we know far wider action is needed on prevention across society, to help stem it at source and stop so many lives being cut short.”

He continued: “There is very rarely anything in medicine that is completely a holy grail, and as in other areas of medicine it’s a combination of approaches that is required, and it’s a combination of approaches that are required to manage obesity.

“What we now have is some pharmaceutical options that we didn’t have previously. Clearly, that’s a good thing, but on their own they are not the holy grail.”

Sir Stephen said: “A healthy lifestyle is part of what we will always suggest to patients, whether it’s physical activity, whether it’s eating healthily.

“So, that is part of our weight management programmes and is also part of the individual conversations that clinicians will have with patients.

“That really illustrates that managing weight and obesity is not just about pills – it’s around healthy lifestyles: it’s about eating properly, it’s about physical activity, it’s about a whole range of things, and it should be about all of those things and not just one of those.”

On the use of weight-loss jabs in children, he added: “I think all healthcare professionals would not want to reach to medication first for children if [they] can help it.

“So, I think in children, as in adults, there will need to be a combination of approaches.

“I think a lot of healthcare professionals would be cautious about over medicalising children and young people, so there’s no doubt that other approaches need to be taken too.”

It comes after leading politicians, including the Prime Minister and Health Secretary, suggested the rollout of the weight loss jabs could help boost both the nation’s health and the economy.

Sir Keir Starmer said that weight-loss jabs could help boost the economy in Britain by getting people “back into work” while Wes Streeting said the medication could have “monumental” benefits.

Asked about the impact of the jabs on worklessness, Sir Stephen said: “Obesity is an important factor in economic inactivity and people’s difficulty getting to work.

“You know, it’s quite right that in our approach to weight management that we are aiming to help individuals and benefit individuals. And getting people into work is one of the ways of doing that.”

On the cost of the drugs, he said: “Of course, cost is always a concern, but there is a benefit to both the health service and an economic benefit as well, so all these things have to be weighed up.

“Clearly, obesity is a problem. It’s become an increasing problem over the last few decades – it is starting to level out a bit in terms of our latest surveys, but there’s clearly more that we need to do, and clearly having another approach, a drug approach, is an important addition.

“But we will need to work out exactly where it fits in the range of approaches and it will not be one thing, it will be a combination of approaches.”

NHS officials have suggested the rollout of Mounjaro, also known as tirzepatide, across England will need to be staggered due to anticipated high levels of demand.

Nearly a quarter of a million people are expected to receive the Mounjaro jab over the next three years, officials have said.

Mounjaro is a glucagon-like peptide-1 (GLP-1) agonist, a family of medications that help manage blood sugar and are used to treat type 2 diabetes and obesity.

These medicines have seen a number of supply issues in recent months.

Figures from the health survey for England show that in 2022 29% of adults in England were obese and 64% were deemed to be overweight or living with obesity.

David Buck, senior fellow at The King’s Fund, said: “Preventing ill health is one of the biggest challenges of our age.

“Prevention is better than cure and that has never been truer than at a time when our health as a population is poor, including high rates of obesity, and many of our problems are preventable.

“Obesity is so widespread – with around six in 10 adults overweight or obese – we simply cannot treat our way out of obesity at population level.

“Tackling obesity does need effective treatments for individuals, but it also needs far more efforts on prevention and bold, cross-government action to make it easier for people to live healthier lives.”