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Original poster

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

337 replies

nextdoorconundrum · 31/08/2024 18:03

I've posted about this before but following the news today from the chief scientific officer for the British Heart Foundation - Professor Brian Williams - that the health benefits of these drugs appears to be beneficial in the reduction of heart disease, high bp, stroke , arthritis and even Alzheimer's.. (interviews on R4 today programme and channel 4 news just now for anyone wanting to hear all he had to say ) .: Is it not time now for the NHS to actually save itself the fortune it spends in treating obesity related diseases - rather than obesity itself.

There is also something highly questionable about a drug that is readily available to people who can afford it - but is mostly not available to those who most need it . With extremely narrow parameters and some ridiculous hoops to jump through before being 'allowed it on the NHS.(Obesity affects 39% of women in the most deprived areas as opposed to 22% in the least )

www.nice.org.uk/guidance/cg189/documents/health-inequalities-briefing-2#:~:text=The%20greatest%20rates%20of%20adult,in%20the%20least%20deprived%20areas.

I say this as a financially comfortable mc woman who has lost 4 stone on WL injections. I no longer cost the NHS any money in BP drugs, Sleep Apnea machine, Corticosteroids for knees etc - in fact for the first time in 26 years I only take thyroxine which is not something that can be reversed. The only reason I have managed this is because I could afford to buy it. Surely this is not only wrong but immoral in a national health system ?

The argument of 'is it safe ?' doesn't hold water . It has been approved through extensive and thorough trials across both the United States and most of Europe. It is no more or less safe than any new drug.

The argument of 'some people get nausea and vomiting and other side effects ' yes this is true. As do some people on all kinds of drugs . I personally can't tolerate penicillin - doesn't mean it should not have been allowed to save the lives of millions for 70 years. !

Last but not least.. what happens when you get to a healthy weight and stop taking it ? Well I guess it's exactly the same as blood pressure medication. You take it when it creeps up again .. perhaps it just becomes one of those drugs that you take lifelong on and off to maintain good health ..

Far far cheaper than treating all the current diseases associated with obesity and morbid obesity..

YABU - we can't afford it
YANBU - it's a false economy not to make it readily available to people with obesity if they want to try it.

OP posts:
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6
Original poster
nextdoorconundrum · 01/09/2024 14:20

Exercise will not make you thinner unless you are able to create a 3500 deficit. 10k steps a day x 7 days = about 1 Ib of weight. That's 35 miles a week !!

Exercise improves cardio vascular health which is a good thing.

The only way to lose weight is to eat less. That's why the weight loss jabs are amazing. They make that easy - and then when you get thinner movement gets easier.. and you lose more. A moderate amount of exercise with a much decreased food intake is the ideal .

OP posts:
BlackShuck3 · 01/09/2024 14:19

@InfradeadToUltraviolent
We are in agreement. Prior to modern times exercise happened by default. It no longer does (for most of us) ergo we are lacking exercise opportunities!

InfradeadToUltraviolent · 01/09/2024 14:09

BlackShuck3 · 01/09/2024 13:56

ps: being obese is mostly very socially unacceptable in Japan AND they do active travel all the time, a great place to walk or cycle
I think this is a very good point @lljkk
In my view the primary cause of obesity is to do with the obesogenic food environment and lack of exercise opportunities, and the normalisation of obesity would be a secondary cause.
It seems plausible that there could be genetic factors which make Japanese people less prone to obesity?
Can we adopt things from other cultures that would help us in the UK?

I'm not sure we have lack of exercise opportunities nowadays. People in the past mostly didn't exercise because they "could" or because they wanted to, they exercised because they had to. We evolved in an environment where we had to fight for every calorie. That has implications for our instincts concerning food, but also for our instincts on exercise.

cunoyerjudowel · 01/09/2024 13:58

BirdFeederFun · 01/09/2024 13:51

I can't walk far or stand for long periods. I have no idea how to start exercising. I tried to see a physio at the doctors who said lose weight...

I think the problem is that the doctors also don't understand or have the time to help
People carve a fitness plan that is accessible to them.

For yourself if your barrier is your size and weight I would give you very small daily goals which increase and are achievable, but to give these goals takes time to understand your daily life if you see what I mean (and I am not a pt but love fitness and program for friends and colleagues as a hobby)

If you struggle to stand I would focus on this and then sat or led down movements. Mobility is so important and so difficult to regain

BlackShuck3 · 01/09/2024 13:56

ps: being obese is mostly very socially unacceptable in Japan AND they do active travel all the time, a great place to walk or cycle
I think this is a very good point @lljkk
In my view the primary cause of obesity is to do with the obesogenic food environment and lack of exercise opportunities, and the normalisation of obesity would be a secondary cause.
It seems plausible that there could be genetic factors which make Japanese people less prone to obesity?
Can we adopt things from other cultures that would help us in the UK?

pickd · 01/09/2024 13:56

BirdFeederFun · 01/09/2024 13:51

I can't walk far or stand for long periods. I have no idea how to start exercising. I tried to see a physio at the doctors who said lose weight...

I haven't been able to even see a physio so don't let that stop you. I found YouTube guides to gentle exercise for my ability which helped loads. I also know weight loss is 80% diet and just 20% exercise. I've barely exercised in my own loss and still reached 80 lbs down so really don't let it hold you back. Keep chipping away at it with reducing calories, actual portion controlling, upping your water intake and little steps. You can do this and unfortunately nobody can do it for us so what other choice do we have? Wishing you and all others on here every success Flowers

cunoyerjudowel · 01/09/2024 13:55

Also how much are these obese people paying on food bills compared to being a healthy weight? Is it more or less expensive to be slim?

I think there is a belief that obese people pay a lot more for food ie takeaways nightly, so therefore it is a lifestyle choice. Where as often the cost of crap food is far cheaper than buying healthy or meal prepping.

I think the lifestyles / values of the ultra healthy and the obese people are so different it's hard to find the common ground, to actually imagine how debilitating obesity is and understand the need for the drug.

BirdFeederFun · 01/09/2024 13:51

I can't walk far or stand for long periods. I have no idea how to start exercising. I tried to see a physio at the doctors who said lose weight...

cunoyerjudowel · 01/09/2024 13:50

BlackShuck3 · 01/09/2024 13:24

The lack of opportunities for enjoyable and safe exercise is also responsible for the much higher rates of obesity that we see in modern times.

I disagree as weight is mostly about nutrition and there are always safe ways to exercise, it's just about priorities and mobility.

The issue is that the bigger you get the harder it is to exercise safely

ObelixtheGaul · 01/09/2024 13:50

nextdoorconundrum · 01/09/2024 13:33

It seems that people are hung up on over weight people being able to saunter off to the GP and get weight loss injections to lose a couple of pounds. My post was not about this at all. Of course they shouldn't. People carrying a little extra weight are least likely to be using other NHS resources. Nor are they candidates for the more expensive and intensive medical interventions that cost the NHS the most.

I am talking about the obese and the morbidly obese. These people are the most costly not just due to obesity but all the associated costs linked to that condition.

A long term study presented by Professor Rachel Batterham , head of Obesity research at University College London. showed that women with simple obesity (BMI 30-40) had a 1:124 chance of returning to a healthy weight. By diet and exercise alone . For those with morbid obesity (BMI 40+) had a 1:644 chance. Of those very rare '1s' 75% had put all on and more within 5 years.

These are peer reviewed facts. Not opinions. Which means whatever your views on obesity .. running the full gamut from 'greedy lazy fuckers' all the way to 'it's a disease that can't be helped. - and as of the last NHS survey this is the reality for 26.8 of the adult uk population . That's 18 MILLION people !! . Even more concerning is that for our current 10-12 year olds this is a staggering 23%.

So regardless of your feelings on how they have got there . They ARE there - and statistically highly unlikely to ever be a healthy weight again without intervention and the numbers are growing alarmingly.

It is also a fact that diet and exercise, has a I virtually no impact on changing this. It is what it is. The cost to the country is staggering and without some help in the form of medication.. it is going to get exponentially worse.

The average morbidly obese person costs the NHS twice that of a person of healthy weight. £638 vs £1375 (2023) .

There is also another cost. That of economic inactivity. The most obese are highly unlikely to be working and paying tax. . and due to the other comorbidities much more likely to be received state benefits and disability payments.

Easy access to Ozempic/Mountjaro for this group of Obese and Super obese individuals at £80 per month (with its added benefits to heart/bp/arthritis Seems a complete no brainer. With it being a life long drug like insulin or thyroxine to keep them healthy. In case of re gain.

I really believe there is a whole prejudice out there that think fat people deserve all they get and should not receive any help from the public purse - without realising their taxes currently pay towards the 1.3BN that obesity costs the NHS last year. Let alone the cost to the treasury

Exactly. You are talking about a medical need. This is what I have been trying to get across. This isn't about an 'easy option' for all and sundry who want to lose a few pounds.

lljkk · 01/09/2024 13:49

My back of envelope calc's...
14 mln children in UK
67 mln ppl in UK, of whom 58 mln in England (86%)
54 mln UK adults, of whom 25% are obese, call it 14 mln
Suppose only 25% of them want these drugs, 3.5 mln, or will have the equivalent doses each yr.
Cost seems to be £70/week. 52 weeks a year, 70 x 52 = 3640.
£3640/yr, 3640 * 3.5 mln = £13 billion a year.
I don't cost the NHS £3640 a year for any health issue much less a preventable health condition.
I could be kind of annoyed to be asked to help subsidise that.... for a condition that can be treated much more cheaply and is usually preventable.

NHS England annual budget is about £181 bln, 86% of £13bln is £11.2 bln. Wegovy doses could be 5% of total NHSE budget.

ps: being obese is mostly very socially unacceptable in Japan AND they do active travel all the time, a great place to walk or cycle.

cunoyerjudowel · 01/09/2024 13:48

I see both sides.

Tackling obesity would massively reduce the strain on nhs and mental health support, let alone save money on fuel consumption and is better use of space (as in people weigh less / take less space up in small areas etc)

It could potentially save a lot of money but if the people are still consuming so much food the impact on the environment will still be there etc.

Big people will raise big children and the cycle will repeat- so how does the drug deal with this?
Would the smaller people feel more inclined to exercise as it impacts less on joints and therefore it solves the problem or will people then be lazier as there is no need to exercise and therefore raise kids who don't see it as important?

I think it's a no brainer if it saves the nhs money. There could even be a loan system like a student loan, potentially where the person pays I back pre tax if there is not the money in the pot?

My adhd meds make me far more productive and I therefore am able to save the country money by doing more in my working day and not having time off work. So I see the theory.

BirdFeederFun · 01/09/2024 13:45

nextdoorconundrum · 01/09/2024 13:33

It seems that people are hung up on over weight people being able to saunter off to the GP and get weight loss injections to lose a couple of pounds. My post was not about this at all. Of course they shouldn't. People carrying a little extra weight are least likely to be using other NHS resources. Nor are they candidates for the more expensive and intensive medical interventions that cost the NHS the most.

I am talking about the obese and the morbidly obese. These people are the most costly not just due to obesity but all the associated costs linked to that condition.

A long term study presented by Professor Rachel Batterham , head of Obesity research at University College London. showed that women with simple obesity (BMI 30-40) had a 1:124 chance of returning to a healthy weight. By diet and exercise alone . For those with morbid obesity (BMI 40+) had a 1:644 chance. Of those very rare '1s' 75% had put all on and more within 5 years.

These are peer reviewed facts. Not opinions. Which means whatever your views on obesity .. running the full gamut from 'greedy lazy fuckers' all the way to 'it's a disease that can't be helped. - and as of the last NHS survey this is the reality for 26.8 of the adult uk population . That's 18 MILLION people !! . Even more concerning is that for our current 10-12 year olds this is a staggering 23%.

So regardless of your feelings on how they have got there . They ARE there - and statistically highly unlikely to ever be a healthy weight again without intervention and the numbers are growing alarmingly.

It is also a fact that diet and exercise, has a I virtually no impact on changing this. It is what it is. The cost to the country is staggering and without some help in the form of medication.. it is going to get exponentially worse.

The average morbidly obese person costs the NHS twice that of a person of healthy weight. £638 vs £1375 (2023) .

There is also another cost. That of economic inactivity. The most obese are highly unlikely to be working and paying tax. . and due to the other comorbidities much more likely to be received state benefits and disability payments.

Easy access to Ozempic/Mountjaro for this group of Obese and Super obese individuals at £80 per month (with its added benefits to heart/bp/arthritis Seems a complete no brainer. With it being a life long drug like insulin or thyroxine to keep them healthy. In case of re gain.

I really believe there is a whole prejudice out there that think fat people deserve all they get and should not receive any help from the public purse - without realising their taxes currently pay towards the 1.3BN that obesity costs the NHS last year. Let alone the cost to the treasury

These are the statistic that terrify me. I'm 40+ bmi. I don't know what to do. My quality of life is decreasing and it is affecting what work I can apply for.

What do I do?! Like so many on this thread my Dr suggested I eat less. Yet there's a less than 1% chance of that working 😭

Original poster
nextdoorconundrum · 01/09/2024 13:33

It seems that people are hung up on over weight people being able to saunter off to the GP and get weight loss injections to lose a couple of pounds. My post was not about this at all. Of course they shouldn't. People carrying a little extra weight are least likely to be using other NHS resources. Nor are they candidates for the more expensive and intensive medical interventions that cost the NHS the most.

I am talking about the obese and the morbidly obese. These people are the most costly not just due to obesity but all the associated costs linked to that condition.

A long term study presented by Professor Rachel Batterham , head of Obesity research at University College London. showed that women with simple obesity (BMI 30-40) had a 1:124 chance of returning to a healthy weight. By diet and exercise alone . For those with morbid obesity (BMI 40+) had a 1:644 chance. Of those very rare '1s' 75% had put all on and more within 5 years.

These are peer reviewed facts. Not opinions. Which means whatever your views on obesity .. running the full gamut from 'greedy lazy fuckers' all the way to 'it's a disease that can't be helped. - and as of the last NHS survey this is the reality for 26.8 of the adult uk population . That's 18 MILLION people !! . Even more concerning is that for our current 10-12 year olds this is a staggering 23%.

So regardless of your feelings on how they have got there . They ARE there - and statistically highly unlikely to ever be a healthy weight again without intervention and the numbers are growing alarmingly.

It is also a fact that diet and exercise, has a I virtually no impact on changing this. It is what it is. The cost to the country is staggering and without some help in the form of medication.. it is going to get exponentially worse.

The average morbidly obese person costs the NHS twice that of a person of healthy weight. £638 vs £1375 (2023) .

There is also another cost. That of economic inactivity. The most obese are highly unlikely to be working and paying tax. . and due to the other comorbidities much more likely to be received state benefits and disability payments.

Easy access to Ozempic/Mountjaro for this group of Obese and Super obese individuals at £80 per month (with its added benefits to heart/bp/arthritis Seems a complete no brainer. With it being a life long drug like insulin or thyroxine to keep them healthy. In case of re gain.

I really believe there is a whole prejudice out there that think fat people deserve all they get and should not receive any help from the public purse - without realising their taxes currently pay towards the 1.3BN that obesity costs the NHS last year. Let alone the cost to the treasury

OP posts:
BlackShuck3 · 01/09/2024 13:24

The lack of opportunities for enjoyable and safe exercise is also responsible for the much higher rates of obesity that we see in modern times.

BlackShuck3 · 01/09/2024 13:23

Obesity is not caused by a lack of willpower.
Obesity is caused by the omnipresence of edible food like substances which have been highly engineered to be as addictive as possible.

HeySummerWhereAreYou · 01/09/2024 13:16

fizzymizzy · 01/09/2024 11:53

@HeySummerWhereAreYou

I know someone will say I sound smug - and it's a bit annoying when people say this, but really, why are people not just cutting down their food and getting more exercise?

Not smug, but lacking knowledge for sure.

I know the absolute ins and outs of how to lose weight. I know what to eat, when to eat it, the best exercise etc etc

What I do not know is how to stop myself from eating. How to put all that in place and make it stick.

You yourself say you have yo-yod for years, so you also can not make it stick. For whatever reason.

My reasons are neglect, trauma and neurodivergence. They make it difficult, very difficult, like running a marathon every weekend.

It's never going to be as simple as eat less move more.

I am not 'lacking in knowledge.' As I said, I have struggled with my weight for decades, and been between 9 stone and 15 and a half stone. Binged, crash dieted, and had eating disorders since I was 15-16. (So over 40 years!) I have a tricky relationship with food, and have spent half my life on a diet and fretting about my weight. And frankly, your comment that I am 'lacking in knowledge' about weight struggles, and eating disorders, disgusting - and insulting.

IMO weight loss surgery AND the injections need binning altogether. The fact that the vast majority of people regain the weight tells me that. Injections are risky and we don't know the long term effects yet. And the surgery is life threatening!

And many people who have weight loss surgery go on to be very ill, and often cannot ever eat properly again. They are NEVER the same, and their health never recovers. And as for the ones who ARE OK after it, nearly always regain the weight. So I stand by what I say. Weight loss surgery (and the injections frankly, are pointless and they should all be banned.)

I am entitled to that opinion, whether you like it or agree with it or not. And you are entitled to your opinions.. But do NOT tell me that I am 'lacking in knowledge' about this. Such a rude and ignorant comment from you. Hmm

.

BirdFeederFun · 01/09/2024 13:16

fizzymizzy · 01/09/2024 11:53

@HeySummerWhereAreYou

I know someone will say I sound smug - and it's a bit annoying when people say this, but really, why are people not just cutting down their food and getting more exercise?

Not smug, but lacking knowledge for sure.

I know the absolute ins and outs of how to lose weight. I know what to eat, when to eat it, the best exercise etc etc

What I do not know is how to stop myself from eating. How to put all that in place and make it stick.

You yourself say you have yo-yod for years, so you also can not make it stick. For whatever reason.

My reasons are neglect, trauma and neurodivergence. They make it difficult, very difficult, like running a marathon every weekend.

It's never going to be as simple as eat less move more.

Similar here. I'm 10 stone overweight and it all seems impossible to be honest. And then read statistics that for 95% of people it actually is.

Just eating a bit less won't sort this. Injections might but I can't afford them. Surgery is fairly drastic when injections could help.

Or treatment for ND or intensive eating disorder support but neither of these are currently available to me either.

Grumpy12345 · 01/09/2024 13:10

ObelixtheGaul · 01/09/2024 13:02

Because you don't have a medical need for them.
I've explained all this. You are treating this like a cheat. Not a serious solution to a serious medical problem.

Show quote history

A lot of obese people don’t have a medical need for them. I agree some do as losing weight is impossible for some due to disabilities, trauma etc. But some obese people could exercise more and eat less.

I’m just playing devil’s advocate to be honest. But a lot of people do see it as a cheat and will be annoyed at their taxes paying for other people getting the easy option to losing weight when they have to put in the hours at the gym and not eat whatever they like.

ThatsNotMyTeen · 01/09/2024 13:08

Grumpy12345 · 01/09/2024 12:19

No I don’t want to get fat. But I would like to be half a stone to a stone lighter. And it sounds like these drugs would make it easy for me to do that compared with diet and exercise. So why shouldn’t I have access to them?

Show quote history

Because as others have said they do or can have side effects

if someone is 5 stone overweight the risks of that make the risks of the drug worth it

but not if they are a stone overweight

the manufacturers say they are not for cosmetic weight loss

ObelixtheGaul · 01/09/2024 13:02

Grumpy12345 · 01/09/2024 12:19

No I don’t want to get fat. But I would like to be half a stone to a stone lighter. And it sounds like these drugs would make it easy for me to do that compared with diet and exercise. So why shouldn’t I have access to them?

Show quote history

Because you don't have a medical need for them.
I've explained all this. You are treating this like a cheat. Not a serious solution to a serious medical problem.

pickd · 01/09/2024 12:26

@Funnywonder thank you Daffodil I can see your point too. I hope you have a calm and happy Sunday Smile

ObelixtheGaul · 01/09/2024 12:23

Zerro · 01/09/2024 11:45

No, non-overweight people absolutely should not have access to this.

My point earlier in the thread was that research suggests much wider uses for this drug than weight loss. It was found to reduce CRP levels by 40%. CRP being a measure of inflammation. My life is ruled by inflammation due to inflammatory disease, not something that can be cured by eating less and I'm not overweight anyway. Once it can be produced cheaply it could have potential in all kinds of diseases.

If that's the case, then yes, absolutely, but again, that is a medical need, not a want. You'd get it on prescription for that condition.

The response you quoted was to someone who thought it should be available to the non-overweight just so they don't have to be a bit careful. So basically, to 'cheat'.

Grumpy12345 · 01/09/2024 12:19

ObelixtheGaul · 01/09/2024 12:13

But you don't want to get fat. You've said so, and you are able to stop it happening. So it's hardly likely you are going to do this, is it?

Surprisingly, most morbidly obese people don't want to be that way. They don't get there because they can control their eating like you clearly can. Yes, out of desperation, some very overweight people have resorted to tipping the scales that bit further to qualify for surgery.

But honestly, can you think of a single person with a normal BMI and a standard attitude to food that has stuffed themselves to the extent they become obese enough to qualify for medical intervention?

You have a standard attitude to food. You have to be a bit more careful now you have reached menopause (don't we all). Are you really going to sacrifice your health to that extent just to be able to not have to be a little bit careful? I don't think so.

Some on this thread have given very good medical reasons why this drug might be needed. Not wanted.

Earlier in the thread I gave a very good reason why handing it out like a sweetie to everyone who 'wants' it is far from a good idea.

Show quote history

No I don’t want to get fat. But I would like to be half a stone to a stone lighter. And it sounds like these drugs would make it easy for me to do that compared with diet and exercise. So why shouldn’t I have access to them?

Funnywonder · 01/09/2024 12:15

pickd · 01/09/2024 11:57

@Funnywonder just seen your reply to my comment. No of course it's not a failing. It is sad but not a failing, though I never used the word fail in my post in the first place so not sure where that's stemming from. My point is that we need to be dealing with the actual causes rather than the result if you see what I mean. So much more mental health focus rather than handing out temporary fixes, otherwise people will be left with the exact same things they started with. Nobody gets to morbidly obese by accident, nobody gets there by chance. There is an underlying reason for each person and that is the bit that needs the support. Flowers

Ah, sorry @pickd. Honestly, that wasn't an attack on you. It's just that there have been so many comments on here and a couple of similar threads where posters are mystified that obese and overweight people can't just quit eating and go for a run. I genuinely wanted to congratulate you. I was just being supportive of all the people who struggle and will never be able to lose weight without intervention.