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New highly effective weight loss drugs could create a market worth more than $100bn in annual revenue by 2030. Whilst the majority of this value will be captured by the pharma industry, HBI hears there will be a significant role for specialised clinical providers who can deliver these medicines alongside behavioural and lifestyle changes. 

A new class of weight loss drugs have been shown to be much more effective than previous treatments for obesity. GLP-1 receptor agonists are a class of drugs that have been used to treat diabetes since 2005. They work by mimicking the body’s natural hormonal ‘off switch’ which makes you feel full and can become dysregulated in overweight people. The first of these drugs – Saxenda – was approved for weight loss by the FDA in 2014. Multiple others have come out since, the latest being Wegovy, which has recently been shown to help people achieve up to 15-20% weight loss in clinical trials.

HBI caught up with Dr. Frank Joseph and Kevin Dryhurst, who run a weight loss clinic in London called Dr Frank’s Weight Loss Clinic, to find out more.

“The ‘magic’ of these medications is that they are 100% effective, as long as you can tolerate them,” Dr. Frank tells us. “The only reason someone wouldn’t progress on it is if they experience side effects. The commonest side effects are gastrointestinal, nausea, a bit of constipation, or diarrhoea. For a lot of people these are transient, but for the few people for whom they’re persistent the risks outweigh the benefits. But most people can tolerate it.

“You see results that are literally life changing. People can lose six to seven stone in 12 months. This is hugely transformational: patients find their aches and pains from arthritis are gone, they have a significantly reduced risk of type 2 diabetes, high blood pressure, high cholesterol and in turn cardiovascular disease risk can be reduced. 

“Taking all that into account, we created Dr. Frank’s Weight Loss Clinic, to take the tech that exists in the medical sphere, along with the years of experience I have of achieving effective sustainable weight loss as a clinician, combining the drugs with behaviour changes using nudges, dietary changes, exercise, motivation, to allow people to sustain the weight loss they achieve, and to turn it into a service and offering that the masses can avail and benefit from, not just within the UK but abroad. We officially began this year, our first virtual consultation was in March 2023. The main drug we are using is Wegovy, but we have on the rare occasion used a tablet version called Rybelsus (this is off-label, and we have only used it in exceptional circumstances). We are looking forward as well to offering the latest injectable medication to have been approved by regulators, called Mounjaro.”

Frank’s business partner Kevin Dryhurst tells us: “Where we have a USP is that we are very passionate that there is a clinician at the core of our service. Whether it be a physical consultation or digital consultation, we always have a doctor or nurse that can guide and advise. A lot of the mass marketers in this space don’t. You have pharmacies just offering the drug. But we’re about long-term, sustainable weight loss and managing the complexity of an individual’s health.”

NICE began recommending Wegovy for weight loss treatment in the UK early this year. However it is only available on the NHS for people on the more severe end of the spectrum. Frank tells us this is unlikely to change in the coming years, and so the bulk of the UK’s market in the future will be private pay. Whilst estimates of the total cost that obesity imposes on the UK are in the 10s of billions a year, only a minority (around £6.5bn) of the costs come from treatment within a health care setting, which explains why the cash-strapped NHS is only providing it to the most severely obese.

“All our patients are private pay, although we would be willing to work with the NHS in the future. The NHS is starting to offer it, but you can only get it if you go through a Tier 3 weight management service, which means going through a specialist hospital that usually prepares people to have weight loss surgery. Some people can be offered the medication via those hospitals, but there are only a handful of places in the country that have been able to start offering it, so it can be a bit of a postcode lottery as to who can get it.”

Dr. Franks charges £200-300 per month for the treatment and support service. Frank points out that when you take into account the amount of money saved on food and drink (people often find they crave alcohol less on the drugs), this is actually almost cost neutral for most patients. Dryhurst says they are not targeting just the affluent, but “anyone who is conscious about their health and willing to make the investment to look after themselves”. 

Unlike diabetics who typically have to take the medication for the rest of their life, Frank tells us for weight loss “six to 12 months is typical, however it can vary a lot depending on their starting weight and how much change is needed. The experience is generally that once we get them to a target weight where they’re comfortable, we can reduce down and then withdraw the medication. But some people are unable to maintain that weight loss because their biology says ‘you’re hungry again’ when they reduce the medication.” 

When asked whether, with millions of potential customers and not many competitors, the company even needs much of a marketing strategy, Dryhurst tells us: “At the moment we’re still very much at the exploratory stage where people aren’t fully aware yet. There’s been a significant take-up of these drugs in the US, so we’re watching that and reading Morgan Stanley’s reports and future predictions. In the US it’s become very topical, it’s been the choice of some very famous individuals (Elon Musk, Jeremy Clarkson, Oprah). We’ve all been there where you find yourself carrying a bit too much weight after a summer. Some people will take these meds to bring them back in line. They’re not our customer base but we’re finding articles reporting individuals who have found it works as a short term solution. But we would very much like to focus on an individual who is obese, perhaps a middle aged man or woman, life’s caught up with them, perhaps they’re married and have had kids, and for whom going to the gym is hard because they’re so busy. Before you know it you’ve found yourself obese and at risk!

“This sector’s going to be $100bn+ per annum in the next few years, as awareness grows across the country and the international community, we will be perfectly placed to be able to support that growth. We have an aggressive international roll-out program: we’re currently live in the UK, Spain, India and New Zealand, we’re in the process of launching in Australia. We’re looking at working with insurance companies and employers. Frank has been a pioneer for weight loss in the UK with all the research and clinical trials he has been involved in. We’re very excited about what the future may bring over the next 12 months and beyond. It’s going to be very busy for us. We want to make a significant impact on obesity globally and in turn support public health and health care systems that are under pressure from the consequences of obesity.”