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Obesity: How long should drug treatment last?

BMJ 2023; 382 doi: (Published 01 August 2023) Cite this as: BMJ 2023;382:p1772
  1. Elisabeth Mahase
  1. The BMJ

GLP-1 agonists for obesity are being rationed in the UK, but that hasn’t stopped doctors considering how patients should be treated in the long term. Elisabeth Mahase reports

Injectable appetite suppressant drugs should be considered a lifelong treatment for obesity rather than a two year fix, researchers have argued.

At a briefing at London’s Science Media Centre on the GLP-1 “weight loss drugs” that have made headlines around the world in the past year, speakers said that the UK’s current prescribing limit of two years was based on economics rather than clinical benefit.

“With regards to the two year rule, it’s a cost measure rather than a clinical measure,” said Barbara McGowan, consultant endocrinologist and obesity physician at Guy’s and St Thomas’​ NHS Foundation Trust on 26 July. “We all agree that obesity is a chronic disease. We feel that these medications should not be stopped after two years. You wouldn’t stop a statin, you wouldn’t stop a blood pressure tablet.”

Regaining weight was also a concern when the treatment ended, along with the “psychological issues” that came with that, she added.

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of injectable antidiabetes drugs that work by increasing the secretion of insulin and suppressing appetite. Two are approved on the NHS: liraglutide (marketed as Saxenda) and semaglutide (Wegovy), although semaglutide has yet to be officially launched, because of supply problems.

Guidelines on …

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