Growing awareness regarding the potential risks associated with weight loss medications has prompted leading experts to question the current approach to obesity treatment. Professor Ray O’Connor from the University of Limerick School of Medicine has advocated for the ‘de-medicalisation’ of obesity, alongside raising concerns about the State's capacity to fund expensive GLP-1 weight loss drugs, often referred to as ‘skinny jabs’, especially amidst rising global drug prices.

The Government faces increasing pressure to include GLP-1 drugs such as Ozempic, Wegovy, and Mounjaro under the HSE Drug Payment Scheme. While Health Minister Jennifer Carroll MacNeill previously indicated that reimbursement for medical card holders was under consideration, Professor O’Connor expressed reservations. He warned that emerging evidence of negative side effects linked to GLP-1s could divert limited Government finances from more critical healthcare needs. Citing the substantial cost of the school meals programme (€288 million annually), he questioned the affordability of adding a drug payment scheme for these medications, particularly in the event of a recession. While acknowledging 'special circumstances' where such medications are necessary, he stressed the importance of a balanced view, highlighting adverse side effects and the State's spiralling drug bill.

Professor O’Connor pointed to the limitations of these medications, noting that approximately one in ten people are 'non-responders' to drugs like Ozempic. Furthermore, a major international survey revealed that individuals who cease taking the jabs typically regain their original weight within two years. Adverse side effects include common nausea, which one patient described as severe enough to interrupt swimming. More serious, albeit rare, complications include pancreatitis and thyroid tumours, each affecting about one in a thousand users annually. Professor O’Connor also referenced singer Robbie Williams's fear of vision loss due to weight loss drugs, explaining that non-arteritic ischemic optic neuropathy, a rare condition affecting about one in ten thousand, can lead to permanent vision loss, and cases accumulate with widespread drug use.

He also observed that some individuals use weight loss drugs as a 'quick fix' without adopting essential lifestyle changes, such as maintaining adequate protein intake and engaging in weight training to preserve body and bone mass. Many GLP-1 users, he noted, eventually 'get stuck'. Professor O’Connor emphasized the need to address the root causes of the country’s escalating weight problem rather than just its effects. He called for a robust public health policy on obesity, underscoring that adult obesity rates have more than doubled and adolescent obesity has quadrupled globally since 1990, driven primarily by social factors rather than genetics.

A critical area for intervention, according to Professor O’Connor, is the prevalence of ultra-processed foods, particularly in children's diets. He advocated for integrating dietary nutrition education into national schools as a crucial step to reverse current trends. Additionally, he proposed a national promotional campaign to highlight a more holistic approach to obesity, educating the public about the limitations of weight loss medications. He stressed the message that these are not 'simple jabs' that resolve all problems, but require ongoing monitoring, carry adverse effects, and are not a short-term solution.

Despite his concerns, Professor O’Connor reiterated that he is ‘not against these drugs’ and acknowledged evidence of benefits for conditions such as kidney disease, cardiovascular disease, and potentially polycystic ovary syndrome. However, he cautioned against the drugs becoming 'socially desirable,' with individuals seeking 'skinny jabs' for cosmetic reasons without fully appreciating the potential adverse effects.

In contrast, Professor Donal O’Shea, the HSE’s lead on obesity, highlighted the positive impact GLP-1s have had on many patients and noted their safe use in treating diabetes for nearly two decades. He agreed that unmanaged weight loss could increase frailty and stressed that any reimbursement scheme for weight loss drugs should be accompanied by accessible lifestyle programmes, ideally delivered digitally for scalability. Professor O’Shea believes drug costs will decrease as patents expire and generic versions become available, emphasizing the benefits of these medications becoming a routine part of obesity care, preventing conditions like diabetes, and facilitating access to treatments such as kidney transplantation. He underlined the importance of treating obesity as the disease it is.

Currently, weight loss injections typically cost private patients between €200 and €350 or more per month. A Department of Health spokesperson confirmed that the HSE’s leadership determines funding for new or existing medicines based on competing demands and available resources, in line with legislation. Liraglutide (Saxenda) is currently the only GLP-1 reimbursed by the HSE for weight management.