Drugs such as semaglutide (Wegovy/Ozempic) and tirzepatide (Mounjaro) are revolutionizing the treatment of obesity, but without affordable, healthy food and the right support, health inequalities in the UK could widen, say researchers at UCL and the University of Cambridge.
In a communication published in natural medicineresearchers argue that incretin-based treatments, also known as weight-loss drugs, have revolutionized obesity treatment, but their long-term effects may depend on factors beyond the drugs themselves.
Access to nutritional advice, healthy foods and ongoing medical support are all likely to influence whether patients are able to use medicines safely and maintain improved health outcomes over time, the researchers argue.
We have emphasized that obesity treatment is not just a medical problem, but a social and structural problem. Without comprehensive dietary support and attention to food affordability, these medicines can exacerbate existing health inequalities.
The key message is clear. These treatments are powerful, but their long-term public health impact will depend on having the right support systems in place to ensure fair and safe access for all patients. ”
Dr Adrian Brown, UCL Medicine Senior Author
The authors warn that healthier diets are often more expensive, creating an additional barrier for people already facing food insecurity and financial hardship.
An estimated 1.6 million adults in England, Wales and Scotland used drugs such as Wegoby and Munjaro to lose weight between early 2024 and early 2025, according to a study by UCL researchers in January 2026. An additional 3.3 million people said they were interested in using weight loss drugs over the next year. Mounjaro (which includes tirzepatide) is typically priced at £200 a month, which puts it out of reach for many people.
Lead author Dr Marie Sprinkley (University of Cambridge) said: “The key question is not just who has access to these treatments, but who can benefit from them in the long term. If access to healthy food, nutritional support and ongoing care is uneven, there is a risk that the benefits of these treatments will also be uneven.”
Researchers highlight the growing dangers of a “two-tier system” in obesity treatment. In this system, some people have access to comprehensive support and continued treatment as well as medication, while others face significant barriers to both.
Dr. Sprinkley continued: “If we want these treatments to reduce health disparities rather than widening them, we need to consider equal access to support alongside equitable access to medicines.”
Patients living in poorer areas often face greater barriers to accessing health care and healthy diets, as well as a greater burden of obesity-related diseases.
Large-scale clinical trials have shown that incretin-based treatments result in significant and sustained weight loss, along with improvements in metabolic health. However, the document warns that day-to-day outcomes can vary widely depending on the patient’s social and economic circumstances.
Drugs commonly decrease appetite and food intake and can cause gastrointestinal side effects such as nausea and early satiety. Without proper dietary guidance and monitoring, reduced food intake can increase the risk of poor diet quality, poor nutrient intake, and loss of lean body mass in some people.
Co-author Dr Kara Ruggiero (University of Cambridge) said: “Food insecurity remains a huge reality in the UK, affecting 12% of UK households. Healthier food tends to be more expensive and we cannot ignore this important context.”
“Guidance that assumes that everyone can afford and have access to healthy food risks being unrealistic and inequitable. We need to ensure that these treatments are provided with appropriate support, such as nutritional advice and help with access to healthy food, because food insecurity shapes health outcomes even before patients arrive at the clinic.”
The authors conclude that as the use of incretin-based therapies continues to increase, ensuring that all patients receive the support they need to use them safely and effectively will become an increasingly important public health priority.
sauce:
university college london
Reference magazines:
Spukley, M.; Others. (2026). Incretin therapy, nutrition and food insecurity in the UK. natural medicine. DOI: 10.1038/s41591-026-04426-2. https://www.nature.com/articles/s41591-026-04426-2
