As an NHS GP, I can now prescribe weight-loss jabs – but a quick fix for obesity is not what we need | Helen Salisbury

A The medicine that takes away your appetite by making you feel that you are full and a bit nausea does not seem very attractive, but it is a price that many people prepare to pay the opportunity to lose weight. Although it is widely available, until this week only doctors in specialized clinics prescribe Tirzepatide (Mounjaro) to treat obesity on NHS and it was almost impossible to introduce their patients into these clinics. People up and down in England are undoubtedly happy In the news Their doctor can now prescribe it.

Any premature celebrations may be, as the medical prescription standards are drawn in the first stage of its presentation tightly so much that a few patients will qualify. You need a BMI (BMI) for more than 40, which corresponds to the weight of 102 kg (16) for a medium height woman or 123 kg (more than 19) for a man. (BMI standard slightly lower if it comes from a high -risk set.)

In order to be eligible, patients must be at risk of complications caused by obesity, but they are already suffering from them. They should have diagnoses existing four out of five specific cases: diabetes 2, high blood pressure, abnormal levels of blood in the blood (dyslipidaemia), obfuscation during obstructive sleep and damage to blood vessels. Individually, all these conditions are somewhat common, and they are more likely if you are obese. However, in our 12500 patients practicing, we set only two of those who meet these standards. Expect inquiries, we have asked our reception staff to tell patients that we will contact them if they are eligible.

In the second stage of starting, expected next summer, the BMI will be reduced, although the list of conditions will remain the same, it seems unlikely that many my patients will qualify. I have some patients who really stumble with severe obesity, with a body mass index for more than 50 years, and I think it will benefit from this medicine, however I cannot prescribe it because they do not have specific diagnoses.

One of the slow reasons for the start imposed by NHS England Fear of overwhelming GP services may be. Six hours of training is recommended before we start describing, patients must be seen monthly and monitoring harmful effects with an increase in the dose, then every six months. With relaxation of standards, the number of qualified patients expands, this will add many additional dates. Along with injection, patients should also have “wrapping care”, which will provide diet and exercise.

We are waiting to hear from our integrated care panel on how to provide it exactly to our patients, but the nutritional advice is important. Many people with obesity suffer from malnutrition because the food they eat is often high in fats, sugar and low essential nutrients. If, in response to the suppression of appetite, they eat much lower than the same low -quality food, they may face major problems with protein deficiency, vitamins and minerals. Dehydration may also be a problem where thirst and hunger are reduced. Rapid weight reduction leads to the loss of bone mass and muscles as well as fats, so exercise is needed to prevent weakness.

Tirzepatide is not cheap: at the maximum dose, it costs 122 pounds for the patient per month, or 1,464 pounds annually. This can be considered a deal if compared to the cost of treating obesity conditions, and we must move in improvements in the quality of life that will bring it to a healthy weight. However, there are great questions to answer the time when people should use weight loss medications, and what happens when they stop.

Almost a global bounce weight after a period of diet, but it appears to be it Even faster After taking drugs like Terzopatid; One study found that patients can expect it Return to her original weight Within less than two years of stopping. This is inevitable, as a lot of a diet learns to change your response to your body’s hunger signals; If you are taking a medicine that eliminates these signals, when your appetite stops and the return of your appetite, you are likely to respond just as you did in the past.

At the population level, I am concerned that by focusing on this pharmaceutical technical reform of our obesity problem, we are heading to the wrong path. More than a quarter The adult population in England suffers from obesityAnd all of them permanently treatment cannot be the answer. If the government is serious about its transformation from treatment from treatment to prevention, we need more bold and more imaginative plans to treat obesity. We need restrictions on the availability of fast fast food in calories and poor food.

Imposing taxes on sugar and fat will be one of the ways to change the nation’s diet, and we must also look at the quality of school meals. In addition to organizing food, we need to buy school playing fields again, provide opportunities to exercise for free, and encourage active transport by making fun importance and safe cycle paths. The current obesity crisis arises from a complex mixture of social and commercial determinants of health, and these are not problems that can be repaired with simple injection.

• Helen Salzbury is GP in Oxford

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