The safety of weight-loss injections: A growing concern

The recent tragic death of a nurse in the UK using Mounjaro injections for weight-loss has sparked widespread discussion and concern. While this was the first publicly reported death linked to Mounjaro in the UK, further investigation reveals that other fatalities may be associated with this class of medications.

What do the reports say?

According to Community Pharmacy News Analysis, there have been reports of 10 fatalities related to Glucagon-like Peptide-1 Receptor Agonists (GLP-1) and GIP medications, as of October 2024. Clearly, there must be more gathering of data to assess whether the use of these injections is safe with regard to weight-loss.

These drugs were developed initially for individuals with diabetes, therefore, the question should be raised if an individual does not have the physiological deficits leading to diabetes, should they be taking a drug that was designed for that use? Whilst the GIP element of these medications is known to suppress appetite, is there endocrine conflict at play? Further research and evidence is needed to answer this question.

Interestingly, at the end of October 2024, the MHRC received 7,228 reports of gastrointestinal reactions to this type of drug including Mounjaro, such as nausea vomiting and diarrhoea. Of these cases, 68 individuals were hospitalised. In August 2024, 46 hospitalisations were reported. There are likely to be more cases which have gone unreported as individuals are fearful of their weight-loss drug being stopped.

The problem of accessibility and misuse

As the use of this medication increases, with a parallel increase in accessibility through online pseudo and online prescribing pharmacists, the number of hospitalisation cases is increasing.

The medicines are open to misuse due to inappropriate dispensing. With online prescriptions, some patients have claimed to answer an in-depth questionnaire but there is scope for misinformation from both parties. There is limited regulation, and it is open to abuse.

There is a worrying trend and evidence now that these medications are likely to add another burden on the already stretched health services.

Are we overlooking long-term weight management?

There appears to be very limited mention of dietary and psychological counselling for when the individual stops the medication and during the term of the prescription. There is substantial evidence of up to 20% weight gain on cessation of the injections. Therefore, is this route the best weight-loss option, as it encourages people not to take ownership of their own health and diet?

Will individuals continue to eat inappropriately and follow the path that led to their weight gain? Some individuals will see these injections as a quick fix or a magic button and not be prepared to put in the work to ensure that their health is optimum and the best it could be.

Are we encouraging individuals to surrender their own agency and responsibility for their health and weight?

Safeguards and recommendations

Safeguards must be implemented so these medications are not abused and consideration must be given to compulsory attendance to healthy lifestyle programmes for the duration of supply, to ensure that the drug is not abused, and not a potential ‘time bomb’ for healthcare services.

There are many questions still to be answered and I am very concerned that this alleged weight-loss saviour will become the elephant in the room.

A consultation with a nutritionist to discuss weight-loss is advisable as the injections may not be necessary. Professional guidance and monitoring is a safe route. Encouraging individuals to be prepared for dietary changes and in some cases lifestyle changes can lead to not only saving the patient a great deal of expense, but will lead to a lifetime of knowledge and self-management.

References

• Wegovy: Ten deaths linked to weight loss injections, says MHRA
• Once-Weekly Semaglutide in Adults with Overweight or Obesity | New England Journal of Medicine