Obesity and Fatty Liver Disease

Jim Shannon Excerpts

Tuesday 28th October 2025 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to serve under your chairship, Mr Efford. I thank the hon. Member for Worthing West (Dr Cooper), who is co-chair of the all-party parliamentary group on liver disease and liver cancer, for setting the scene incredibly well. I thank her for the detail and for her requests to the Minister. It is, as always, a pleasure to see the Minister in her place. I wish her well and I look forward to her answers. I also thank the British Liver Trust and the Foundation for Liver Research, which supplied me with a briefing that made clear the excellent work at the Roger Williams Institute of Liver Studies, which continues to drive world-leading research into metabolic liver disease to shape how it is diagnosed and treated.

Liver disease is a growing cause of premature mortality and lost years of working life in all four nations of the United Kingdom. It has been estimated that some 4,878 potential years of life were lost due to chronic liver disease in Northern Ireland. It is clear that the UK is in the midst of a liver disease crisis, to which the hon. Lady referred. It is as serious as that, and we should all take note. While premature mortality rates from other major diseases have fallen over the past two generations, deaths from liver disease have risen 400% since the 1970s. There are more than 18,000 deaths from liver disease and liver cancer each year in the United Kingdom.

[Clive Efford (in the Chair)]

Order. Members are asking that you speak into the microphone, Mr Shannon, so that they can hear you.

[Jim Shannon]

That has never been a problem in the past, Mr Efford. Do I need to lift it up to my mouth? I thought it was good enough to carry my voice; apologies if it is not. This would be the first time it has not worked.

Two thirds of adults are overweight or living with obesity, and one in three children are classified as overweight or obese when they leave primary school. Sadly, four in 10 children with obesity may already have liver disease. One in five people are affected by liver disease and liver cancer in the UK, and as many as 12% of those—more than 1 million people—go on to develop the more severe form of fatty liver disease.

The stats for Northern Ireland are unreal. That is not the Minister’s responsibility, but it gives a flavour for the debate. Some 64% of adults in Northern Ireland were overweight or obese, a marked increase from 23% in 2010-11. My goodness me—if ever we needed a reality check, that is one for us. Shockingly, Northern Ireland has the highest rate of overweight or obese primary 1 children in the UK, with 25.3% of children fitting that category. In my constituency of Strangford, 27% of year 8 children were overweight or obese. It is estimated that 70% of adults and 40% of children who are overweight or obese have fatty liver disease, so urgent work must be done to prevent this health crisis in the making.

Shockingly, 37 million extra sick days are estimated to be taken by people living with obesity, harming economic output on a massive scale—a figure of 1% to 2% of UK GDP as estimated by the Institute for Government. The NHS alone is expected to shoulder an estimated £10 billion per year obesity bill by 2050, with obese patients costing twice as much as those of a healthy weight. Reducing obesity prevalence by 10% could save £6 billion per year in the UK economy.

Let me tell a personal story. I am a type 2 diabetic. Some 16 or 17 years ago, I realised that I needed to drastically change my eating habits. I was 17 stone. To be honest, to put it very starkly, I was a big fat pudding. I realised that if I did not lose weight for my diabetes, I was going to be in trouble, so I reduced my weight quite substantially, by 4 stone. I have managed, by and large, to keep at that reduced level. First, it was down to stress but, secondly, it was down to Chinese takeaways five nights a week with two bottles of Coca Cola. That just does not work; when it is added up, you just get fatter and fatter. I took that away and tried to reduce my chocolate intake.

My hon. Friend the Member for East Londonderry (Mr Campbell) has said that he is reducing his sugar intake—well done to him; he does not need to, but it is definitely a good purpose to have. The point I am making is that not everyone can. For those who cannot, it is important to look towards the weight-reduction injections, to which I will refer in a moment. I have been able to control my diabetes for the last 10 years by tablets. I take nine tablets in the morning and five at night to keep everything under control.

Newly released weight-management drugs such as Ozempic and Mounjaro have been shown to reduce the weight of patients by an average of 5%, reducing the risk of a variety of health effects, including fatty liver disease. However, although those drugs are available for those who obesity and type 2 diabetes, they are not for those with fatty liver disease. Making that happen would be my one request of the Minister. If someone has a body mass index of over 40, and does not yet have those comorbidities, unfortunately they will not qualify.

There is a new generation of drugs targeting advanced fatty liver disease. Resmetirom has recently been approved by the US Food and Drug Administration and is expected to be approved in the UK within 12 to 18 months. Could the Minister give us an indication of where those drugs are in the system? Those new drugs—some of which improve liver function and some of which enable weight loss—can reverse fatty liver disease and must be made available in a timely fashion to save lives. The NHS needs to ensure that services are ready to support that, as previously no treatment has been available for those patients.

The UK faces a very challenging commercial environment for drug pricing. Lilly recently announced that it will increase the price of Mounjaro by as much as 170% in response to pressure from the US Government and historic pricing inconsistencies. My second question to the Minister is about what has been done to ensure that the price of drugs is reduced or kept controlled in a way that can make a difference.

Thirdly, I say to the Minister that ICBs must have an effective pathway for the early detection of liver disease. A new nationally endorsed pathology pathway to improve early diagnosis of liver disease is essential. Every community diagnostic centre should also have a fibroscan to assess fibrosis.

Finally, I say to the Minister that patients with advanced liver disease and cancer need access to weight management services in line with access for people with type 2 diabetes. This is a ticking timebomb, but there are scientific breakthroughs there to address it. I believe in my heart that the Government need to cut that wire and stop that timebomb now.