Can the NHS Actually Treat Obesity?

GLP-1 receptor agonists — semaglutide (Wegovy, Ozempic) and tirzepatide (Mounjaro) — represent the most significant advance in obesity treatment in a generation. Clinical trials show average weight losses of 15–22%, comparable to bariatric surgery.^[1] NICE approved Wegovy for NHS use in 2023, estimating 860,000 people eligible under the criteria. By the end of 2025, approximately 35,000 had received a prescription — around 4% of those eligible.^[2] The NHS has implemented a strict tier system requiring patients to access specialist weight management services first, a bottleneck that has limited uptake to a fraction of potential beneficiaries.

While GLP-1 drugs have begun reducing demand for bariatric surgery — referrals fell 18% in 2024 — those already waiting have faced dramatically longer delays. The average wait for bariatric surgery reached 30 months in 2024, up from 8 months in 2018.^[4] COVID-19 theatre closures created an initial backlog, but the structural underfunding of tier 3 and tier 4 obesity services has meant recovery has been slow. Adult obesity prevalence stands at 29.5%, the highest recorded.^[3] England has the third highest obesity rate in Europe. The economic cost to the NHS is estimated at £6.5 billion annually, rising to £9.7 billion by 2050 without intervention.