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Flawed NHS Guidance Denies Millions Access to Vital Treatments
15 Aug
Summary
- BMI measures do not account for ethnic differences, excluding millions
- NHS to roll out weight-loss jab Mounjaro, but access limited by BMI
- Experts warn current guidelines are "broad-brush" and problematic

According to a report by the King's Fund, the NHS's reliance on outdated Body Mass Index (BMI) measures to determine obesity levels and treatment eligibility is excluding millions of people, particularly those from diverse ethnic backgrounds.
The analysis reveals that the current BMI thresholds, which are primarily based on research for White European or American people, do not adequately account for the inherited differences in health risks among Black, Asian, Brown, dual heritage, and indigenous populations. This means that some groups may be denied access to treatments like weight-loss jabs and other obesity-related interventions, even if they face similar health risks at a lower BMI.
The issue is set to become more pressing as the NHS prepares to roll out access to the weight-loss drug Mounjaro for 250,000 patients annually over the next 12 years. Eligibility for Mounjaro and other treatments, such as IVF, bariatric surgery, and joint replacement, is largely determined by a person's BMI.
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Experts warn that the current "broad-brush" approach of lowering BMI thresholds for all "Black, Asian or Middle Eastern" individuals is problematic, as it fails to address the nuances within these diverse communities. This could lead to further health inequalities and inaccurate measurements of obesity prevalence across different ethnicities.
The report calls for a more nuanced and inclusive approach to BMI guidelines, one that recognizes the unique health risks and needs of various ethnic groups in the UK.