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

As a weightloss professional I chose weightloss surgery to physically help me to lose weight.

I mean you do see how that reads don’t you?

were you a registered nutritionist with patients when you were morbidly obese pre surgery?

I am a registered nutritionist who had weightloss surgery because I was morbidly obese. I knew every single mouthful of food, everytime I didn’t go for that walk, everytime I ate until I was bursting was contributing to my obesity. Could I stop? Nope. I knew what UPFs were doing to my guts and my brain. I knew that I was making wrong choices. But I was still fat. Sorry but I was fat. I had a degree in nutritional biochemistry and a masters in nutrition but I was fat.

As a weightloss professional I chose weightloss surgery to physically help me to lose weight. However, I think we need to be very careful prescribing surgery or weightloss jabs on the nhs. These methods are NOT permanent and need to be treated as such. A person needs to be very educated on how these aids (and that’s what they are, aids not cures) can help them with a LOT of will power and commitment. The NHS can not fund these jabs forever as well as the counselling I feel needs to go alongside them. As soon as the jabs are stopped most people will put weight back on if they are not careful, same with surgery. Which is a waste of money.

Obesity is a very complex disease. And whilst I agree we need to stop treating it differently to any other disease I also think we need to be careful and realistic with our approach to tackling it.

One of the big external factors in Japan is very low social acceptance for obesity. Under the Metabo Law employers and the public sector are responsible for monitoring health of the employees/local population and take action when someone is at risk of the metabolic disease.

Given the level of denial of the link between personal food choices and weight on every thread like this, I don’t think the Japanese model would be warmly received in the UK.

in fact from this thread alone we know some were obese because of this

why?

because they are open about it!

Do you seriously think that not one obese person is obese because they just really bloody enjoy eating shit day in and day out and have no inclination to walk further than to their car

I mean they may well be the minority

but there will be some!!

oh man alive

Yeah, again you’re assuming we’re idiots and that we have no ability to have insight on our lived experience. It’s rather gaslighty - are you meaning to come across like that?

I mean, you’re in good company as plenty of drs and health workers hold the same attitude.

Thankfully there are many drs who work in this field with years of experience and years of observations who thankfully are excellent advocates for obese people and understand that it’s not simply a matter of choosing not to be obese.

Just saying it’s “systemic” is an oversimplification. Some of it is down to that, some is down to people being lazy (physically or in terms of food), some is down to genetics/hormones etc (I’m not going to pretend to know anything about that), some is down to people not caring and “the NHS will fix me”. It’s a very complex issue with a multitude of factors, I’m not arguing with you so I’m not sure what you feel the need to be so defensive. Just blaming systems isn’t the answer…eg I’ve just looked at Tesco and a 4 pack of Mars bars is the same price as a pack of Royal Gala apples, that comes down to a choice. You can’t chalk 50% of the population up as not knowing what a balanced diet is and what isn’t. I agree it’s complex.

Not liars

but they may not be the most objective person on why they are morbidly obese

Yes I get that impression.

I think some people (on this thread!) don't want the problem to be fixed @workingforcunard because all they're interested in is that fat people get punished. It's really important to them that fat people stay fat. They need them that way to keep boosting their own sense of smug superiority - fat people losing weight and keeping it off is actually the worst-case scenario for these people.

If you’re morbidly obese you may find that the differences in your body will make it nigh on impossible (and this is backed up by research) to lose weight and maintain based on making better food choices.

In the long run we need to make societal changes which should include removing food corporations input into healthy eating advice (remember the Change4Life campaign that was sponsored by nestle?), teaching children in school how to make healthy food, making healthy food cheaper and more accessible, having more hours of exercise in school, addressing the MH crisis that starts with very young children in school, changing the NHS diet advice which still harks back to the bad and corrupted science of the 1950s which arguably has led to the obesity epidemic both in the US and here.

Blaming people for being obese gets you nowhere, and has been shown repeatedly, doesn’t fix the problem.

Within groups, within meet ups, yes.
Are you also suggesting fat people are liars as well?

And what if someone like that takes these injections and loses their taste for junk food? What if, while taking it, they become more active and start to feel better? What if, unable to eat greasy burgers because that kind of food makes you sick on Mounjaro, they learn some recipes involving fresh, healthy ingredients and as the weight comes off they decide they prefer to be slimmer and healthier and keep it up?

The creon issue is a real problem. I have had a whipple surgery and as a result most people who have this need creon as they have half a pancreas essentially so need help digesting food. I personally don’t as I produce enough still with my remaining pancreas but many people in the support group I’m a member of really struggling to get hold of them and needing to change to a different type. Using a diabetes group for weight loss will cause issues with people who genuinely need it for diabetes so I can see why the NHS are hesitant to provide it given there are supply issues.

Also of course we know that the funding for the NHS doesn’t work on the basis of let’s spend x amount on this patient as data tells us that in the next 10yrs they will develop x problems due to obesity and therefore there’s a saving of Y.

Where's your evidence for that?

Every single morbidly obese person I know has underlying causes. Every single one. Whether it is genetic, or stems from mental illness (remember there’s also a mental health crisis going on and an NHS that cannot cope), or medication.

Every single morbidly obese person you know has told you this

not “all”!!

NO where did i say or allude to “all”

quite the opposite

but daft to deny that some will be. or idly obese because they actively chose to eat loads of shit because they enjoyed it and didn’t like to move beyond sofa to car door

and because of your insight and honestly, you have a MUCH greater chance of keeping off the weight long term

I'm fat and I don't think this is something that should be funded. Therapy so that people can make better food choices on their own maybe. Not this.

If you read her post in full, she explains that she can't be active because she needs hip replacements (I think there is a typo and she means can't instead of can!) and is in a catch-22 whereby the problem with her hips is keeping her inactive and making it impossible for her to lose the weight she needs to lose in order to get the hip replacements. So this seems like a case where maybe the NHS would save money overall giving her the injections until she's able to have the hip surgery and then once her mobility is restored then perhaps she is more likely to maintain the loss rather than becoming more ill and requiring more health care long term.

The NHS spends a lot of money treating complications of obesity, it might well be cheaper overall to prescribe injections as a long term, even lifelong, treatment. Companies are working on pill forms, and patents will expire worldwide so that internationally these meds will become available in cheaper generic forms in a few years time. And they're constantly working on more effective ones too. So I don't think it would be unmanageable for them to become a long term treatment; I think it's likely that will happen.

I was morbidly obese because I ate too much food and did too little exercise. It aggrevated conditions such as sore knees, asthma and high blood pressure.
A lot of people are obese because of other reasons, but it's also true, for lots of us, we need to make better food choices and need help to do that.

7 stone is an amazing weight loss, well done, you must feel much better in yourself.
But if the weight is already creeping back on, will this need to be a lifelong medication for you?

Perhaps this is why the NHS is reluctant to prescribe, it will become unmanageable to keep prescribing.

I'm a GP. I am happy to prescribe the GLP 1 meds for weight loss. I am however NOT allowed to. We get email reminders and queries of we do from our pharmacists/health boards. Wrist slapped if we do in a pt with no diabetes. In my area there is NO accesible tier 3 service. NICE guidance is that the meds need to be prescribed with psychological support hence referral to the service and no initiation via us with weight loss alone as an indication. (if we follow the guidance as it is set out) Lifestyle changes that mean the weight stays off when the meds are stopped. A hurdle yes, but nothing is straight forward in the NHS. Funding is an issue as is supply.

I have prescribed in exceptional circumstances where weight loss is a prerequisite for life saving surgery. Transplant etc. That I can argue. Weight loss helps long term health conditions and means people come see us less. Trust me we want to prescribe the meds!