Control your weight to protect your heart health

Authored by: Dr Matthew Lee; BMSc, MBBS, MSc

Last reviewed: Jan 2025

What's in this PocDoc Article:

What is obesity and being overweight?
The growing problem of obesity and being overweight
Being overweight or obese leads to increased health risks
Lifestyle changes can prevent obesity
Medical interventions can be helpful in the weight loss process
Weight loss medications are more effective with lifestyle changes and regular health checks

What is obesity and being overweight?

The World Health Organization defines overweight and obesity as the abnormal accumulation of fat that poses a health risk. This excess fat can be caused by:

Unhealthy portion sizes
Diets high in saturated fats and low in fruits and vegetables
A sedentary lifestyle
Stress and lack of sleep
Genetics
Medical conditions / Medication

Body Mass Index (BMI) is a widely accepted method to check if an individual is obese or overweight. According to the NHS, a BMI of:

18.5 to 24.9 means an individual is in the healthy weight range
25 to 29.9 means an individual is in the overweight range
30 to 39.9 means an individual is in the obese range
Over 40 means an individual is in the severely obese range

Disclaimer:

If you have an Asian, Chinese, Middle Eastern, Black African or African-Caribbean family background, you'll need to use a lower BMI score to measure overweight and obesity.

The growing problem of obesity and being overweight

In 2022, the World Health Organization (WHO) revealed that 2.5 billion adults globally were overweight, with 290 million being obese. Though the impact is being felt worldwide, the UK particularly struggles with obesity rates, with 1 in 4 adults estimated to be obese.

PocDoc data generated in 2025 supported this finding with 39% of all individuals screened by PocDoc being overweight and 31% being obese.

Being overweight or obese leads to increased health risks

Excess weight has been shown to cause atherosclerosis and increase the risk of certain medical conditions in individuals. The most common are high blood pressure, high cholesterol and type 2 diabetes, which have all been linked to increased cardiovascular disease risk.

The increase in premature cardiovascular disease has been labelled as the cause of 31,000 heart-related deaths every year in the UK. The increase in weight of children, has led to the implementation of a junk food ad ban on daytime TV by the UK’s government and schemes to promote healthy eating in schools in an effort to curb childhood obesity.

The majority of cases of being overweight and obese, as well as their related noncommunicable diseases, are largely preventable and manageable through lifestyle changes and medical intervention.

Lifestyle changes can prevent obesity

Another beneficial habit is to maintain an active lifestyle with at least 150 minutes (2 hours and 30 minutes) of moderate-intensity activity weekly.

Medical interventions can be helpful in the weight loss process

Though medical treatments do not replace the need for lifestyle changes through diet and exercise, there has been a steady increase in the use of medication to treat obesity.

The three main drugs that have been approved by the NHS for weight loss management are:

Orlistat ( e.g. Xenical)
Liraglutide ( e.g. Saxenda)
Semaglutide (e.g. Ozempic, Wegovy)

*Tirzepatide ( Mounjaro) has since been approved by NICE (National Institute for Health and Care Excellence) for treating obesity in the UK on 23 December 2024.

1. Ozempic

Originally designed to treat obesity in individuals with type 2 diabetes, Ozempic is now gaining increasing popularity as a weight loss drug in overweight individuals without this condition. It contains the active ingredient, semaglutide, which suppresses appetite.

Guidelines from the National Institute for Health and Care Excellence, (NICE) recommend that Ozempic can be prescribed to adults with type 2 diabetes in certain circumstances.

Ozempic is mainly only prescribed to people who have a BMI of 35 or more and have additional psychological or other medical conditions that are related to obesity.

However, if someone has type 2 diabetes, they can be prescribed Ozempic if they have a BMI below 35 and:

Using insulin would affect their job due to the risk of hypoglycaemia
Weight loss would lead to improvements in other obesity-related health issues.

2. Wegovy (Semaglutide)

Wegovy has been approved by the NHS as a weight loss drug, alongside diet changes and physical activity. Wegovy contains the active ingredient semaglutide, also found in Ozempic and similarly must be prescribed through a specialist weight management service.

Wegovy works by regulating your appetite and increasing feelings of fullness while reducing feelings of hunger and your preference for fatty foods. A study in 2021 by the New England Journal of Medicine has shown that individuals who have used Wegovy for 15 months saw a 15% loss in their body weight.

However, not only has Wegovy been approved for weight loss, but in July 2024, it was also approved to help lower the risk of heart attacks and strokes in individuals with heart and circulatory diseases, with a BMI of 27 or higher by The Medicines and Healthcare products Regulatory Agency (MHRA).

Research in 2023 from the same journal concluded that those using Wegovy had a 20% lower risk of death from circulatory disease, heart attack or stroke, supporting the MHRA’s approval.

In order to be prescribed semaglutide (Wegovy), you must have health problems due to your weight and either have:

BMI of over 32.5-35, depending on your ethnicity.
or BMI of over 27.5 – 30, depending on your ethnicity, and you meet other criteria to be treated by a specialist weight management service.

3. Saxenda (Liraglutide)

Unlike Wegovy and Ozempic, Saxenda contains the active ingredient liraglutide. However, it also works to lower feelings of hunger, which helps to reduce food intake.

Saxenda also helps the stomach to digest food more slowly, leading to increased feelings of fullness and must also be prescribed through a specialist weight management service.

A randomised controlled trial published in the New England Journal of Medicine revealed that 3.0 mg of liraglutide paired with diet and exercise was linked to a reduction in body weight and improved metabolic control.

In order to be prescribed liraglutide ( Saxenda) you must meet all of the following criteria:

BMI of 32.5 - 35 or more, depending on ethnicity.
Have non-diabetic hyperglycaemia (high blood sugar)
Have a high risk of heart problems such as heart attacks and strokes.

4. Xenical

Xenical contains the active ingredient, orlistat, which has been linked to weight loss. Xenical works by preventing your body from breaking down around 1/3 of the fats you eat, resulting in the undigested fat being passed in your stool.

Along with proper diet and exercise, Xenical is an effective treatment for weight loss. A study published in 2019 revealed that 60 mg of orlistat, along with a reduced calorie, low fat diet may be an effective weight loss tool.

The NHS recommends that Orlistat be taken only after significant efforts have been made to lose weight through diet, exercise or changing lifestyle.Then orlistat is mainly only prescribed if either:

a body mass index (BMI) of 28 or more, and other weight-related conditions, such as high blood pressure or type 2 diabetes.
a BMI of 30 or more.

5. Mounjaro

Similar to Ozempic, Mounjaro was designed to target individuals living with type 2 diabetes. Recently, it was announced that the drug would be rolled out by the NHS over the next 12 years. The National Institute for Health and Care Excellence has recommended that the rollout begin in March 2025 as a weight-loss treatment. Mounjaro will be offered to individuals with a BMI of over 35 and those with at least one obesity-related health problem.

The active ingredient in Mounjaro is tirzepatide, which mimics naturally occurring hormones that aid in blood sugar regulation and appetite suppression. Clinical trials have shown up to a 20% reduction in weight after using the drug for 18 months when combined with lifestyle changes.

Additionally, other trials conducted from December 2019 to April 2022 revealed that 36.2% of the participants who consumed 15mg of tirzepatide had a weight reduction of 25% or more.

Table showing how to access these weight loss medical interventions

Most of the weight loss medications mentioned above are available through the NHS or through private services; if you meet certain criteria and are referred to a weight management service.

How much do these weight loss drugs cost?

While these medications are available through prescription at private pharmacy services, the costs may vary depending on your provider. Here are a few of the costs associated with each drug:

Weight loss medications are more effective with lifestyle changes and regular health checks

Though medical treatments provide an effective solution to the obesity epidemic, they are more effective when paired with lifestyle changes. A well-balanced diet, low in saturated fats, and increased physical activity will help make your weight loss more sustainable and prevent gaining weight when you stop the medication.

In addition, regular health checks can help you to monitor your BMI as well as your risk for obesity-related illnesses such as cardiovascular disease.