Abstract
SummaryIn the UK, over one‐quarter of the adult population have obesity (body mass index ≥30 kg m−2). This has major implications for patients’ health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints. There is also a lack of belief that specialist weight management services and anti‐obesity medications (AOMs) are a viable alternative to bariatric surgery for long‐term maintenance of weight loss. This article discusses the challenges facing obesity management and explores the reasons for the lack of investment in AOMs in the UK to date. The aim of this article is to identify whether the newer AOMs, such as naltrexone/bupropion and liraglutide 3.0 mg, are likely to perform better in a real‐world setting than current or withdrawn AOMs. In addition, it considers whether the equitable provision of specialist weight management services and future clinical trial design could be improved to help identify those individuals most likely to benefit from AOMs and, thus, improve outcomes for people with obesity in the UK.
Highlights
In 2015, the UK had the highest level of obesity in Western Europe (26.9%), ahead of countries such as France (15.3%), Germany (23.6%) and Spain (16.7%) [1]
Health Service (NHS) Commissioning Board recommended the introduction of multidisciplinary weight management services for people with severe and complex obesity, including for those being considered for bariatric surgery, which include specialist oversight, training in behaviour change techniques and psychological support [8]
This article examines the challenges facing obesity management in the UK, in particular why anti-obesity medications (AOMs) have not been widely accepted in clinical practice. It considers whether the newer AOMs are likely to perform better, and how we can improve current clinical practice and future clinical trial design to identify those individuals most likely to benefit from AOMs and, improve outcomes for people with obesity
Summary
In the UK, over one-quarter of the adult population have obesity (body mass index ≥30 kg m−2). This has major implications for patients’ health and the National Health Service. Despite published studies showing that significant weight loss can be achieved and maintained in primary care, and guidance from the National Institute for Health and Care Excellence, weight management services are inconsistently implemented. This may be due primarily to workload and financial constraints.
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