Now one in four adults in the UK is obese.
Wegovy can help people lose around 15% of their starting body weight before the benefits plateau.
Despite constantly being labelled a “skinny drug” this could take someone weighing 20 stone down to 17 stone. Medically, that would improve health in areas like heart attack risk, sleep apnoea and type 2 diabetes.
But Dr Margaret McCartney, a GP in Glasgow, cautions: “If we keep putting people into an obesogenic environment, we’re just going to increase need for these drugs forever.”
At the moment the NHS is planning to prescribe the drugs only for two years because of the cost. Evidence shows, external that when the injections stop, the appetite comes back and the weight goes back on.
“My big concern is the eye is taken off the ball with stopping people getting overweight in the first place,” says Dr McCartney.
We know the obesogenic environment starts early. One in five, external children is already overweight or obese by the time they start school.
And we know that it hits poorer communities (in which 36% of adults, external in England are obese) harder than wealthier ones (where the figure is 20%), in part due to the lack of availability of cheap, healthy food in those less affluent districts.
But there is often a tension between improving public health and civil liberties. You can drive, but you have to wear a seatbelt; you can smoke, but with very high taxes alongside restrictions on age and where you can do it.
So here are some further things for you to consider. Do you think we should also tackle the obesogenic environment or just treat people when it’s starting to damage their health? Should government be far tougher on the food industry, transforming what we can buy and eat?
Should we be encouraged to go Japanese (a rich country with low obesity) and have smaller meals based around rice, vegetables and fish? Or should we cap the calories in ready meals and chocolate bars?
What about sugar or junk-food taxes? What about wider bans on where calorie-dense foods can be sold or advertised?
Prof Yeo says if we want change then “we’re going to have to compromise somewhere, we’re going to have to lose some liberties” but “I don’t think we’ve come to a decision within society, I don’t think we’ve debated it”.
In England, there have been official obesity strategies – 14 of them across three decades, external and with very little to show for it.
They included five-a-day campaigns to promote eating fruit and veg, food labelling to highlight calorie content, restrictions on advertising unhealthy food to children and voluntary agreements with manufacturers to reformulate foods.
But although there are tentative signs that child obesity in England may be starting to fall, none of these measures have sufficiently altered the national diet to turn the tide on obesity overall.
There is one school of thought that weight-loss drugs may even be the event that triggers the change in our meals.
“Food companies profit, that’s what they want – the only ray of hope I have is if weight-loss drugs help a lot of people resist buying fast foods, can that start the partial reversal of the food environment?” asks Prof Naveed Sattar from the University of Glasgow.
As weight-loss drugs become far more available, deciding how they will be used and how that fits into our wider approach to obesity will need to be addressed soon.
At the moment we are only dipping our toes in the water. There is limited supply of these drugs and because of their huge expense, they are available on the NHS to relatively few people and for a short time.
That is expected to change dramatically over the next decade. New drugs, such as tirzepatide, are on the way and the pharmaceutical companies will lose their legal protections – patents – meaning other companies can make their own, cheaper versions.
In the early days of blood-pressure-lowering medicines or statins to reduce cholesterol, they were expensive and given to the few who would benefit the most. Now around eight million people in the UK are taking each of those drugs.
