GPs should support patients for one year after GLP-1 treatment, says NICE

GPs should monitor patients who have taken weight-loss medication ‘for a minimum of one year’ after treatment is completed, according to a new NICE quality standard. 

Published today, the updated standard asks healthcare professionals including GPs to offer advice, follow-up support and provide tailored action plans including regular check-ins. 

The standard said they should ‘ensure that they deliver advice for maintaining changes and support for improving health and wellbeing at the end of prescribing or as part of discharge from the service and care planning.’ 

Patients who have completed treatment should ‘receive feedback and monitoring at regular intervals for a minimum of one year so they can get help if they are not maintaining changes,’ the statement added.

It also said healthcare providers should promote patient self-management, the benefits of physical activity, and national healthy eating programmes like NHS Better Health. 

NICE said healthcare providers and commissioners are expected to begin rolling out the new standard ‘immediately’. 

Around 240,000 people are expected to be offered tirzepatide (Mounjaro) for obesity via the NHS over the next three years. However the rollout, which began in June, saw many ICBs unprepared to offer the service.

It has also been estimated that there are already 1.5 million users of weight loss jabs in the UK, mostly through private providers.

In all, 29% of adults in England are obese and 64% classified as overweight or obese, according to figures from NHS Digital. 

Dr Rebecca Payne, chair of NICE’s Quality Standards Advisory Committee, said weight management was a ‘long-term journey, not a short-term fix’. 

‘This quality standard will help ensure all healthcare providers adopt these best practices, giving every person the best chance of maintaining their weight management success over the long term’, she said.

Professor Jonathan Benger, deputy chief executive and chief medical officer at NICE, said: ‘Successful weight management doesn’t end when medication stops or when someone completes a behavioural programme. 

‘We know that the transition period after treatment is crucial, and people need structured support to maintain the positive changes they’ve made. 

‘This new standard makes sure services provide that vital continuity of care, and it supports the NHS 10 Year Plan to shift from a ‘sickness service’ to a genuine health service focused on prevention.’

Dr Adam Janjua, chief executive of Lancashire and Cumbria LMCs, told Pulse: ‘These jabs are useless if they aren’t accompanied by concurrent pathways of patient education, lifestyle management courses and long term follow up.  

‘NHS England took a very short term view on management of obesity when they gave the go ahead for these jabs to be used across the nation in June without adequate resources and infrastructures in place to create a long term solution.  

‘If this was to be done correctly and in a sustainable manner then it needs planning, engagement with GPs and adequate resourcing to pay for all the extra work that this will entail – including longer term follow up plans.’  

Last month, the BMA said GPs should bulk-warn patients about the possibility of GLP-1 weight-loss drug injections making hormonal contraception less effective. 

Earlier this year, the Medical Defence Union warned GPs could be at medico-legal risk if they ignore requests from online pharmacies.

NICE’s quality standard on maintaining weight after GLP-1 treatment

Advice for maintaining changes and support for improving their health and wellbeing

Ensuring that people stopping medicines for weight management or leaving behavioural weight management services after completing a behavioural overweight and obesity management intervention:

• receive feedback and monitoring at regular intervals for a minimum of 1 year so they can get help if they are not maintaining changes

• have well-rehearsed action plans (such as ‘if–then’ plans) that they can easily put into practice if they are not maintaining changes

• have thought about how they can make changes to their own immediate physical environment to prevent weight regain

• have the social support they need to maintain changes

• are helped to develop routines that support the new behaviour (note that small, manageable changes to daily routine are most likely to be maintained)

• are offered a range of options for follow-up sessions after an intervention active phase has been completed, including at different times and in easily accessible and suitable venues.

And ensuring that weight management interventions encourage people to make lifelong behavioural changes and prevent future weight gain, by:

• fostering independence and self-management (including self-monitoring)

• encouraging dietary behaviours that support weight maintenance and can be sustained in the long term (for example, emphasise that national programmes promoting healthy eating like NHS Better Health can support overweight and obesity management)

• emphasising the wider benefits of keeping up levels of physical activity over the long term

• discussing strategies to overcome any difficulties in maintaining behavioural changes

• encouraging family-based changes

• discussing sources of ongoing support once the intervention or referral period has ended (opportunities could include the programme itself, online resources or support groups, other local services or activities, and help from family or friends).

Source: NICE

Portfolio careers

What is the right portfolio career for you?

Click here to take our quiz