Emily Stearn, health reporter for Mailonline
12:14 p.m. June 4, 2024, updated 7:26 p.m. June 4, 2024
The ‘King Kong’ of slimming injections is to be made available on the NHS, health chiefs announced today.
According to current guidelines, only those with type 2 diabetes who do not have the condition under control are eligible for Munjaro through the health service.
But draft guidance from the UK’s drugs watchdog has now recommended its use be extended to weight loss in those who are severely obese.
It comes only a year later The National Institute for Health and Care Excellence (Nice) said it needed “more evidence” before giving the drug the green light for NHS use for weight loss.
The move shocked diabetes and obesity specialists at the time, who agreed that the treatment, given in weekly self-injections, was highly effective.
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Mounjaro, the brand name of the drug tirsepatide, has already been labeled a weight loss treatment by US health chiefs.
It was also made available privately in Britain in February, with clinics charging around £40 for a week’s supply.
A drug made by US pharmaceutical giant Eli Lilly could help obese people lose more than 20 percent of their body weight in less than a year and a half, studies have found.
According to the draft guidelines, Nice recommended that anyone with a BMI of at least 35 and one weight-related comorbidity should be eligible for the drug.
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Eli Lilly proposed that it be available to anyone with a BMI of 30 or higher and at least one weight comorbidity.
But the “cost-effectiveness estimates” were “above the range that Nice considers an acceptable use of NHS resources”, the watchdog added.
Mounjaro would provide an alternative to Wego – or semaglutide – which was also in short supply due to huge demand.
Tirzepatide works by suppressing two appetite-regulating hormones, making people feel fuller for longer while also having less appetite.
The jab should come in a four-dose pen that provides a month’s worth of treatment when used once a week, Nice said.
It was previously only available in individual doses.
Patients in the US are already able to get an “unapproved” weight loss intervention from some doctors, with many sharing their incredible transformation.
One overweight man claimed the drug helped him lose up to 100 pounds (45.4 kg).
Before and after pictures show the transformation of Matthew Barlow, a 48-year-old health technology executive living in California.
He started using the drug last November. At the same time, according to the recommendations, he also changed his diet and lifestyle.
“Psychologically, you don’t want to eat.” Now I can eat two bites of dessert and be satisfied,” he said.
Meanwhile, one TikTok user named Emily claimed to have lost 140 pounds (63.5 kg) since getting scared of weight loss injections.
“The incredible amount of joy I have when I look in the mirror right now is crazy,” she said. “I cried at myself in the mirror. Now I feel like one of the best kids.”
Professor Sir Stephen O’Rahilly, Director of the Metabolic Diseases Unit at the University of Cambridge, said today: “Given the very positive recent results of large, randomized control trials with this drug and its beneficial effect on a range of outcomes, this decision is not surprising.
“We are clearly in a new era of obesity management, where for the first time we can have access to drugs that are effective and, if not without some side effects, largely safe.
“This class of injectable drugs is currently expensive and presents particular challenges for a taxpayer-funded healthcare system such as the NHS.
“In the long term, these drugs significantly reduce the risk of stressful and costly complications such as type 2 diabetes, heart attacks and kidney failure, but their cost represents an immediate financial challenge at a time when NHS budgets are tight.”
He added: “The genie is out of the bottle here. Safe and effective medical treatment of obesity is not going away.
“We must continue to work to make our environment less conducive to obesity. But that will require political will and time.”
Meanwhile, Professor Naveed Sattar, an honorary consultant and expert in cardiometabolic medicine at the University of Glasgow, said the updated Nice guidelines were “pragmatic”.
He added: “I think this guideline seems pragmatic given that we have to start somewhere and that for the time being we are helping people at greater risk of developing other obesity-related co-morbidities more quickly, even if many others at risk will initially be turned away.”
“As drug costs decrease and more evidence of additional benefits emerges, BMI thresholds for treatment will decrease.
“However, with so many people already living with a BMI above 35, there will be a significant amount of work on the NHS to treat and care for this group of individuals.”
But like all drugs, Mounjaro is not without side effects.
The MHRA warned that the drug could affect how well the contraceptive pill works in obese or overweight patients.
Other potential side effects include nausea, diarrhea, vomiting – which usually subsides over time – and constipation.
Low blood sugar is also “very common” in patients with diabetes, the agency added.
One study of 900 participants also found that a fifth suffered from nausea and diarrhea, and about one in ten reported vomiting or constipation.
Other people taking the drug outside of clinical trials have reported hair loss while taking Mounjaro.
A link to an increased risk of cancer from stings has also been suggested.
The European Medicines Agency said this year that research in rodents suggested that the artificial hormones in tirzepatide could increase the risk of medullary thyroid cancer.