In this powerful and personal blog, Councillor Jo Monk shares her journey with obesity and the transformative impact of new weight-loss medications. But she goes further, calling for a compassionate, whole-system approach that tackles the social, environmental, and cultural drivers of obesity.
I never imagined I'd be writing publicly about my weight. For years, it was something I carried quietly-alongside the physical burden, the emotional weight, the stigma, and the self-doubt. Obesity isn't just a number on a scale. It's a complex, deeply personal challenge that intersects with health, identity, and society.
I've tried everything. Diets, exercise regimes, support groups. Some worked for a while. Most didn't. The turning point came when I was offered a new obesity drug-one of the much-talked-about GLP-1 receptor agonists. I'd heard the hype, seen the headlines, and watched the debates unfold and in the media.
The results were dramatic. My health has significantly improved in several ways. I have experienced increased energy levels, clearer skin, and most importantly, a noticeable reduction in joint pain. My blood pressure is now better controlled, and the journey has been an invaluable tool in helping me maintain a healthy diet and consistently eat nutritious meals.
As of early 2025, approximately 344,927 unique patients in England were prescribed medicines licensed for weight loss management through the NHS between March 2024 and February 2025. These include drugs such as tirzepatide (Mounjaro), semaglutide (Wegovy), liraglutide (Saxenda), and Orlistat.
However, the majority of people accessing obesity drugs in the UK are doing so privately. Estimates suggest that around 2.5 million people in the UK were using weight-loss injections like Mounjaro and Wegovy by July 2025. This means that over 90 per cent of users are accessing these medications outside the NHS, often through online pharmacies or private clinics.
NHS England has committed to a phased rollout of tirzepatide, prioritising 220,000 patients over the first three years based on clinical need. This reflects the challenge of balancing demand, cost, and capacity within the public health system.
NICE's guidance (NG246) makes it clear that medicines like tirzepatide, semaglutide, and liraglutide should be used alongside a reduced-calorie diet and increased physical activity-not as standalone solutions. These drugs are recommended for adults with a BMI of 35 or more and at least one weight-related comorbidity, or for those with slightly lower BMIs who meet criteria for specialist services. Importantly, NICE also advises using lower BMI thresholds for people from ethnic minority backgrounds, recognising the different risks they face.
This is a step forward. But it also reinforces what many of us already know: obesity is not just a medical issue. It's a social one. It's about poverty, access to healthy food, walkable communities, mental health, education, and culture. It's about the way we design our towns, the way we fund our services, and the way we talk about health. And it's about the systems that either support people-or fail them.
In Worcestershire, I've seen promising examples of what a whole system approach can look like. The Healthy Worcestershire programme offers free weekly sessions in community venues, combining gentle exercise, nutritional advice, and social support. There's also a 12-week virtual weight management programme, including interactive workshops. These services are open to anyone over 18 and can be accessed through online self-referral or by calling. Slimming World Vouchers are also available to anyone over 16 with a BMI over 25 (or 23 for ethnic minority groups), and referrals can be made through GPs or social prescribers.
These kinds of initiatives matter. They meet people where they are. They offer wraparound care. And they recognise that sustainable weight loss is about more than willpower-it's about support, environment, and opportunity.
Drugs like the one I took have a place. They can be life-changing. But they must be part of a broader strategy, not a substitute for it. We need a whole system approach-one that recognises the complexity of obesity and responds with compassion, evidence, and ambition.
I'm still on my journey. But I'm also hopeful. Because I know that change is possible-not just for individuals like me, but for communities across the country. And I'll keep speaking up, not just about my own experience, but about the kind of system we need to build: one that sees the whole person, not just the weight
Councillor Jo Monk