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Leela Barham casts her economist’s eye over the complex market of weight loss treatments, which is becoming ever more dynamic as new treatments are approved

New treatments represent an opportunity for community pharmacy to serve unmet demand for weight management, yet it needs to be carefully managed. 

There are now multiple treatments that are approved to help people lose weight; NICE recommends not only these but lifestyle interventions, behavioural interventions and physical activity.

From the treatments available, the options include tablets like Xenical (orlistat) or injectable pens that deliver GLP-1 agonists, including Saxenda (liraglutide), Wegovy (semaglutide) and the most recently NICE-approved Mounjaro (tirzepatide). 

While the list of treatments has become longer, that doesn’t mean it has translated into routine availability. NICE approved Mounjaro in December 2024 but has set out, at NHS England’s request, a longer implementation period than the usual three months for NICE guidance.

Instead, there is a three-part plan to implement which could run for 12 years. Implementation of NICE guidance is due to begin in March.

In high demand

There is a lot of demand for weight loss services. Government statistics put the prevalence of overweight and obesity in England at 64 per cent of adults. Over a quarter (26.2%) are living with obesity.

The trend has been up since 2015/2016. Of course, not all of these people will want to take up the opportunity to manage their weight, yet many will.

There is advertising for those treatments available over the counter which could contribute to greater awareness too (or persuasion). 

There could be some who are interested in taking up a weight loss treatment, but some might be worried about the stigma of doing so versus tackling their weight through diet and exercise.

That’s the claim from digital weight loss provider Juniper UK. It has some stats from a December 2024 survey of 1,000 UK women aged 30-75 that suggests it’s a real issue:

31% of those surveyed said that they have been prevented from making a decision on starting GLP-1s based on their perceived stigma of medicated weight management

Of those using GLP-1s for weight management, 20% have been made to feel ashamed for using medical treatments to manage weight

38% believe that people who use weight loss medications are treated differently from those who rely on diet and exercise alone.

There looks to be a demand that won’t be met by the NHS any time soon. There are an estimated 3.4 million people who could be eligible for Mounjaro in total, but around 220,000 will be identified and funded within the first three years of implementation of NICE guidance.

Mounjaro is considered cost-effective so the problem is not with the £122 per month price tag, but the scale of the task if the NHS were to open up treatment to all.

That could push out other NHS activity. Digital services could help to provide more capacity for the NHS to provide weight loss services, at least that’s the hope.

Community pharmacy is being encouraged to help the NHS tackle obesity. Back in January 2022, a new weight loss referral option was introduced to allow community pharmacists to refer patients to a 12-week online NHS weight management programme.

That was followed by a two-year pilot to deliver Wegovy outside of hospital, launched in June 2023. That included a community pharmacy dispense and delivery service. 

Cautious approach needed

While offering a service like weight loss can help contribute to the bottom line, there is a need for caution. The GPhC has already highlighted patient safety issues with weight loss services including how pharmacies do not always have adequate risk assessments, publishing a patient safety spotlight to improve the provision of weight loss services.

The MHRA has also highlighted hospitalisations seen in those taking weight loss treatments. There has also been a worrying recent headline about a woman who died while taking a weight loss treatment. 

Some pharmacists are raising the alarm too about just how to deliver an online pharmacy service safely. Numan has been criticised for allegedly expecting pharmacists to sign off one weight loss prescription every four minutes.

That’s not long enough with 20 minutes being suggested as the minimum needed to engage with the patient. 

Commissioned weight loss services in community pharmacy look to be limited. In January 2025, CPE listed 13 examples of weight loss services delivered in community pharmacies, although just four are ongoing and five decommissioned with others marked as completed.

With fewer services commissioned, that leaves community pharmacies in the position of going it alone and making it essentially a private market. 

Online pharmacies have taken up the opportunity. Numan, for example, offers weight management services, including Monjaro, as does LloydsPharmacy Online Doctor, and Pharmacy2U.

More options for treatments and many suppliers should mean plenty of competition on prices and quality of service to attract patients who have the inclination and money to pay.

The downside is arguably about a divide in who can access treatments, with a private market not contributing to the goal of health equality.