MILLIONS of Britons could receive free weight-loss vaccines on the NHS under proposals to overhaul the BMI system.
Currently, “miracle” fat loss treatments – which make you feel fuller and less hungry – are offered to people with a BMI of 30 or more.
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But experts say those who aren’t technically classified as obese may still need medications like Wegovy or Mounjaro.
They argued that factors such as the accumulation of belly fat should also be a component in identifying obesity and prescribing fat loss vaccines.
Abdominal or visceral fat, as it is known, is different from the soft layer of fat that is just one layer below the skin.
Instead, it lies beneath the abdominal wall and surrounds the liver, intestines, and other organs.
Although visceral fat makes up only a small proportion of body fat, it is a key player in a variety of health problems – linked to a higher risk of heart disease, dementia and even certain types of cancer.
But as a result of current BMI index guidelines, people with excess abdominal fat may still not be considered obese – thus missing out on treatments they could benefit from.
Writing in the diary Nature Medicinea coalition of experts from the European Association for the Study of Obesity (EASO) stated: “In many settings, the diagnosis of obesity is still based solely on body mass index (BMI) cut-off values and does not reflect the role of distribution and role of adipose tissue in disease severity.
“Furthermore, the indications for the use of the different therapeutic approaches now available for the treatment of obesity continue to be based mainly on anthropometric measurements, and not on a more complete clinical assessment of the individual.”
Anthropometry is the practice of taking measurements of the human body.
The study authors called for the way we diagnose obesity – and therefore the requirement to achieve a BMI of 30 or more to receive obesity medications – to be overhauled.
“In current practice, strict application of these evidence-based criteria precludes the use of obesity medications or metabolic and bariatric procedures in patients with a substantial burden of obesity but low BMI values,” they explained.
Experts have proposed that people should receive weight loss medications if they have a BMI greater than 25 and a waist-to-height ratio (WHtR) greater than 0.5, as well as a weight-related health complication such as high blood pressure or diabetes.
Abdominal fat is most accurately measured with an MRI, but WHtR is often used. This is your waist measurement divided by your height.
The larger your waist, the higher your waist-to-height ratio, and a ratio above 0.5 suggests you have excess fat around your belly and are at greater risk of health problems.
CALL FOR CHANGE
“The basis for this change is the recognition that BMI alone is insufficient as a diagnostic criterion and that the distribution of body fat has a substantial effect on health,” the obesity experts wrote.
“More specifically, abdominal fat accumulation is associated with an increased risk of developing cardiometabolic complications and is a stronger determinant of disease development than BMI, even in individuals with a BMI level below standard cutoff values for diagnosed with obesity (BMI of 30).”
If these criteria were implemented in the UK for diagnosing obesity, it would mean millions more Brits would be eligible for weight loss injections.
The 29 EASO experts responsible for the new obesity framework included specialists in endocrinology, nutrition, internal medicine, bariatric surgery and primary care.
In total, 79 percent of experts agreed that obesity medications should be considered in patients with a BMI greater than 25 and a WHtR of 0.5 or greater.
The authors also called on pharmaceutical companies to use their new BMI diagnostic framework in clinical trials of obesity treatments.
“This statement can also be seen as a call to pharmaceutical companies and regulatory authorities to use inclusion criteria that are more adherent to clinical staging of obesity and less to traditional BMI cutoffs when designing future clinical trials of obesity medications,” they wrote.
Everything You Need to Know About Fat Scams
Weight loss vaccines are a hot topic in the media right now, with hundreds of success stories of people losing weight.
In March 2023, the NHS announced that it would make Wegovy, a medicine made by Danish company Novo Nordisk, available on prescription to thousands of obese Britons.
It contains the drug semaglutide, which has reportedly helped reality TV star Kim Kardashian and Twitter boss Elon Musk lose weight.
Wegovy, which helped a third of people reduce weight by 20% in trials, is now available in pharmacies such as Boots.
How do they work?
Vaccines work by suppressing your appetite, making you eat less and, consequently, lose weight.
To do this, semaglutide mimics the role of a natural hormone, called GLP-1.
GLP-1 is part of the signaling pathway that tells your body that you have eaten and prepares it to use energy from food.
London GP and founder of wellgoodwellbeing. withZoe Watson, said: “Your body naturally produces an appetite-regulating hormone called glucagon-like peptide-1.
“These injections work by regulating your appetite, which can lead to eating fewer calories and weight loss.”
Aren’t they diabetes medications?
Semaglutide, the active medication in Wegovy, was originally sold under the name Ozempic specifically for patients with diabetes.
But people began to realize that it helped suppress their appetite, stopping them from eating as much and helping them lose weight.
Novo Nordisk then developed Wegovy, which contains the same chemical but in higher doses, specifically to help with weight loss.
Wegovy is not prescribed for patients with diabetes.
Can I get them?
Wegovy is offered by prescription to obese adults receiving specialized weight loss treatment.
The NHS also currently offers a similar medicine called Saxenda, or liraglutide.
Both are only available in Level 3 and Level 4 weight management services, which means you should be referred to specialist-led weight management clinics.
General practitioners also cannot prescribe them themselves, Dr. Watson said.
Vaccinations should be taken as part of an overall program to help with lifestyle changes and psychological support to get the best effect from the prescribed medication.
Despite being approved for use, the supply of Wegovy on the NHS has been delayed indefinitely due to increased global demand.
Supply also fell by half in the US due to soaring demand.
Are there risks?
Like all medicines, vaccines have no side effects.
About half of people taking the medicine experience intestinal problems, including nausea, bloating, acid reflux, constipation and diarrhea.
Sarah Jarvis, GP and clinical consultant at patient.info, said: “One of the more unusual side effects is severe acute pancreatitis, which is extremely painful and happens to one in 500 people.”
Other uncommon side effects include altered taste, kidney problems, allergic reactions, thyroid tumors, gallbladder problems, and hypoglycemia.
What other options are there?
Mounjaro (trade name for tirzepatide) also hit the market in early 2024.
Like Wegovy, tirzepatide is derived from a medication originally developed to treat diabetes.
The weekly injection helped overweight people lose more than two kilos in 18 months.
It is available on order with an online prescription from pharmacies including Superdrug and LloydsPharmacy Online Doctor.
It works similarly to Wegovy and Saxenda, but is more effective.
Dr. Mitra Dutt of Lloyds Pharmacy says: “Based on clinical trials, 96 percent of people were able to lose more than five percent of their body fat using Mounjaro. In similar trials, 84 percent of people lost more than five percent of their body weight on Wegovy and 60 percent on Saxenda.
“Mounjaro works by activating two hormone receptors (GIP and GLP-1), which increase insulin production, improve insulin sensitivity and act to decrease food intake.”
This is not the first time that the BMI system for diagnosing obesity has been questioned.
Italian scientists have found that lowering the BMI threshold for obesity to 27 could paint a more accurate picture of who is affected.
Meanwhile, researchers found that a simple “rope test” was more accurate at detecting excess fat in children and teenagers than BMI.
In other skinny jab news, drugs like Wegovy could reduce a person’s risk of 10 types of cancer, a new study has suggested.
This story originally appeared on The-sun.com read the full story
