There are real lives behind the numbers.

A person who has tried to lose weight many times, only to find themselves back where they started. A teenager becoming conscious of their body and how others see them. Someone whose health is beginning to suffer while carrying something less visible too: frustration, anxiety, embarrassment or simply the exhaustion of trying again.

That is where any serious conversation about obesity must begin - with understanding, not judgement.

Too often, weight is discussed as though the answer were obvious: eat less, exercise more, show greater discipline. Healthy eating and physical activity are essential, and personal choices matter. But the World Health Organisation recognises obesity as a complex, chronic disease influenced by biological, behavioural, social and environmental factors.

The scale of the challenge in Malta is significant. According to the OECD's Country Health Profile 2025, 26% of adults in Malta were obese in 2022, with the rate higher among men (29%) than women (23%). Among 15-year-olds, 32% were overweight or obese, almost one in three and around 1.5 times the EU average of 21%. On both measures, Malta recorded the highest rates in the European Union.

These figures should prompt action, not stigma.

Prevention must remain central. We need to help children develop healthier relationships with food and physical activity from an early age. Our schools, workplaces, communities and public spaces should make active living easier. At the same time, we cannot ignore the impact that body image and stigma can have on mental wellbeing.

Yet for some people, lifestyle changes alone may not be enough. Needing medical treatment should never be regarded as a personal failure, any more than needing treatment for hypertension, asthma, or another chronic condition.

My experience as a pharmacist has taught me both the value of medicines and the responsibility that comes with their use. The right treatment can transform a person's health, but it must be grounded in scientific evidence, clinically appropriate, and accompanied by professional care.

That is how we should approach the glucagon-like peptide-1, known as GLP-1 medicines. These type of medicines mimic this natural gut hormone to help lower blood sugar, slow digestion, and reduce appetite, making them useful for treating type 2 diabetes and chronic weight management. They can play an important role in evidence-based treatment, but they are medicines, not cosmetic products or miracle injections.

It is within this framework that the Government decided to introduce GLP-1 agonists into the public health service. Following evaluation and consultation with healthcare professionals, the first phase is intended for around 2,000 patients with Type II diabetes and severe obesity, with an investment of approximately €5 million.

For me, the significance of this decision goes beyond the medicine itself. It speaks to a fundamental principle of public healthcare. When a treatment is clinically appropriate and evidence-based, a person's ability to pay should not determine whether they can access it. For people to have an equal share in healthcare (equity) is a core value of the Labour government,

But equal access must also mean responsible access. Public healthcare has a responsibility not only to make appropriate treatments available but also to ensure that they are prescribed to the right patients, properly monitored, and evaluated based on clinical evidence.

The government's approach combines medication with physical activity, balanced nutrition, multidisciplinary care, and ongoing professional monitoring.

Ultimately, we are treating a person, not a number on a weighing scale.

This distinction becomes particularly important amid growing interest in online-promoted weight-loss treatments. The issue is not whether a treatment is new, fashionable or technologically innovative. The questions that matter are whether it has been properly evaluated, authorised for its intended use, manufactured to appropriate standards and prescribed and monitored within a safe clinical framework.

So as such, peptides are not the problem. Established medicines available in Malta, including Ozempic (semaglutide), are peptide-based therapies. What matters is not the label attached to a product, but the evidence behind it, its regulatory status, its quality assurance and the professional clinical oversight surrounding its use.

It is easy to ask why anyone would take such a risk. But consider someone in Malta who has struggled with their weight for years and is then confronted online with a constant stream of dramatic transformations and promises of rapid results.

What a healthcare professional sees as an obvious risk may, to someone exhausted by years of trying, look like hope. We should understand that hope without allowing it to be exploited.

The recent case involving products claiming to contain Retatrutide shows why that distinction matters in Malta. In June, the Superintendence of Public Health and the Malta Medicines Authority warned about products claiming to contain Retatrutide being offered through unverified and unauthorised sources, including online platforms, social media and informal sellers. Retatrutide is not authorised for public use, and no product containing it has been approved.

This is where the line between pharmaceutical innovation and unsafe, unauthorised access in Malta must remain clear.

Regulation should not be seen as bureaucracy standing between a patient and treatment. It is an essential part of protecting the person who relies on that treatment. Knowing what a medicine contains, where it came from, whether its quality has been assured, whether it is being used appropriately and what risks need to be monitored are not administrative details. They are patient-safety safeguards.

There is therefore no contradiction between widening access to evidence-based treatment in Malta and warning against unauthorised products. The principle remains the same: embrace innovation where evidence supports it, while protecting patients where the necessary safeguards are absent.

But warnings alone are not enough. If people are prepared to seek unauthorised products in the hope of losing weight, we must also understand what drives them there. Good public health policy cannot simply tell people what not to do. It must also provide the knowledge, support, and legitimate alternatives that enable safer choices.

Our responsibility therefore goes beyond prevention or prescribing. We must promote healthier lives, strengthen health literacy, provide equitable access to appropriate treatment, and protect people from those who seek to profit from vulnerability.

Malta already has important safeguards in place. The Medicines Authority maintains a public database through which people can check whether a medicinal product is authorised for placement on the Maltese market. At the European level, the common EU logo enables citizens to verify whether an online pharmacy or retailer is legally operating in the EU country where it is established.

But having safeguards is not enough if people do not know about them or think to use them. This is where we can and should go further.

The European Medicines Agency has taken medicines communication directly into the digital space through its #HealthNotHype campaign, working with content creators to promote the safe and responsible use of GLP-1 medicines and address misleading information. Malta should build on this approach by making medicines literacy more visible and accessible, particularly in the digital spaces where people increasingly obtain health information, so that people can better recognise safe options and avoid misleading products.

This is ultimately the balance modern medicines policy must strike: embracing innovation without lowering our standards, improving access without abandoning clinical responsibility, and protecting people without judging the circumstances that may lead them towards unsafe choices.

There are no simple answers to obesity. A compassionate public health system can offer something better than either stigma or false promises because it believes that prevention and knowledgeable information can empower people to make safer choices and receive evidence-based treatments.

Because medicine policy is ultimately not about the medicine. It is about the person who places their trust in it.