The largest and longest study of the obesity drug Wegovy has shown people maintain significant weight loss for at least four years, with fewer serious adverse events than those given placebo ‘dummy’ treatment.
Doctors say the finding will add pressure on UK health authorities, which currently limit treatment to just two years.
Results revealed at an international obesity conference show those given weekly injections of the drug shed pounds for the first 65 weeks of treatment, and then sustained a stable body weight over the longer term.
On average they lost 10.2% of their body weight and 7.7cm from their waist size after four years.
Significantly, even those who were only slightly obese, or who only lost a small amount of weight, still benefited from a reduction in cardiovascular risks, according to results presented at the European Congress on Obesity in Venice and published in the journal Nature Medicine.
Dr Simon Cork, senior lecturer in physiology at Anglia Ruskin University, who wasn’t involved in the study, said the results show for the first time that patients maintain a “weight plateau” if they continue treatment long term.
“Importantly one of the decisions by the UK health service to limit (treatment) to two years was because of questionable long-term cost effectiveness,” he said.
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He added: “That this data demonstrates improved cardiovascular and metabolic parameters continuing to four years may go some way to negating that argument.
“This study also neatly demonstrates that obesity is a lifelong condition and the decision by NICE to limit prescription to two years does a disservice to patients suffering with obesity.”
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Image: A dosage of Wegovy, a drug used for weight loss. Pic: PA
The SELECT (Semaglutide and Cardiovascular Outcomes) trial involved 17,604 adults with obesity or who were overweight from 41 countries. None of them had diabetes, but all had previously had a heart attack, stroke or peripheral artery disease.
Over the first two years of the study, the proportion of people who were obese fell sharply from 71% to 43% in the group given Wegovy.
But in those given placebo injections, the rate dropped only slightly, from 72% to 68%.
After three years of treatment, participants had a 20% lower risk of a heart attack, stroke or dying from cardiovascular disease, according to analysis released last year.
Professor Donna Ryan from Pennington Biomedical Research Centre in New Orleans, USA, who led the study, said the weight loss was seen irrespective of age, gender and ethnicity.
“This degree of weight loss in such a large and diverse population suggests that it may be possible to impact the public health burden of multiple obesity-related illnesses,” she said.
“While our trial focused on cardiovascular events, many other chronic diseases including several types of cancer, osteoarthritis, and anxiety and depression would benefit from effective weight management.”
The study showed that serious adverse events were less common in those given the drug than those given placebo.
That was largely because people taking Wegovy were less likely to have cardiac disorders.
But people taking the drug were more likely to have gallbladder stones, and were more likely to stop taking treatment because of gastrointestinal problems such as nausea and diarrhoea.
A second analysis of the same group of patients, led by UK researchers, showed that cardiovascular benefits were seen even in patients who only had mild obesity or lost only modest amounts of weight.
Professor John Deanfield, from University College London, said the finding had “important” clinical implications.
“Around half of the patients that I see in my cardiovascular practice have levels of weight equivalent to those in the SELECT trial and are likely to derive benefit from taking Semaglutide on top of their usual level of care.
“Our findings show that the magnitude of this treatment effect with semaglutide is independent of the amount of weight lost, suggesting that the drug has other actions which lower cardiovascular risk beyond reducing unhealthy body fat.
“These alternative mechanisms may include positive impacts on blood sugar, blood pressure, or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these.”
However, the researchers warn there isn’t yet evidence that treatment prevents major cardiovascular events.
Semaglutide, the active ingredient of Wegovy, is part of a growing class of GLP-1 drugs that make people feel full, reducing their calorie intake.
You know bad economic news is looming when a Chancellor of the Exchequer tries to get their retaliation in first.
Treasury guidance on Tuesday afternoon that Rachel Reeves has prioritised easing the cost of living had to be seen in the light of inflation figures, published this morning, and widely expected to rise above 4% for the first time since the aftermath of the energy crisis.
In that context the fact consumer price inflation in September remained level at 3.8% counts as qualified good news for the Treasury, if not consumers.
The figure remains almost double the Bank of England target of 2%, the rate when Labour took office, but economists at the Bank and beyond do expect this month to mark the peak of this inflationary cycle.
That’s largely because the impact of higher energy prices last year will drop out of calculations next month.
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5:27
Inflation sticks at 3.8%
The small surprise to the upside has also improved the chances of an interest rate cut before the end of the year, with markets almost fully pricing expectations of a reduction to 3.75% by December, though rate-setters may hold off at their next meeting early next month.
September’s figure also sets the uplift in benefits from next April so this figure may improve the internal Treasury forecast, but at more than double the rate a year ago it will still add billions to the bill due in the new year.
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Minister ‘not happy with inflation’
For consumers there was good news and bad, and no comfort at all from the knowledge that they face the highest price increases in Europe.
Fuel prices rose but there was welcome relief from the rate of food inflation, which fell to 4.5% from 5.1% in August, still well above the headline rate and an unavoidable cost increase for every household.
The chancellor will convene a meeting of cabinet ministers on Thursday to discuss ways to ease the cost of living and has signalled that cutting energy bills is a priority.
The easiest lever for her to pull is to cut the VAT rate on gas and electricity from 5% to zero, which would reduce average bills by around £80 but cost £2.5bn.
More fundamental reform of energy prices, which remain the second-highest in Europe for domestic bill payers and the highest for industrial users, may be required to bring down inflation fast and stimulate growth.
Schools need to be “brave enough” to talk about knives, Sky News has been told, as the killer of Sheffield teenager Harvey Willgoose is sentenced today.
His killer, who was also 15 and cannot be identified for legal reasons, had brought a 13cm hunting knife into school.
Image: Harvey Willgoose. Pic: Sophie Willgoose
Following Harvey’s murder, his parents Caroline and Mark Willgoose told Sky News they wanted to see knife arches in “all secondary schools and colleges”.
“It’s 100% a conversation, I think, that we need to be empowered and brave enough to have,” says Katie Crook, associate vice principal of Penistone Grammar School.
The school, which teaches 2,000 pupils, is just a few miles away from where Harvey was killed.
After being contacted by the Willgoose family, it has decided to install a knife arch.
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The arch – essentially a walk-through metal detector – has been described as a “reassuring tool” and “real success” by school leaders.
“We’re really lucky here that we don’t have a knife crime problem – but we are on the forefront with safeguarding initiatives,” says Mrs Crook.
“I didn’t really think we needed one at first,” says Izzy, 14. “But then I guess at Harvey’s school they wouldn’t think that either and then it did actually happen.”
Joe, 15, says he did find the knife arch “intimidating” at first.
“But after using it a couple of times,” he says, “it’s just like walking through a doorway”.
“And it’s that extra layer of, like, you feel secure in school.”
After Harvey’s death, then home secretary Yvette Cooper said that she would support schools in the use of knife arches.
But there remains no official government policy or national guidance on their use.
Some headteachers who spoke with Sky News feel knife arches aren’t the answer – saying the issue required a societal approach.
Others said knife arches themselves were a significant expense to schools.
But Mrs Crook says they are “well worth the funding” if they prevent “a student making a catastrophic decision”.
“I’m a parent and, of course, my focus every day is keeping our students safe, just as I want my son to be kept safe in his setting and his school.”
Mrs Crook says she thinks schools would “welcome” a discussion at “national level” about the use of knife arches and other knife-related deterrents in schools.
“It’s sad, though that this is what it’s come to, that we’re having lockdown drills in the UK, in our school settings.
“But I suppose some might argue that has been needed for a long time.”
If you eat beef, and ever stop to wonder where and how it’s produced, Jonathan Chapman’s farm in the Chiltern Hills west of London is what you might imagine.
A small native herd, eating only the pasture beneath their hooves in a meadow fringed by beech trees, their leaves turning to match the copper coats of the Ruby Red Devons, selected for slaughter only after fattening naturally during a contented if short existence.
But this bucolic scene belies the turmoil in the beef market, where herds are shrinking, costs are rising, and even the promise of the highest prices in years, driven by the steepest price increase of any foodstuff, is not enough to tempt many farmers to invest.
For centuries, a symbolic staple of the British lunch table, beef now tells us a story about spiralling inflation and structural decline in agriculture.
Mr Chapman has been raising beef for just over a decade. A former champion eventing rider with a livery yard near Chalfont St Giles, the main challenge when he shifted his attention from horses to cows was that prices were too low.
“Ten years ago, the deadweight carcass price for beef was £3.60 a kilo. We might clear £60 a head of cattle,” he says. “The only way we could make the sums add up was to process and sell the meat ourselves.”
Processing a carcass doubles the revenue, from around £2,000 at today’s prices to £4,000. That insight saw his farm sprout a butchery and farm shop under the Native Beef brand. Today, they process two animals a week and sell or store every cut on site, from fillet to dripping.
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Today, farmgate prices are nearly double what they were in 2015 at £6.50 a kilo, down slightly from the April peak of almost £7, but still up around 25% in a year.
For consumers that has made paying more than £5 for a pack of mince the norm. For farmers, rising prices reflect rising costs, long-term trends, and structural changes to the subsidy regime since Brexit.
“Supply and demand is the short answer,” says Mr Chapman.
“Cow numbers have been falling roughly 3% a year for the last decade, probably in this country. Since Brexit, there is virtually no direct support for food in this country. Well over 50% of the beef supply would have come from the dairy herd, but that’s been reducing because farmers just couldn’t make money.”
Political, environmental and economic forces
Beef farmers also face the same costs of trading as every other business. The rise in employers’ national insurance and the minimum wage have increased labour costs, and energy prices remain above the long-term average.
Then there is the weather, the inescapable variable in agriculture that this year delivered a historically dry summer, leaving pastures dormant, reducing hay and silage yields and forcing up feed costs.
Native Beef is not immune to these forces. Mr Chapman has reduced his suckler herd from 110 to 90, culling older cows to reduce costs this winter. If repeated nationally, the full impact of that reduction will only be fully clear in three years’ time, when fewer calves will reach maturity for sale, potentially keeping prices high.
That lag demonstrates one of the challenges in bringing prices down.
Basic economics says high prices ought to provide an opportunity and prompt increased supply, but there is no quick fix. Calves take nine months to gestate and another 20 to 24 months to reach maturity, and without certainty about price, there is greater risk.
There is another long-term issue weighing on farmers of all kinds: inheritance tax. The ending of the exemption for agriculture, announced in the last budget and due to be imposed from next April, has undermined confidence.
Neil Shand of the National Beef Association cites farmers who are spending what available capital they have on expensive life insurance to protect their estates, rather than expanding their herds.
“The farmgate price is such that we should be in an environment that we should be in a great place to expand, there is a market there that wants the product,” he says. “But the inheritance tax challenge has made everyone terrified to invest in something that will be more heavily taxed in the future.”
While some of the issues are domestic, the UK is not alone.
Beef prices are rising in the US and Europe too, but that is small consolation to the consumer, and none at all to the cow.