Why are the NHS making access to 'fat jabs' almost impossible.

And in the meantime there is an obesity crisis in young children. If I was a cynic I would be taking out shares in weight loss drug companies because they are going to be a money spinner for the next fifty or sixty years until people stop feeding their kids meals full of fat and sugar and topping them up with unnecessary snacks in between. When you have four and five year olds wearing clothes sized for seven year olds the alarm bells should be ringing.

If the government as no rationing at all and tej drugs were freely available from the GP the loads of people with only a small amount of weight to lose would definitely want them

So there needs to be some rationing at least by BMI surely so that they are prescribed for those people whose obesity is a medical not just a cosmetic issue

Currently it's rationed by BMI and medical comorbidity which surely most people can understand but also by attendance at these courses etc which it seems to me is essentially a bit of a test of motivation. Like requiring drug and alcohol addicts to engage with a community rehab programme before they get an inpatient detox. If you don't do that you just end up repeatedly detoxing the same people at great expense with them relapsing straight away. I think there is some kind of reasonable analogy there that weight loss drugs and surgery have their place but ought to be accompanied by some motivation and commitment to a diet and lifestyle change.

Where is your evidence that people are doing this?

@jasminocereusbritannicus

That's great for you

It varies from area to area some GPs prescribe specifically only to people with diabetes and others not at all

I have a BMI of 45. The only thing I was offered was a one hour virtual seminar on the food pyramid.

I'm fat, not stupid.

I’m a little confused… I haven’t had any problems with being offered weight loss injections from my GP.

I was diagnosed type 2 diabetic 2 years ago now, and have been on Ozempic from my GP for about the same amount of time, along with metformin/dapagliflozin. I was 23 stone and now I’m 16.5 stone. The weight loss has slowed down, but is still happening. I was very sick with it to begin with, but after about 4 months the awful side effects stopped.
There was a few times when it was difficult to get hold of my prescription, but that seems to have sorted itself out now.

I do worry that that it maybe stopped… I know that I would easily fall back into old habits. The injections not only make you feel fuller, but actually puts you off some foods!

whilst I am glad to have lost the weight, it has also left me with spare skin on my arms and tummy, but that can easily be disguised, so is not a huge problem to me. I think people aren’t clear on how massive weight loss leaves you. If you’re not able to cope with an ‘imperfect’ body, it will not be useful to you at all!
( I know it’s not just me… a person I work with who also was diagnosed type 2 diabetic has similar ‘problems’’ to me.)

Except it is possible. Biologically, we're designed to gain if we eat a lot, and lose if we don't. Agreed that it may be more difficult, but it is definitely achievable. To say otherwise is crazy. We're all the same species, after all. The process of losing that amount of weight is not fun or easy, but everything is too much like hard work for us these days as we've been spoon fed everything and had our lives run on convenience.

Get rid of all bread, cookie, rice, cakes and sweet mueslis in your diet, bump up the porridge, meat, fish, fruit and veg and in three months you would be down to the correct amount of weight - neither overly skinny, neither feeling hungry

I wouldn't mind losing a couple of stone but personally I wouldn't touch these drugs

You don't need to 'touch these drugs' at a couple of stone overweight. It is people who are classified as obese who could be significantly helped and for whom it would mitigate some of the long term health risks associated with obesity.

The hoops are rationing. The NHS cannot afford for everyone to have these drugs. Even if there would be future savings it does not have the money right here and now to spend

OP you say you knew all the healthy eating advice but I am sure there are many people who actually don't and would benefit from having that knowledge even if they also need surgery or injections. Surely the surgery and injections have to go alongside people changing their habits and they need knowledge and accountability to do that.

You do see people who regain weight after weight loss surgery because they learn how to get around the restriction and consume more calories even if it makes them ill. It's a waste of a precious resource to give that surgery to people who won't ultimately benefit. Same as a liver transplant or a detox of you are not ready to stop drinking.

Lots of treatments are rationed because we don't have the resources. They are rationed by a waiting list if nothing else. I guess you could have just sat around on a waiting list to have the surgery but it seems productive to try to use that time to impart some knowledge that might have helped some people.

So I think it's all of

• no money to give it to all
• wanting to select out people who will have long term benefit
• wanting to enhance the effectiveness with education

If you eat less you will lose weight. Look at the contestants off I'm a celebrity. Some lost 2 stone by the time they left.

So you know that it's achievable for you, but that doesn't mean it's achievable for other people.
The levels of obesity and the levels of recidivism strongly suggest that it's not achievable for most people.

Pushing healthy natural steps to lose weight through diet and exercise isn’t jumping through hoops though. As with any quick fix, unless someone learns to control their weight themselves then injections are just a temporary fix.
It’s not sustainable to be injecting these medications forever.

Fair enough. I think that's a very unhealthy way to live.
I do think supermarkets and governments need to make healthy food cheaper and processed food expensive so we are drawn to healthier options like fruit and not a grab bag of crisps for example. And I've been there and done it. I'd choose processed food every day it's been a real struggle lose my weight

There’s much more science to it than willpower though.

Then sitting in a 'workshop' where we are given amazing revelations such as (promise this is true) a pork pie has more calories in it than an omelette, that processed sugar laden food is worse for you than salad. That protein keeps you feeling fuller than a doughnut.

If so many people already know this why don't they apply it to their own lives?
There comes a time when we have to take responsibility for our own actions. Why blame and penalise the rest of the population and expect us to share the nurses time and other resources with those who can't be bothered to control what goes into their mouths food or alcohol?
The NHS is for people who are ill not for the can't-be-arsed team.

It is because I've done it. It's not easy though!

If you can afford to buy them privately or you can access them on the black market you can stay on them for as long as you please.
I'm not saying that's advisable I'm just saying you could.

Blackshuck3 I wasn't sure you can stay on them for life without an underlying health condition? Would that not mean you'd creating more issues for yourself. I genuinely don't know hence asking

@Iloveeverycat it's really not as simple as willpower. If you want to be informed read Ultra Processed People by van Tulleken or Why We Eat by Andrew Jenkinson. Or if you don't want to be informed you can carry on lazily believing "it's all about willpower".

I don't think natural weight loss is realistic or achievable when we live in such an unnatural environment.
When I say unnatural I mean from the point of view of the food that is available, i.e the constant temptation from highly palatable food-like substances which have been engineered to be as addictive as possible.

They were turned off when the post was made. This usually happens when the OP already knows they're being unreasonable.

Surely you could just stay on the injections for life provided you could afford it?
Also the fact that obesity is such a big problem provides a large incentive for pharmaceutical companies to provide even better (meaning more effective with fewer side effects) weight loss injections.
That being the case it won't be a problem staying on them for life, surely?

But loads of treatment, not just related to weight, has hoops. It's - and you'll hate me for saying this - to discuss relationships around food, exercise etc. I would think it much more safe for the NHS to try and encourage weight loss naturally than the first port of call be jabs. Just dishing them out willy nilly isn't tackling the root cause of obesity

I was sad to see Drew Barrymore has gone down this path.

I wouldn't mind losing a couple of stone but personally I wouldn't touch these drugs - there are already reports of some very sinister side-effects. The NHS won't want to pay because as soon as people stop taking them, the weight goes back on - they'd be bankrolling the prescriptions for decades. It's not sustainable - healthwise or financially IMO