Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the relative effectiveness of reducing body weight through (1) weight loss medication alone, (2) non-medicated lifestyle change support, such as nutritional and fitness guidance as is currently offered through NHS tier 2 weight management services, and (3) weight loss medication combined with lifestyle change support.

The National Health Service and local government provide a range of services to help people living with obesity to lose weight, ranging from behavioural weight management programmes to specialist services which could offer more intensive support, pharmaceutical treatments, or bariatric surgery. Exactly what treatment is most appropriate for an individual is down to clinicians to advise, in discussion with patients, considering relevant clinical guidance.

The National Institute for Health and Care Excellence (NICE) produces guidance for health and care practitioners and provides rigorous, independent assessments of complex evidence for new health technologies. The NICE has recently published an updated clinical guideline on overweight and obesity management. It brings together and updates all of the NICE’s recommendations on overweight and obesity. The guideline includes recommendations on behavioural interventions, physical activity and diet, and digital technologies, as well as medicines and surgery.

The guidance states that all medicines for weight loss should be used alongside a reduced-calorie diet and increased physical activity, and that patients who are prescribed such medicines should receive information, support, and counselling on additional diet, physical activity, and behavioural strategies. Patients receiving weight loss medication on the NHS should not receive it alone, without additional support from appropriate healthcare professionals.

The guidance is clear that dietary, exercise, and behavioural approaches for weight management should be tried before medicines are considered. Whilst research has found that people receiving medicines for weight loss alongside a reduced-calorie diet and increased physical activity on average lose a greater amount of weight than people receiving behaviour change support alone, medicines are not a first-line treatment, and dietary advice and behavioural support should be provided first.