Additional Information for health care professionals can be found in Professionals section >Clinical Trials and Treatments.
Anti-Obesity Medications (AOM)
Thanks to a substantial amount of research by teams around the world, several new anti-obesity medications (AOM) have been developed. These medications are transforming the treatment of people with obesity for whom options have been limited in the past.
How do these AOMs work?
The new medications boost the effects of a natural hormone called GLP-1, which is released by the body after meals and affects hunger, fullness and blood sugar levels. The medications are called GLP-1 receptor analogues or agonists.
Known side effects include nausea, vomiting, diarrhoea and abdominal pain. These side effects are mild in most people and usually ease on their own. To limit side effects, doctors usually increase the dose of medication slowly.
These medications have been extensively tested in clinical trials, where on average people lost 10-20% of their starting weight over a year.
Two medications currently available in the UK are:
Liraglutide (Saxenda) - A daily injection under the skin using a pen device.
Semaglutide (Ozempic-people with type 2 diabetes, or Wegovy-people with obesity) - A weekly injection under the skin using a pen device.
New medicines, some of which boost two or even three hormones that affect weight, are expected to become available in the near future.
Who can get these treatments?
In the UK, decisions about who can receive treatment in the NHS are made by a panel of experts (called National Institute for Health and Clinical Excellence, NICE) who look at the benefit, the costs and the safety information that’s available from trials.
NICE recommends that adults (over 18 years) who have a Body Mass Index (BMI) more than 35 kg/m2 with at least one weight-related health condition (e.g. high blood pressure, diabetes or arthritis) can receive Semaglutide. People from some ethnic minority family backgrounds may be treated at a different BMI level if they have an increased risk of type 2 diabetes.
These medications have mostly been given to people who have obesity without an underlying known genetic problem. In our experience, they also work well when given to people with ‘genetic obesity’ (i.e. obesity caused by a faulty gene) including people with MC4R deficiency.
How do I get treatment?
Patients need to be referred by a Doctor to a specialist obesity clinic to have these medications prescribed on the NHS. As the medications were tested in people who were also given advice about following a reduced-calorie diet and increasing their physical activity, NICE recommends that specialist obesity clinics should provide this advice alongside starting treatment.
Unfortunately, waiting lists for NHS specialist obesity clinics are currently long. Some government and local initiatives are testing whether patients can receive treatment from their GPs but this is not available in most towns. Some AOM are available through private clinics where a healthcare professional qualified to prescribe medicines can provide a prescription which can then be prepared by a local pharmacy. There were supply issues with both medications in the UK but this situation is improving, particularly for Wegovy.
Patients should take great care obtaining medication through the internet as fake medication and fake pen devices are being sold. Buying prescription-only medicines online without a prescription poses a direct danger to health.
How can I get involved in clinical trials of new medications?
Several new AOM are currently in clinical trials. Initially they will be tested in adults and if effective, they are likely to be trialled in adolescents and children.
New medications are first tested in clinical trials under very strict supervision to ensure that they are both effective and safe. Usually, patients are randomly given either the new medication or another medication that looks exactly the same but has no effect, called a ‘placebo’. This helps us learn how well a new medication works and how safe it is. If a medication passes all these checks, it can be considered (or licensed) by NICE.
All new medications must go through these very strict checks before they can be given the green-light for doctors to prescribe for patients in the NHS.
NIHR Be Part Of Research Website
The ‘Be Part of Research’ website (https://bepartofresearch.nihr.ac.uk/), hosted by the NIHR (National Institute of Health and Care Research), provides an up-to-date list of all of the clinical trials running in the UK. This is a great place to find clinical trials (for both anti-obesity medications and other interventions) or observational studies that could be interesting and relevant to you.
When on the website you can select an area of interest (i.e. ‘obesity’ or ‘over weight’) and you will be provided with a list of trials related to that area of interest. You can narrow your search by geographical area, age range and gender and be sure to tick ‘recruiting’ to get only those studies that are currently open.
To find out more information about a particular trial just click on the title and you can see information about the study, including a study summary, participant requirements, locations around the UK and contact details.