AIBU to think it's time for the NHS to do itself a favour and make WL injections readily available.

So how do they actually work in practice? Do you take them forever? Or just until the weight is lost? What’s the chances of people just getting into a put weight on - medication - lose weight - stop medication - regain weight - medication….. cycle?

@Cantsleepdontsleep Mounjaro is what most people buy privately, most people are prescribed different medications for diabetes etc Wegovy or Ozempic

Doesn't the emerging evidence show that people put back on the weight once they stop taking it ? The NHS would have to evaluate the really long term value of this drug. It's essentially an appetite suppressant from what I understand so it would make sense that people who stop it get their appetite back and over a few years will likely go back to old habits. I've read threads on here of people saying they've stopped taking it and are ravenously hungry and have ended up putting on more weight!

My MIL is on the injections (pays privately for them) and has lost a good chunk of weight, she looks great but she hasn't changed her actual eating habits, she's just not hungry, once she comes off them I'm almost certain she'll pile it back on. Obviously I hope that doesn't happen, I want her to be well.

I on the other hand am severely overweight. My BMI is in the 50's. I'm doing a calorie controlled diet and exercise. I am starving all the time. I can't turn the noise off that tells me I want to eat. Food is all I can think about some days. It's soul destroying to work so hard, to constantly think and worry about what I'm going to eat, how many calories are in it etc etc and have the number on the scale stay the same. I've been referred for a weight management program but that could take a long time to come through. I cannot afford the injections and I cannot get them on the NHS as currently I don't have any other conditions other than obesity. I think the injections would really help me to kick start the process and allow me to form new habits without the distraction of all that noise in my head. But it isn't to be at the moment and the road ahead looks really, really long.

Oh absolutely, I'm sure the balance will shift over time. I just get a bit fed up of these regular threads claiming that the NHS must fund these drugs because 'it stands to reason' they will save the health system money, when actually this is far from given based on current clinical evidence and pricing.

Meanwhile, all the financially comfortable
mc willing to pay for wl drugs are reducing supply and means those with genuine health concerns are faced with hospitalisation and death because they can no longer get the medications which they need.

A close friend is in this situation. She is terrified.

The overall diet of the people.

They make you feel full, so you don't want to eat the same quantities as you feel physically uncomfortable if you eat too much. They also reduce the compulsion/impulse to eat and significantly reduce sugar craving.

Exactly. The NHS can't afford to pay for these expensive drugs unless it's clear that they are cost effective balanced against obesity related costs. It's by no means clear yet that this is the case.

How do the WL injections work for someone who comfort eats?
Many morbidly obese people didn't get to that point by stopping eating when their hunger was satisfied. Many used food as an emotional crutch.
Do WL injections work for emotional eating? And if so, how?

Ultimately good food, active lifestyle and their culture:

https://www.msn.com/en-us/health/nutrition/surprising-factors-behind-japan-s-low-obesity-rates-while-32-americans-struggle/ar-AA1gJmDp

How did you get approved it if you were only 16lbs or so away from healthy weight? My BMI was 30 so on the edge of criteria and I was over 3 stone away from healthy weight.

I think it 5 years time it will be more available, and it 10 years time it will be less stigmatised, with more people recognising that there is a real difference in how bodies work, and that obese people are not just stupid or lazy.

Think of the difference between 10 years ago and now with ADHD. There used to be a bunch of people saying that it wasn’t real/ kids were just badly disciplined/ lacked self control/ weren’t getting enough exercise. Now there is more understanding that it’s a medical condition and that medication helps.

Bang on 👍

I'm intrigued by Japan, ok they've never had an overweight population problem but what is so different there?

True.

But the other dynamic is that the price isn't set in stone. The manufacturers are going to ramp up production to a point where they can make as much as they can sell, and at that point there will be a deal to be struck with the NHS - NICE may loosen up their recommendations as evidence of long term benefit and safety improves and that decision will change if the price is right.

And of course in 2031 it will come off patent and become properly cheap. In between now and then there may be a grey market for Chinese imports (it comes off patent in China in 2026), so that might increase the manufacturers' motivation to strike a deal with the NHS.

I think they have probably worked out that it's too expensive. As pps have said BP meds and insulin are probably a lot cheaper! Also, it just isn't statistically true that every obese person will be diabetic and have high BP.

It would be nice if they were available for longterm, morbidly obese people. Not every obese person. That would be ££££££££££££

I agree@AutumnLeaves5 . There needs to be a massive cultural shift in how food is viewed, and consumed in this Society. The teaching of nutrition in schools is just inadequate.

Do you mind me asking which one you are on and how much you've spent on it so far? I'm really considering it x

Mounjaro is started to be prescribed more a few of our patients have been offered it in the past month (community mh) all are pre diabetic or have diabetes and all obese

but most are reluctant to take anymore medication than they have to (they are under conditions to take mh medication)

I think it is started to be prescribed more but it won’t be for people who are a stone or two overweight it will be for those who are long term obese

But wouldn’t money be better in treating the cause rather than the symptoms? Maybe that’s better education at school around nutrition and the huge impact ultra processed food has on our health, maybe it’s more mental health support for those that use food as emotional support or don’t have the willpower to make changes, maybe it’s making healthy nutritious food affordable. I know this doesn’t help anyone struggling with their weight right now, but for a developed country we should not be this unhealthy.

About 20% of children under 16 in the Uk are obese - should we accept that because we can just give them a weight loss injection for life once they reach 18?

Ah! Boots website very misleading 😅

People keep saying 'it's cheaper in the long run' to fund the injections but this needs to be evidenced. It might be true, but then again it might not. That's why NICE and the SMC undertake extensive evaluations of new drugs, to try to understand whether the cost savings and quality of life improvements are sufficient to justify the cost of the drug. You can't just assume they are cost effective and blow the budget.

Key reason currently is cost Ozempic costs the NHS around £80 a month. Wegovy £180 once you are on the higest dose. Average blood pressure medication is around £1 a month, which for the majority of paitents will manage their blood pressure well. Thus reducing risks of cardiovascular issues.

Currently there are shortages of these products, and even those that need them for diabetes are having issues with supply - this has eased the last few months. However it would be unwise for the NHS to suddenly allow these to be mass prescribed as those people who need them to actually keep themselves alive would struggle a lot. Manufacturing would need to be increased a lot before it would be wise to allow it to be prescribed for more conditions.