The government announced this week that an investment from drugs manufacturers Eli Lilly will increase access to new weight loss medications, which has added further speculation as to what the future holds for treating overweight and obesity in this country.
A new report from the Obesity Health Alliance (OHA) published on Wednesday seeks to address some of these questions by laying out a comprehensive review of the evidence, alongside research and policy recommendations.
We have fed into this report with insights and evidence on the issues that people with type 2 diabetes and gestational diabetes encounter when accessing weight management support.
What the OHA report says
Supported by a range of leading healthcare professionals and people with lived experience, the OHA report into overweight and obesity treatment looks across the evidence and current provision of overweight and obesity management services in England for both people with diabetes and more broadly.
The OHA finds that there is a strong evidence base for a range of weight management interventions, including for services like the Diabetes Prevention Programme, but there are currently significant issues that need to be overcome around access and delivery of many of these interventions.
There has been increasing interest in the role of weight loss medications (also used to treat type 2 diabetes) in supporting more people to manage their weight.
The report calls for decisive action from Secretary of State Wes Streeting to use the current public and political interest in weight loss medication to tackle the issues with the entire overweight and obesity management treatment pathway.
Challenges facing weight loss management services
The OHA says that there are a number of challenges that need to be overcome in terms of the stigma experienced by those seeking support, and the inequalities experienced by those who are most likely to be living with overweight and obesity, and how support services need to be tailored to their needs.
This chimes with many of the experiences shared with us from people with type 2 diabetes who have described the profound negative impact that stigma can have on their health. One person with type 2 diabetes shared this with us:
“My T2 diagnosis was given to me by a rheumatologist who said, ‘Oh, I see your diabetes is uncontrolled. Boy, are you going to have a hard life by the time you’re 50. You need to try harder and do better.’”
The report also calls for greater research into better support services for people from different backgrounds (including people from more deprived backgrounds, living with mental illness and women of reproductive age).
Overall, overweight and obesity management services were found to be underfunded, with too often patchy provision, and a lack of joined up care.
In the media we are seeing frequent discussion about the potential role of weight loss medications in treating obesity but these options are subject to the same challenges as the wider range of treatment options. The NHS currently only has capacity to treat a fraction of the people who are eligible for weight loss medications.
News this week that the government is interested in potentially prioritising people for weight loss medications based on supporting people to return to the workforce rather than who is in most need of the treatment for health reasons raises concerns for many.
The OHA has issued several recommendations
As called for in the OHA report, overweight and obesity management services should be available to all who could benefit but where prioritisation must be made, this must be done based on clinical need not the potential economic output of the patient.
The OHA report makes a series of pointed recommendations for stakeholders including government, the Department of Health and Social Care, NHS England, Integrated Care Boards, and healthcare professionals to address challenges across the treatment pathway. We are endorsing these calls.
The report has been backed by over 200 healthcare professionals in a letter to Mr Streeting, calling for urgent actions to be taken to improve the overweight and obesity management treatment pathway.
Colette Marshall, Chief Executive of Diabetes UK, said:
“Weight management support that is both properly funded and accessible would make a massive difference to the long-term health of people at risk of, and living with, type 2 diabetes.
“Many people with diabetes tell us there’s not enough support and they are often shamed and disrespected when trying to access what is available. This report clearly spells out what the government and healthcare system should do.”
