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

@Pussycat22 I find it interesting that being morbidly obese isn't considered as an eating disorder. Would you advise an anorexic simply eat more and move less?

I'd be interested to see if somebody posted a thread about the severe complications caused by deliberately depriving oneself of food would be met with similar comments made by some, here.

I had an ED in the eighties. Fortunately was managed by school and family, but I could do easily have ended up in hospital. Some of the 'food chatter' comments remind me of what my brain was doing in the opposite direction.

Why is there so little sympathy for those struggling with their weight at the obesity end?

No - eat less, exercise more and spend more money researching cures for eg cancer

So here is one article suggesting other benefits not linked to weight @blackshuck - all very speculative at the moment, but it explains it's to do with the mechanisms of the drug, not weight.

https://www.theguardian.com/science/article/2024/may/14/can-weight-loss-drug-such-as-ozempic-also-treat-addiction-and-dementia-semaglutide-cancer-diabetes

It's being reported that the medication could be used to treat these other conditions - how much of this is hype I don't know, but no it's not a consequence of weight loss. As these drugs were developed as diabetes drugs - and they are dosed differently for treatment of diabetes - and weight loss was discovered as an unintended side effect then a specific version of the drugs were developed as weight loss treatments, so a different version might be developed for these other conditions if indicated.

I think weight has been so irrevocably linked to disease and death that we automatically assume everything is treated by losing weight and that any positive health benefits are due to lower weight but that's not the case - slim people develop diabetes, Alzheimers, dementia, Parkinsons, cancer etc too. Semaglutide and tirzepatide are used to treat diabetics without inducing weight loss, but are prescribed in higher doses for weight loss.

@SippedAway
surely the other health benefits attributed to these injections are directly related to not having an excessive amount of body fat?
Or are you saying that if the injections were given to slim people they would also have a reduced risk of Alzheimers, Parkinsons etc?

A lot of them are young people, particularly young women and in the 15-20 stone range. When attending a hospital appointment, recently, I noticed a lot of the nurses ( one of which advised my husband as to the importance of losing weight pre op) were morbidly obese.

@BirdFeederFun

Well done that's a huge achievement.

And sod @mm81736
Who can only belittle you

To be scrupulously fair, some people report that it improves their mental health as well.

For me personally though it was awful.

There are some potential serious side effects and if you roll these drugs out to millions of people, that small percentage who experience those side effects will be a lot of patients. I guess that's one argument for keeping them off the NHS for now. However, drug companies are racing to produce newer, better versions and now the technology is here, I don't think it's going back in the bottle. There are clearly some potential benefits beyond weight loss - I've seen reports claiming they might help treat Alzheimers or Parkinsons, that they can slow ageing, that they reduce inflammation and cancer risk and all sorts of things. If any of those turn out to be the case, this could be a development similar to the discovery of antibiotics or vaccines - it might change healthcare completely, and certainly attitudes to weight. I imagine they'll be improved and refined, that there will be so much money up for grabs for the company which manages to produce safer and more efficient versions with fewer side effects and so a huge incentive for that to happen.

I don't know if that's a utopian or nightmare vision of the future honestly, but it seems far more likely to me than a society which goes back to pre-industrialised food production or one that adopts the Japanese model and starts taxing employers on their staff's waist measurements.

It's all pretty new and very hyped right now, but I do expect OP that the NHS will be prescribing these drugs (or rather the new versions) within a few years. I think it's much more likely than huge societal changes, and the reality is that only a tiny tiny fraction of obese people are able to lose weight and keep it off and so what are the options?

That’s interesting.

Good that people are studying it, because apparently even adjusting for the same calorie intake, same exercise level, and roughly the same macros, People are still 10% heavier than they were in the 70s and 80s.

One of the theories is that it could be changes in the gut biome. Another that it could be prevalence of antidepressants.

But sure, self control is probably the problem.

.

When I was a young theatre nurse back in the eighties people who were above 11/ 12 stone were rare . They were looked upon as very fat. Surgeons refused to operate on them until they lost weight . There is no explanation for the obesity crisis other than people eat a lot of rubbish and find excuses not to exercise these days. If people could exercise some self control and discipline they wouldn't be in the state they are in today. Less in and more out is key.
.

The PATIENTS fail at preventative (prophylactic) care.!!!!!

I’ve chickened out! The thought of “Wegovy face” and the possibility of it making my gastric reflux worse has put me off. I’ve got a poor appetite anyway, so that’ll help!

@mm81736 yes I do realise the possibility of this. Though given my weight loss is due to my medical scare last year I have exactly the motivation needed to keep it off as there's no chance I'd risk scaring my family or leaving my children when I can control the risk with basic dietary focus. So I see your point but a weight loss injection would do nothing to change that anyway and by doing it myself I've been able to learn proper diet and health rather than a potential magic wand approach. This isn't meant to be judgy or anything like that. I just wouldn't want anyone putting themselves at risk or depriving diabetics of their medication when they could lose the weight in a healthier way.

I was responding to the person who said she had reduced her BMI without imjections

30% of people on weight loss injections do not put anything back on.

30% do gain weight after stopping but not to the original weight. Will be approx 20-30% below the final weight.

30% will gain weight to their original weight. But the fat distribution (eg visceral fat) and fat levels will be permently reduced.

There is further research underway but the assumption is that the first and last group combine weight loss injections with weight bearing exercise. It’s why consultants tell you to lift weights while doing this.

You realise that the chance of you not putting it all back on and more is very slim?
Losing it is (relatively)easy? Keeping it off is the difficult part.

OP you’re borderline evangelical about it - and in many ways I can see why.

Let’s be clear that some of the statements you have made so emphatically aren’t from scientific or medical knowledge, but from your own research which is fine. I don’t doubt it is in some cases ‘a wonder drug’. Do I believe at the moment it should be widely available - 100% no.

If you knew anything about clinical trials you’d understand it can’t be widely available to anyone who needs to lose ‘some’ weight, despite what appear great tertiary benefits. That is why GPs can’t prescribe it like that even if there were no supply issues.

There’s an argument that aspirin wouldn’t even get through a clinical trial these days because the mechanism of action stated has to be so specific.

Yet a vegan diet is actually more effective, cheaper and doesn't have the risk of thyroid cancer. Instead of adding to the NHS bill we could just ban the sale of meat and dairy products.

www.pcrm.org/news/news-releases/move-over-wegovy-plant-based-diet-may-be-better-answer-weight-loss

I have a friend who has lost a lot of weight on Mounjaro. The interesting thing (to me at least) is that she said it was a revelation when she would have a normal portion of food and feel full. She said she assumed this whole time slender people were saying no because they had much better willpower than her and they were still hungry but just better at saying no, but she's come to realise that they actually just don't want any more food so it's easy to say no. And I thought that was really interesting actually and I wonder if some people just miss or don't have as strong a response to being 'full' as others naturally. If that's the case, then injections like this could be a large part of solving the issue.

@Ozanj Mounjaro is specifically a drug for Diabetics.

It isnt designed to be an appetite suppressant as some people in this thread seem to have mistakenly determined.

It is designed to increase the hormones that enable insulin production and the processing of glucose. The improved processing of glucose does as a side effect help to reduce appetite but that's because the insulin is balancing the glucose levels better rather than allowing to get too high which increases hunger.

Metformin is less effective.

What is Mounjaro? And how does it work?
Mounjaro belongs to a class of medications that mimic two hormones involved in digestion, which are glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

A delicate balance: Glucagon is a hormone that your pancreas makes to help regulate your blood sugar levels. Glucagon increases your blood sugar level and prevents it from dropping too low, whereas insulin, another hormone, decreases blood sugar levels. For people without diabetes, insulin and glucagon work as a team, to keep blood sugar in balance.
In a person without diabetes, the process of eating signals the brain and small intestines to release GLP-1 and GIP. These hormones then signal the pancreas to release insulin. Finally, insulin works throughout other cells in the body to decrease blood sugar levels and promote the metabolism of sugars.
In the case of diabetes, however, the effects that GLP-1, GIP and sugar have on the pancreas are weakened or absent.
Enter Mounjaro, which is designed to fool your body into thinking that the drug is GLP-1 and GIP. By mimicking these hormones, the drug does the following:
Increases insulin secretion, resulting in lower blood sugar
Decreases glucagon production (For those with diabetes, unchecked glucagon production can result in blood sugars that are too high.)
Slows gastric emptying (process by which the contents of the stomach are emptied into the duodenum, the first part of the small intestine).
Furthermore, by mimicking GLP-1 and GIP, Mounjaro can decrease a person’s appetite and food intake, which often leads to weight loss.

Interesting. No one really talks about it do they? I really think it should be more well publicised.

Oh thanks, I'm so pleased you have explained it to me! Now I feel stupid for not knowing the answer.

Diabetics could just start eating healthier or manage their sugars better on metformin.