Weight loss drugs could widen health inequalities without nutritional support

Drugs such as semaglutide (Wegovy/Ozempic) and tirzepatide (Mounjaro) are transforming obesity treatment, but without affordable, healthy food and appropriate support, they could widen health inequalities in the UK, according to researchers at UCL and the University of Cambridge.

In a correspondence published in Nature Medicine, the researchers argue that while incretin-based therapies, also known as weight loss medications, have transformed obesity treatment, their long-term benefits may depend on factors beyond the medications themselves.

Access to nutrition advice, healthy food, and ongoing healthcare support are all likely to shape whether patients can use the drugs safely and maintain health improvements over time, the team argues.

We have highlighted that obesity treatment is not just a medical issue, but a social and structural one. Without integrated dietary support and attention to food affordability, these medications could deepen existing health inequalities.

The key message is clear: these treatments are powerful, but their long-term public health impact will depend on whether the right support systems are in place to ensure equitable and safe access for all patients."

Dr. Adrian Brown, Senior Author, UCL Medicine

The authors warn that healthier diets are often more expensive, creating additional barriers for people already facing food insecurity or financial hardship.

According to a study by UCL researchers in January 2026, an estimated 1.6 million adults in England, Wales and Scotland used drugs such as Wegovy and Mounjaro to help lose weight between early 2024 and early 2025. An additional 3.3 million people said they would be interested in using weight loss drugs over the next year. Mounjaro (containing tirzepatide) typically costs £200 a month so is unaffordable for many.

Lead author Dr Marie Spreckley (University of Cambridge) said: "The key question is not simply who can access these medications, but who can benefit from them in the long term. If access to healthy food, nutrition support and ongoing care is uneven, there is a risk that the benefits of these treatments will also be uneven."

Researchers underline the danger of a growing "two-tier system" in obesity treatment, where some people can access medication alongside comprehensive support and continuity of care, while others face significant barriers to both.

Dr Spreckley continues: "If we want these therapies to reduce health inequalities rather than widen them, equitable access to support must be considered alongside equitable access to medication."

Patients living in more deprived areas often face greater barriers to healthcare and healthy food access, while also experiencing a higher burden of obesity-related illness.

Large clinical trials have shown that incretin-based therapies can produce substantial and sustained weight loss alongside improvements in metabolic health. However, the correspondence warns that outcomes in everyday life may differ significantly depending on a patient's social and economic circumstances.

Medications commonly reduce appetite and food intake and can cause gastrointestinal side effects such as nausea and early satiety. Without appropriate dietary guidance and monitoring, reduced food intake may increase the risk of poor dietary quality, inadequate nutrient intake and loss of lean body mass in some individuals.

Co-author, Dr Cara Ruggiero (Cambridge University) said: "Food insecurity remains a major reality in the UK effecting 12% of UK households. Healthier foods tend to cost more, and we cannot ignore this critical context.

"Guidance that assumes everyone can afford and access healthy food risks being unrealistic and inequitable. We need to make sure these treatments come with proper support, including nutrition advice and help accessing healthy food since food insecurity is shaping the health of patients before they ever reach the clinic."

The authors conclude, as the use of incretin-based therapies continues to grow, ensuring that all patients can access the support needed to use them safely and effectively will become an increasingly important public health priority.