Addressing growing rates of obesity and its increasing strain on healthcare systems has become a key focus for many public health strategies around the globe. As part of the evolving landscape of obesity interventions, GLP-1 receptor agonists (commonly referred to as GLP-1 agonists) have emerged as a promising pharmacological solution. But how effective are GLP-1 agonists as part of a broader public health obesity strategy?
To help answer this, HealthLumen was recently commissioned by Nesta – the UK’s innovation agency for social good – to model the health and economic impact of 30 obesity policies in the UK, including several involving GLP-1 agonists. These insights were used to inform Nesta’s Blueprint tool, which supports their broader strategy which aims to halve the prevalence of obesity in the UK by 2030.
What are GLP-1 agonists and why are they on the rise?
GLP-1 agonists are a class of drugs that mimic the action of glucagon-like peptide-1, a hormone that regulates appetite and insulin secretion. By slowing digestion and promoting a feeling of fullness, GLP-1 agonists can significantly aid weight loss.
NICE (National Institute for Health and Care Excellence) guidelines support the use of GLP-1 agonists such as semaglutide for adults with a body mass index (BMI) of 35 or higher, or for those with a BMI of 30-35 who have additional weight-related health risks. However, these drugs are recommended as part of a comprehensive weight management program that includes lifestyle changes such as healthy eating and regular exercise, which not only enhance the effectiveness of GLP-1 agonists but also help tackle the root causes of obesity.
Modelling the impact of GLP-1 agonists on obesity and obesity-related disease
HealthLumen’s modelling study aimed to help Nesta answer questions such as:
What if 3 million people living with obesity (which equates to approximately all those living with obesity in the UK) were treated with semaglutide every year over a 6-year period?
It was found that this intervention would markedly reduce the incidence of obesity-related conditions including type 2 diabetes, cardiovascular disease, and certain cancers (Table 1), and would be a cost-effective* policy – meaning the cost of implementing the intervention is deemed to be justified by the costs saved by the health benefits that it would bring.
Nesta estimated that this intervention could lead to a 41% decrease in obesity prevalence in the UK within just 5 years, showing that GLP-1 agonists could be highly impactful in tackling obesity rates in the UK.
| Disease | Incidence avoided |
| Type 2 diabetes | 21,740 |
| Hypertension | 59,705 |
| Coronary heart disease | 14,995 |
| Colorectal cancer | 6,582 |
| Gall bladder disease | 150,398 |
| Knee osteoarthritis | 25,707 |
| Stroke | 6,945 |
| Liver cancer | 1,041 |
| Depression | 971 |
These projections were generated using HealthLumen’s microsimulation modelling capabilities.
How does microsimulation work?
Microsimulation modelling uses virtual populations that represent the characteristics of real populations of interest to project the potential impact of different interventions. It is particularly suitable for modelling non-communicable diseases (NCDs), such as obesity, as it captures the dynamic interplay of different risk factors and an individual’s behavioural changes over a lifetime, enabling precise predictions of intervention impacts.
The bigger picture: GLP-1 agonists as part of the wider strategy to tackle obesity
While GLP-1 agonists represent a potentially very promising approach to tackling obesity, they are not a universal solution. There are several considerations to take into account, including:
- Unknown long-term effects: As with any relatively new treatment, ongoing research and post-market surveillance will be crucial for assessing potential long-term health effects of GLP-1 agonists.
- Limited applicability: GLP-1 agonists are not recommended for children, who represent a critical demographic in tackling obesity, as childhood obesity is a strong predictor of adult obesity.
- Equity and accessibility: Equitable access to GLP-1 agonists can be challenging due to racial and socioeconomic disparities in accessing these medications, in addition to global variations in medication costs, insurance coverage and availability in public health programs.
Given these considerations, it is crucial to complement the use of GLP-1 agonists with other robust obesity policies, and particularly those aimed at preventing obesity in children.
As part of the Blueprint tool, Nesta has put forward recommendations for policy packages informed by the projected future impact of the 30 obesity policies that HealthLumen modelled. These packages aim to more comprehensively address rising obesity rates in the UK – but could also be extended to other countries – with several packages incorporating pharmacological interventions.
View the Blueprint tool here.
For any questions regarding HealthLumen’s modelling for the Blueprint tool, or how we could help model the real-world impacts of your therapy or intervention, get in touch with us today.
*Cost effectiveness was determined at the threshold of £20,000/QALY (quality-adjusted life year, where one QALY is equal to one year lived in perfect health)