Popularity of Mounjaro since being approved in June has soared but senior doctors warn of severe inequality within London, reports Kumail Jaffer, Local Democracy Reporter

Weight loss drug interest has spiked in London but patients face a “postcode lottery” when it comes to accessing the medication, senior medical figures have warned.

Tirzepatide – also known by its brand name Mounjaro – has been prescribed for severely obese patients in the UK since June, with around 220,000 people with the “greatest need” set to receive it over the next three years.

The drug, administered via a weekly injection, makes patients feel fuller for a longer time, therefore reducing their appetite and overall intake. It is seen by the NHS as an additional tool to tackle the country’s growing obesity rate and reduce the overall workload on the health service.

However, senior doctors and pharmacists have warned that there is severe inequality within London when it comes to accessing weight loss drugs.

Dorottya Norton, a specialist adult weight management lead in Hackney, told the London Assembly health committee: “There is a lack of consistency across London, England and the UK – there is a postcode lottery with weight management services.

“The lack of fairness is apparent to patients – some are able to get started and others are not. We are seeing a huge increase in referrals.

“We need some degree of consistency across London so patients can get away from the postcode lottery. It’s becoming a difficult clinical environment because there is such a gap between what patients understand, what they want and what is available. Many patients are also self funding, so inequality is growing.”

As well as supply, the doctors warned that the wraparound care needed to ensure drugs like Mounjaro worked – which includes psychological and nutritional support – is still lacking.

Dr Tamara Hibbert, who chairs the Newham Local Medical Committee, said interest spiked in London recently following media coverage of June’s mass rollout of Mounjaro.

“Across London, the majority of areas hasn’t got a safe clinical pathway in place,” she added. “We’re all scrambling to get something together.”

The National Institute for Health and Care Excellence (Nice) has estimated that 3.4 million people would be eligible for treatment under their criteria, with all of them to have access within twelve years. But with some NHS trusts less able to deliver than others, a geographic inequality has set in.

This inequity between supply and demand has, in turn, prompted those who are able to afford it to secure unregulated supplies on the black market, the committee was told.

Sokratis Papafloratos, founder of Numan, an online provider of weight loss drugs, said: “In terms of illicit access, I think we really underestimate the problem and misunderstand it.

“You can buy the active ingredients as somebody that does research. However, people are finding these companies and buying and importing ingredients that are designed for clinical research and are injecting them into their bodies, which I find mind blowing.”

Sukhi Basra, National Pharmacy Association vice chair, told London Assembly members that her patients had shown her photos of boxes “full of fake medicines”.

“They’re being sold as generic medications, and that petrifies me.”

Last month the CIty of London Police issued their own warning about counterfeit weight loss medicines after more than £32,000 worth of Mounjaro, and diabetes drug Ozempic which is not intended for weight loss – believed to have been illegally sold in the UK – was seized during an investigation by the Police Intellectual Property Crime Unit.

Detective Constable Jason Theobald said: “Members of the public must be aware of the very real dangers of purchasing counterfeit or unlicensed medicines online. Not only are they potentially unsafe, but they could also be sold without the necessary medical advice and therefore are extremely dangerous to the public.”

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