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Sensemaker: Weighing up Wegovy 

Sensemaker: Weighing up Wegovy 

What just happened

Long stories short

  • At least seven people were killed in a shooting at a Jehovah’s Witness centre in Hamburg, Germany.
  • Xi Jinping formally secured an unprecedented third term as China’s president. 
  • Japanese police arrested three people for “sushi terrorism” over unhygienic pranks at sushi conveyor belt restaurants.

Weighing up Wegovy 

A weight-loss drug used by celebrities including Elon Musk will soon be available to thousands of people through the NHS. Semaglutide, also called Wegovy, was recommended this week by the UK’s health cost-effectiveness watchdog.

So what? As an effective weight loss drug, Wegovy could have significant public health benefits. More than a quarter of adults in England are obese and severe chronic health issues like heart disease and diabetes are associated with obesity. But it is a treatment, not a cure – and effective drugs don’t replace the need for preventative policies.

The buzz is somewhat justified. Historically, obesity treatments have been at best modestly effective and at worst had dangerous side effects. Wegovy is helping people shift meaningful amounts of weight – up to 15 per cent in just over a year in a key clinical trial – and seems to be safe. The UK’s National Institute for Health and Care Excellence (Nice) says it will be available in England “soon”. 

Wegovy went on sale in the US two years ago and its manufacturer Novo Nordisk says sales were up 300 per cent last year despite supply issues. WeightWatchers, better known for meal plans and weigh-ins, has also jumped into the prescription business. They purchased Sequence, a US-based telehealth platform that allows users to access diabetes and obesity drugs – including Wegovy. 

How does it work? Wegovy imitates a naturally-occurring hormone called GLP-1 which suppresses appetite. In other words, patients lose weight by eating less. GLP-1 drugs also help to regulate insulin production and are already used to treat type two diabetes. 

It is taken once a week using an injection pen and common side effects include nausea, diarrhoea, constipation and vomiting. A study in the New England Journal of Medicine found that, for most, the side effects are “mild-to-moderate”. In England, Wegovy will be offered for a maximum of two years through a specialist NHS weight loss service to people

  • with at least one weight-related condition, such as heart disease;
  • who have a body mass index of 35, indicating obesity; and
  • alongside a reduced-calorie diet and increased physical activity.

The hype, led by rumours of “Ozempic parties” in Hollywood and on TikTok, has already resulted in shortages of the drug for diabetes patients. Semaglutide is also the active ingredient in Ozempic – GPs were told last October to prescribe alternative diabetic treatments because of the risk of shortages. 

Not a long-term fix. There is no longer-term data on the effects of Wegovy. Participants in a recent trial funded by Novo Nordisk were monitored after coming off the drug; they all regained around two-thirds of the lost weight over the next year. Reductions in cholesterol levels and blood pressure also returned to pre-trial levels.

“All of this demonstrates the need to be cautious with these types of drugs,” says Simon Cork, a physiology lecturer at Anglia Ruskin University. “Weight loss is difficult, and a single ‘miracle drug’ is unlikely to undo the many physiological changes that are associated with obesity and weight loss.”

Slimming down Britain. Obesity costs the NHS £6 billion annually, expected to rise to £9.7 billion by 2050. It is also tangled up with other social issues: the prevalence of obesity or being overweight in deprived parts of England is nine per cent higher than in the least deprived. 

NHS England has not disclosed the price it is paying for Wegovy, but with tens of thousands of eligible patients, the bill will be significant. Nice is betting that the cost of the drug will be offset over time. 

Another option to consider: food industry regulation. It’s proven to be effective – a series of voluntary salt reduction targets by the Food Standards Agency during the 2000s reduced average blood pressure and is thought to have saved £1.5 billion annually. New drugs will help, but tackling the amount of sugar and fat in our food could prove a cheaper and more lasting way to combat obesity. 


Biden’s budget
Joe Biden unveiled a $6.9 trillion budget proposal in Philadelphia yesterday. It would shrink America’s deficit by $3 trillion over the next decade, aided by $5.5 trillion in tax increases on high earners, billionaires and companies that would also fund policies like more healthcare investment. But it has no chance of passing. Republicans, who control the House, want reduce spending: GOP leaders have said they want $150 billion in cuts while Biden’s budget instead wants to add $77 billion across defence and non-defence spending, according to Bloomberg. File under: a starting point in negotiations ahead of a looming battle over the debt ceiling, the legal cap on government borrowing that expires in July.  


Netherlands joins chip war
The Netherlands will restrict exports of their most advanced microchip technology after pressure from America, with the intention of blocking Chinese access. An agreement was struck between the US and Netherlands in January – in a deal that also included Japan – but it’s taken until now for the Dutch to set out exactly what the restrictions involve. Liesje Schreinemacher, the foreign trade minister, said the move was necessary on “national and international security grounds”. Translation: we don’t want our chips to be used for military applications. The Netherlands is home to ASML, a world leader in making microchip machines, and wants to retain its place as a global leader in semiconductor technology – while also staying in America’s good books as tensions run high with Beijing. China has launched a formal complaint against the Dutch restrictions.  

The 100-year life health, education AND GOVERNMENT

Heroin islands
The Seychelles has the highest per capita consumption of heroin in the world. Wavel Ramkalawan, the country’s president, describes the drug situation as “very bad” in the east African island nation. How did a country with Africa’s highest GDP per capita and renowned for its five-star resorts end up with such a significant heroin problem? BBC Africa Eye has investigated the epidemic in a 45-minute documentary. It found some geographical inevitability at play, as the islands are easily accessed by boat and are located along established heroin trafficking routes from Afghanistan and Iran to east Africa and Europe. But Ramkalawan says the real issue was a group of incarcerated Iranian drug traffickers who set up a network on the islands. Although methadone is available free to anyone who registers, it’s unlikely to stick as a way to detox without residential rehab centres – which the country doesn’t currently have. 

Our planet CLIMATE AND geopolitics

Crime and prosecution
Last December, the US Congress relaxed legal restrictions to allow America to assist the International Criminal Court (ICC) with its investigations linked to the war in Ukraine. But so far, it hasn’t. The Pentagon is reportedly blocking the Biden administration from sharing evidence of Russian atrocities, including evidence that attacks on civilian infrastructure, like the missile bombardment this week, are deliberate as well as information about the abduction of thousands of Ukrainian children to Russia. The NYT reports that US defence officials want to avoid setting a precedent which could lead to the ICC later prosecuting Americans. Karim Khan, ICC chief prosecutor, launched an investigation after Russia’s invasion last year. Kamala Harris, the vice president, declared last month that Russia has committed crimes against humanity in Ukraine. 


The jury’s back
Rishi Sunak heads to Paris today with a host of his cabinet ministers for the first UK-France summit in five years. Both sides want to move on from the “jury’s out” days of Liz Truss when asked if France was friend or foe – Sunak and France’s Emmanuel Macron will discuss unity on Ukraine as well as defence and nuclear cooperation in a one-on-one meeting before a joint press conference. But first, they must navigate small boats. The Times reports that Sunak will offer France annual payments for at least three years to invest in police and security and disrupt small boats being launched off the French coast, totalling at least £75 million in the first year. Don’t mention: the UK government has given France over £232 million in successive deals since 2014 – and small boat numbers have continued to rise.

And finally… This week is not the first time Gary Lineker has controversially sprung to the defence of refugees. Read Martin Samuel’s 2019 essay from the Tortoise Quarterly. 

Thanks for reading. Please tell your friends to sign up, send us ideas and let us know what you think. Email sensemaker@tortoisemedia.com.

Denise Roland

Additional reporting by Jess Winch, Nina Kuryata and Phoebe Davis

Photographs Getty Images

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