The Irish Examiner is reporting on the complex and evolving landscape of weight management in Ireland, with a particular focus on the rising use of GLP-1 agonist drugs, such as Wegovy and Mounjaro, that mimic natural hormones to promote a feeling of fullness and aid weight loss. These medications are currently under assessment for reimbursement by Irish State health schemes, amid growing concern over obesity, which affects over one million people in Ireland.
The discussion comes at a time when societal attitudes towards body image are shifting, with the "body positivity" movement seemingly challenged by the resurgence of very thin models on catwalks and the mass adoption of weight-suppressant drugs. The article highlights the pervasive stigma associated with being overweight or obese, especially for women, and the psychological and social pressures that drive many to seek pharmaceutical solutions.
Ireland is at a crossroads in deciding how to allocate health resources for obesity management. Professor Michael Barry, clinical director of The National Centre for Pharmacoeconomics, posed a critical question at a recent Irish Medical Organisation (IMO) conference about whether funding for these drugs should be extended to all individuals who might benefit or limited to specific subgroups. With the state's medicines bill potentially doubling if these drugs are widely funded, the financial implications are profound. There is also concern about which other areas of healthcare might see reduced investment as a result.
The article draws attention to the complexities underlying obesity, including genetic, neurological, socioeconomic, and cultural factors. It points to a "broken food culture," exacerbated by aggressive marketing of ultra-processed foods (UPFs) by multinational companies, which has contributed significantly to global increases in obesity and related diseases such as diabetes. Recent global data indicates that rates of overweight and obesity have risen across all nations since 1990, with childhood obesity rates tripling in that period.
Side effects of these new weight-loss drugs are still being studied. Initial reports suggest side effects such as vomiting, diarrhoea, constipation, hair loss, and the loss of lean body tissue like muscle and bone. Some cases of pancreatitis have also been reported, especially where the drugs have been misused. Legal actions in the United States over adverse effects are ongoing, raising questions about liability among manufacturers and healthcare providers.
Policy responses differ internationally. Earlier in June 2024, the U.S. Trump administration announced that Medicare and Medicaid will not cover anti-obesity drugs, reversing plans of the Biden administration. Health Secretary Robert F Kennedy has publicly criticised the drugs, an unusual alignment given the political context.
In Ireland, public health officials advocate for a more balanced approach that includes prevention as well as treatment. The article critiques inconsistent government messaging regarding ultra-processed foods in schools, noting that while some officials have pledged to remove unhealthy foods from school meals, broader measures to regulate the marketing and availability of UPFs remain limited.
The piece raises provocative questions about potential preventative measures, such as banning the sale of sugary drinks and sweets to children, experiences with which in other countries have shown to be politically controversial and difficult to enforce. Sugar-laden soft drinks remain hugely popular, with a 12-ounce can of Coca-Cola containing 39 grams of sugar, equating to 10 teaspoons.
Ultimately, while acknowledging the medical advancements represented by GLP-1 agonist drugs, the article stresses that they should be part of a comprehensive strategy focused largely on tackling the root causes of obesity through public health measures and regulation of the food environment, especially for children. The prevention of obesity and associated chronic diseases remains a pressing challenge with significant long-term implications for Irish society and healthcare systems.
Source: Noah Wire Services