The decision to prescribe a weight loss jab to prevent heart attacks and strokes has been hailed by experts as a “major turning point in the battle against obesity”.
Wegovy can now be prescribed for weight loss or to help reduce the risk of major cardiovascular events.
Academics said that the decision will help reduce the risk of disease, and has the potential to reduce health inequalities, as they urged the local health body to ensure that there is no postcode lottery in care when the drug is rolled out in the summer.
But they also urged prescribers to ensure the benefits were “balanced against the risk of side effects”, pointing out that GLP-1 receptor agonist drugs can reduce muscle and fat mass.
As a result, people taking it must also engage in physical activity such as resistance training, which may not be feasible in frail patients, experts say.
It comes as the NHS spending watchdog, the National Institute for Health and Care Excellence (Nice), has given the green light to give semaglutide to overweight and obese patients living with certain heart and circulatory conditions to reduce the risk of major cardiovascular events.
Commenting on the news, Naveed Sattar, professor of cardiometabolic medicine at the University of Glasgow, said: “We now have drugs that not only reduce heart attacks, strokes, and peripheral artery disease, but also lead to significant weight loss – which in turn lowers the risk of many weight-related conditions.
“This treatment also improves the patient’s quality of life in a meaningful way, making this a real win-win.
“Given that many people living with cardiovascular disease also struggle with being overweight, it is not enough to focus on lipids and blood pressure.
“We also need to address weight directly if we want to deliver the best possible outcomes for our patients.
“This new guidance on semaglutide makes that possible, and represents another major turning point in the fight against obesity.
Robert Storey, professor of cardiology at the University of Sheffield, said: “The prescription of semaglutide needs to be appropriately targeted since the drug GLP-1 can reduce muscle mass as well as fat so physical activity, such as resistance training, is important to counteract the potential negative effects on muscle strength, which may not be feasible in frail people.
“The benefits must also be balanced against the risk of side effects.
“These issues and the need to train people to inject drugs as well as ongoing monitoring and prescribing require the allocation of NHS resources to ensure the benefits of this Nice guidance can be fully realised.”
Riyaz Patel, professor of cardiology at UCL, said health leaders needed to address how the drug would be delivered and the capacity in the health system to do so, adding: “We know, for example, that more useful drugs such as inclisiran, to lower cholesterol have been delivered variably leading to a significant postcode lottery.
“ICBs (integrated care boards) should make sure this does not happen with this nice TA (appraisal technology), otherwise we risk exacerbating health inequality, if anything, this should be a powerful tool to reduce health inequality.
“Overall, this is a very good development, both for patients and doctors, giving us a powerful tool to reduce the risk of cardiovascular disease.”
Huw Edwards, chief executive of ukactive, said: “This measure is an important step in tackling obesity and reducing the risk of serious cardiovascular disease and highlights the huge role that treatments like semaglutide can play in improving public health.
“But although the impact of GLP-1 treatment can be transformative, it is not a stand-alone solution and evidence shows that without physical activity, especially strength training, patients are at risk of losing muscle mass, which can damage long-term health outcomes.
“To ensure sustainable results for people taking this medication, the treatment should be combined with structured physical activity and greater lifestyle support.”
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