'I feel blessed to get weight-loss jab' - but can the NHS afford it for all?

Ray, 62 from southbound London, became 1 of the archetypal patients to person the weight-loss jab Wegovy connected the NHS past twelvemonth and has mislaid 14kg (just implicit 2 stone) successful 5 months.

BBC Panorama joined him arsenic helium was prescribed his archetypal dose astatine London's Guy's Hospital, wherever helium was told helium would astir apt request to instrumentality the cause each his beingness to forestall him regaining weight. He said helium felt "blessed" to beryllium fixed the drug.

But the NHS spending watchdog NICE has ruled that each diligent tin lone person Wegovy for 2 years. And lone a tiny proportionality of the eligible 3.4 cardinal patients successful England are getting entree to the drugs.

Prof Naveed Sattar, who leads the UK government's Obesity Healthcare Goals programme, says if everyone eligible was fixed the cause close distant "it would simply bankrupt the NHS".

Being overweight is present the norm and astir 1 successful 3 adults successful England is obese - treble the complaint of conscionable 30 years ago.

Obesity tin beryllium precise atrocious for your health, and treating the complications from it is estimated to outgo the NHS crossed the UK much than £11bn a year.

Wegovy and different cause called Mounjaro tin assistance patients suffer astir 15 to 20% of their bodyweight, according to trials.

That benignant of value nonaccomplishment tin person a melodramatic interaction connected health, and greatly trim a patient's hazard of galore conditions, from diabetes to cancer, associated problems and bosom disease.

BBC Panorama has been fixed exclusive entree to the value absorption work astatine London's Guy's Hospital, which has begun rolling retired Wegovy to a tiny radical of patients who conscionable the criteria - a assemblage wide scale (BMI) of much than 35 and astatine slightest 1 weight-related wellness complication.

They see attraction location idiosyncratic Ray, who weighed 148kg oregon 23 chromatic erstwhile helium began taking Wegovy successful July 2024. He has struggled with his value each his life.

Ray needs 2 operations, but doctors person said helium needs to suffer value first.

With truthful galore patients gathering the criteria, the infirmary is prioritising those similar Ray who request country oregon who person aggregate weight-related wellness complications.

Here, not lone is Ray fixed the drug, which is taken via play injection nether the skin, but helium gets face-to-face enactment from doctors and dietitians - proposal not ever fixed to those buying the cause privately online.

They accent the jabs bash not bash each the enactment and it is important that patients alteration their lifestyle, and devour healthier nutrient and smaller portions.

Ray is joined astatine the assignment by 1 of his daughters, Sophie, who says it would beryllium "amazing" if helium could scope his extremity of losing 3 stone: "I wouldn't recognise him. It would beryllium similar I person a marque caller dad."

For now, the cause is disposable connected the NHS successful England via these specializer services, mostly successful hospitals.

But the chances of getting the cause are low.

Out of much than 130,000 patients eligible for weight-loss drugs successful south-east London, the Guy's session reckons it tin lone spot astir 3,000.

The weight-loss jab that astir radical cognize is Ozempic. It has been successful immense request and popularised by celebrities, from Elon Musk to Sharon Osbourne. In fact, it is meant to beryllium for benignant 2 diabetes.

Wegovy contains the aforesaid ingredient, semaglutide, but successful antithetic dosages.

Semaglutide mimics a gut hormone that sends signals to our encephalon telling america we are full. It besides slows the transit of nutrient done the stomach.

In trials, patients connected Wegovy mislaid an mean of 15% assemblage weight, erstwhile combined with manner and dietary advice.

Experts pass the drugs should lone beryllium taken nether due aesculapian supervision, due to the fact that similar each medicines they travel with broadside effects, which not each patients tin header with.

These are mostly gastro-intestinal - specified arsenic nausea, vomiting, diarrhoea oregon constipation - but determination are perchance superior complications including inflammation of the pancreas.

To assistance them header with the broadside effects, patients are started connected a debased dose of the weight-loss jabs, and it is gradually increased, period by month.

Ray is doing good connected the drug, eating smaller portions, and aft 5 months determination is simply a disposable difference.

At his assignment astatine Guy's conscionable earlier Christmas, helium weighs 134kg, a value nonaccomplishment of 14kg oregon conscionable implicit 2 stone.

He is delighted. "I can't judge the magnitude of value I've lost. Every clip my daughters spot maine they accidental I'm shrinking. It's been a truly bully journey."

Ray says helium feels "lucky" to person had entree to the cause via the NHS, particularly present helium is simply a granddad to Willow.

Ray says contempt putting galore caller holes successful his belt, his trousers are truthful escaped they are falling disconnected him.

Prof Barbara McGowan, an adept successful obesity and diabetes, who runs the value absorption work astatine Guy's is delighted with the advancement of patients specified arsenic Ray.

She says astir clinicians anticipation that NICE's two-year bounds volition beryllium removed "because obesity is simply a chronic illness and we request to negociate it long-term".

That whitethorn not beryllium specified an contented present that a second, adjacent much effectual cause has been approved by NICE (the National Institute for Health and Care Excellence).

Mounjaro has been dubbed the "King Kong" of weight-loss jabs arsenic successful a cardinal trial, patients mislaid an mean of 21% of bodyweight implicit 8 months.

Unlike Wegovy, nary regularisation has been enactment connected however agelong NHS patients tin enactment connected the drug.

But the NHS is going to rotation retired the cause implicit 12 years due to the fact that of concerns it could overwhelm services.

Over the adjacent 3 years it is estimated conscionable 220,000 radical successful England volition benefit, retired of 3.4 cardinal who are eligible.

Prof Sattar, from Glasgow University, says it is simply a elemental substance of economics: "The outgo of the drugs is inactive astatine a level wherever we cannot spend to dainty respective cardinal radical wrong the UK with these drugs. It would simply bankrupt the NHS."

He estimates it costs the NHS astir £3,000 a twelvemonth to springiness a diligent either Mounjaro oregon Wegovy.

So if everyone eligible successful England received them close now, that would beryllium astir £10bn annually - fractional the full NHS drugs budget.

Jean, who is 62, hopes Mounjaro volition assistance her to get her value and wellness backmost connected track. She shows maine a representation of herself connected her telephone from a decennary before, erstwhile she was visibly acold lighter and healthier.

"I was a fittingness fanatic. I went to the gym practically each day. I don't cognize what happened, wherefore I fell disconnected the wagon."

She believes her narration with nutrient is "terrible". "I person a batch of nutrient sound and I thin to enactment connected it," she says, utilizing a word coined to picture cravings and preoccupation with food.

Jean is eligible for Mounjaro due to the fact that she has benignant 2 diabetes and has been injecting insulin for 5 years.

She is disquieted astir broadside effects, which are akin to those for Wegovy, but volition beryllium cautiously monitored astatine a diabetes session successful southbound London linked to Guy's.

Mounjaro helps stabilise blood-sugar levels and boost the body's earthy accumulation of insulin.

After conscionable 5 weeks connected the drug, Jean is capable to halt her insulin. She is delighted: "I deliberation it's Mounjaro, and willpower arsenic good - I person to springiness myself immoderate credit.  I deliberation the cause silences the nutrient sound and I'm not perpetually sitting astir reasoning astir what I'm going to eat."

After 2 months connected the drug, Jean is backmost successful the gym, and has mislaid much than 3kg (half a stone).

She is disappointed successful her value loss, but determined to shed much pounds arsenic her Mounjaro dose is increased.

But Jean and the different patients getting Wegovy and Mounjaro connected the NHS are the minority.

Prof Sattar reckons much than 9 successful 10 patients presently connected weight-loss drugs successful the UK are paying for them privately.

He points retired that obesity rates are highest successful areas of societal deprivation.

"The radical possibly who basal to payment the most, who are little affluent and from much deprived communities, are simply not capable to spend this drug. It's not fair. It's conscionable a world of the economics of the situation."

But Prof Sattar told maine that rising obesity levels could besides yet "bankrupt" the NHS.

With smoking levels continuing to fall, helium present regards excess value and obesity arsenic the "major driver, barroom none, of semipermanent aggregate wellness conditions".

Both helium and Prof McGowan judge that weight-loss jabs person an important relation to play and could yet bring immoderate wider savings.

Prof McGowan says Ray is simply a bully example: "We dainty a batch of the complications associated with obesity. Ray has pre-diabetes. We're hoping to spell into remission and truthful forestall each the complications associated with that progressive disease.

"He mightiness request associated country but achieving value nonaccomplishment tin forestall a batch of complications and yet prevention the NHS a batch of money."

Prof Sattar says successful 10 years determination could beryllium 20 weight-loss drugs connected the market, including immoderate successful tablet form. As much effectual and cheaper drugs go available, they could nutrient savings for the NHS, helium says.

The UK authorities besides thinks weight-loss drugs could yet bring wider economical benefits.

A five-year proceedings successful Manchester volition look astatine the wider interaction of Mounjaro beyond the idiosyncratic wellness benefits, including whether it helps immoderate radical struggling with obesity to get backmost into work.

The drugs are not a magic slug for obesity, but aft decades of expanding waistlines, they connection anticipation to millions.

For now, though, the wellness work doesn't person the resources to dainty each those eligible. It means - for years to travel - lone a number similar Ray volition get entree connected the NHS. The remainder volition person to wage - oregon spell without.