A DECISION ON the availability of State-funded weight-loss injections for medical card holders or under the HSE’s Drug Payment Scheme is imminent.

A health technology assessment (HTA) of the medical, social, ethical and economic implications of the weight loss drug Mounjaro is due to be published soon – the first step in the decision about who will be in a position to avail of these drugs.

However, there is no mention of the huge costs to the HSE of failing to regulate the unhealthy food environment in alignment with the provision of treatments for a disease that affects one in four of the population. That’s 1.2 million people. There is simply no logic to this approach.

Health Minister Jennifer Carroll MacNeill said the application for Mounjaro under the reimbursement scheme could be approved by the end of the year. The HSE’s national clinical lead for obesity, Professor Donal O’Shea, suggested that it is likely that availability will be similar to the approach taken in the UK, which is for people with a BMI over 35, plus complications. This would limit obesity injections to about 80,000 people.

The problem with this approach is that obesity treatments do not factor in the impact of price, marketing, the variety of foods offered or convenience on eating behaviour and body weight. These are the non-nutritional drivers of eating in the real world that need to be tackled in alignment with effective obesity treatment.

But there are ways to mandate for a healthy food environment that would transform health, while reducing risks of obesity and chronic disease. Here are a few suggestions.

The first step is to introduce mandatory reformulation of ultra-processed foods. This would require all companies to reformulate there products with restrictions on hyper palatability and calorie density.

In his book Food Intelligence, human nutrition and........

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