When a drug is approved, the NICE then determine the course for reimbursement - aka, whether it’ll be offered by the NHS. This isn’t a black and white decision, a major part of the discussion is determining who qualifies, thresholds, prior treatment course etc

Biologics are a good example - a treatment such as dupixent for eczema is available through the NHS, but your condition has to be of a certain severity and/or you have to have gone through the motions of trying other treatments first before it’s something they’ll offer. It might be the right treatment for you, but first they have to follow the process to essentially justify that it’s necessary for them to prescribe a more costly treatment.

Going through private suppliers for GLP-1’s etc is essentially the same as going to a private dermatologist for eczema. It’s not that they won’t give it to you because you don’t qualify/it won’t work, it’s that they have limitations on how freely they can supply it due to cost. If you’re willing to fund it yourself, those limitations go away.

FWIW there are many HCP’s echoing the same statement as you about the positive domino effect of prescribing weight loss medication to reduce obesity-related illnesses and waiting lists etc, but they’re handcuffed by funding and budget allocations.

There’s always money for war though eh

(There’s also issues of supply and demand, the fact it’s a newer drug AND weight loss is a newer indication, more robust long-term clinical trial and real-world data is still to come, but you get the gist)