So no extra funding for MH conditions or eating disorders just weight loss jabs!

This has been explained a number of times, but this research trial is being funded by the drug company, Lily, and no money is coming from NHS funds. It's a trial to look at whether use of the drugs improve a number of factors, including - to quote the proposal outline - "health-related quality of life and changes in participants' employment status and sick days from work."

So, the clarify, no NHS money is being used in the trial.

It’s not “ludicrously expensive” when you take into consideration how much it costs to care for people with mental health disorders. You can’t compare government investment to household budgets. Only 300 million is invested in this trial. According to 2020 research paper, it costs 11.6 billion annually to treat people with schizophrenia, 5,6 billion to treat people with bipolar disorder. 300 million is like dropping £3 on a cup of coffee and worrying how it will impact paying your rent for a year.

The NHS finances are mismanaged and have been for a long time. It's full of "jobs for the boys", backstairs deals (like the PPE thing) and full of incompetent managers and "change and transformation" consultants.

Where I worked, they paid a small fortune to an EDI consultant who said we should all wear rainbow badges and display pronouns and go on training that told us all white people are racist. (I don't disagree about systemic racism, and unconscious bias, but this training course was actually borderline abusive). It did nothing to increase inclusivity or change bad attitudes in the team - it made them more entrenched, if anything, because telling people they are horrible for a characteristic they can't help is really not going to make people want to change.

The NHS still funds medications and treatments that other countries regard as out of the ark. It continues to rely heavily on short term CBT in most Talking Therapies services despite there being newer models and integrative approaches that have yielded better results. CBT therapists are paid better than many of the other therapists, and in some cases on par with the psychologists. It's like a bloody religion in there. CBT is good for some things, but it can't fix everything.

Can you really not see the difference between prescribing someone an injector pen they use on themselves at home and the in-patient beds you mention in your OP?

I understand you’re upset, but I think you’re not thinking rationally, reading the responses and understanding. People have really tried fo explain how due to the scale of the obesity epedemic that by spending a small amount of weight loss injections the nhs can likely save a huge amount in nhs costs when the medical treatments associated with obesity lessen. Even keir starmer did a statement yesterday trying to explain it.

I hope things get better for your family, and you. 💐

One of my childhood friends became anorexic. She has been in various forms of therapy/treatment for a long time. But has never been able to recover from anorexia, and has admitted she does not want to. She's tired of therapy, tired of being in and out of inpatient services. She manages to stay out of hospital now by eating just enough to maintain a BMI that's around 15. She is tall as well, and looks skeletal.

MH services have kept trying, but she's not engaged with treatment beyond a very passive, surface level. She accepts she will die from anorexia or she'll get ill with something she can't recover from. It's incredibly sad, and the reasons that keep her attached to her ED incredibly complicated. She has often said she wishes euthanasia were available like it is in the Netherlands. She gave up on herself, a long time ago, and a long time before MH services accepted she wasn't going to engage with treatment beyond getting to a level where she didn't have to be an inpatient. She has capacity. They can't force her to recover.

I've had to accept she will die relatively young at some stage, we are both in our mid 40s now. It's hard to look at photos of when we were kids, before she started restricting (around 15).

I thought these weight loss jabs could, and are, causing a lot of bad side effects in some users?

It doesn’t sound a great idea.

Well, this is a goady thread isn't it!

It's not a race to the bottom.

MH is indeed in a terrible state, but the NHS is also way behind other countries both in how MH is treated and how obesity is understood and treated (AND the link between obesity and MH).

I guess people resent obesity treatments though because the perception is it's the patient's own fault and they are therefore not "deserving". But we can say there is a behavioural link to many illnesses and injuries. The NHS doesn't refuse to treat lung cancer or COPD in smokers, the NHS also does things like fix botched plastic surgery jobs that were not done on the NHS, patches people up after being injured doing extreme sports, etc. We could say also there are behavioural links to certain aspects of mental health too. Cannabis induced psychosis, addictions. I have seen many, many patients in my time in the NHS MH world who were totally unwilling to help themselves or change anything to help their children. But we didn't refuse to treat or help them.

The hatred towards people living with overweight and obesity and the moral outrage on this site that the weight loss jags are available is getting old.

Op, the root causes of MH issues as many and varied. They vary from

Social media
Bullying
Crap parenting
Obsession with body image
Work stress
Childhood trauma
Any other trauma
Poor housing
Over crowding
The capitalist society
Lack of exercise
Drug abuse
Religion
Unemployment
Poverty

And those are just for starters. How do you think the govt are going to sort all of those in one easy move?

However, weightloss pills may help some get back into work, solving poverty, unemployment and homelessness for that group, while generating revenue or at least reducing deficit. Freeing money to sort out the next few issues, and so on.

I'm more concerned that people will be pushed to try a relatively untested medication by the state. Not a situation I would want to be in.

Funding for EDs is a separate issue but absolutely does need tackled. My sister died in 2018 aged 21 from ED. She'd been involved with cahms throughout her teenage years and was even sectioned at one point but there was just no route cause treatment and its disgusting.
However, that's not to say weight loss drugs don't play a massive part in society. My friend has ED but on the other side of the spectrum and she's been using mounjaro for the last few months and it's given her such a boost.
She's privately funded and I do think that whether privately funded or NHS there should be some level of MH or dietetics support because my worry is it will help people lose weight but with no treatment for the route cause of the obesity it won't actually change the thinking and behaviours long term.
It's also unfair to think of them as an easy way out. She had a lot of side effects and a rough first couple of weeks on them.

You are angry at totally wrong thing here OP.

@LivelyMauveHedgehog

Crikey, that's the question. I have no idea. Unhappiness? A total lack of control of everything else and that being the only thing I can truly maintain. I have everything in life that should make me happy. I have a fantastic life, everything I need and more. And yet, there is a cog that's not working or a chip that's missing that causes me to sabotage my very existence. I can spend hours each day picking faults over every aspect of my body and then obsessing over 'fixing' it. I have a built in need (not want) to be skinny. I saw a gp last year (here you never get to see the same one) who spent 5 minutes listening to me cry and tell him and then offered sertraline and told me, and actually said the words 'I don't know how to deal with you'. Therapy isn't currently working. It has in the past. So, to answer your question. I don't know.

In an ideal world everyone would have fully funded treatment for their illness. However, we live in a situation where money is not unlimited, therefore decisions need to be made as to how that limited money should be spent.

The drug is relatively cheap compared with many others. It is certainly cheaper than many of the treatments for obesity complications. Coupled with the anticipated increased productivity and the very widespread nature of the obesity epidemic the government would be stupid not to try this. If there was a drug which had the same effect on anorexia or mental health problems then I expect the government would run similar trials.

The NHS don’t really know what to do with illnesses which require multifaceted treatment of mind body and spirit. Like anorexia, mental health and obesity. These drugs offer some help with the physical side of obesity, it will still be up to the individual to mend their mind and spirit in order to sustain any loss.

OP, I really feel sorry for you. It must be hideous to see your daughter wasting away and struggling to access help. You must be so worried and stay awake at night.

I can see how this stuff might make you feel angry. Seeing people that are eating so much they are putting their health at risk and then having an injection to seemingly sort the problem out, must jar when your daughter is so thin and unwell. But the two are not directly related.

If I’m honest, I occasionally think society is ruined. On one side of the globe we have people starving to death because there is not enough food. Whilst on the other side we have people overeating and then injecting themselves to lose weight. This is a big problem for the world, but I do not blame individuals.

Whilst I can understand why you feel the way you feel, try and reframe it. Think of it as these injections reducing the cost for the NHS on obesity-related illnesses. That might free up money for mental health care. We can hope anyway.

I wish you all the best for your girl. Anorexia can cause such damage to families. I am sorry x

The jabs shouldn’t just be a Sticking plaster. Obviously some people may use them as that. But you could say that for lots of things like therapy. People don’t really engage in it, just get through it.

How long have you been on the jabs?

I am confused. They are putting money into helping people with disordered eating.

Actually the jabs do impact on what many people eat. Many report not wanting alcohol , greasy and high sugar foods make many feel ill so are avoided. Yes there is a calorie restriction needed which usually causes people to prioritise food groups. This calorie deficit is achievable because of the reduction in food noise.

With anorexia and mental health problems (I’ve suffered from both) there is an element of input needed from the sufferer. This involves a willingness to participate in available treatments. Where this doesn’t happen an outside person cannot cure the patient, treatment for these things is a partnership. - it’s a multifaceted treatment programme which is needed.

Do you know what NICE is? It's a decision making body that spends years collecting evidence, monitoring drug company trials, and looking at cost impact of healthcare spending. They have ethicists, patient groups, mental health experts, obesity experts that spend years debating decisions like this. In particular they look at things like the impact of obesity on quality of life. How it leads to mental health issues and eating disorders etc. They examine everything in depth. Meetings are often made public. ultimately they make decisions on the most impact for their spending.

Maybe you should Google things before you make such lazy assumptions.

It’s a very small trial to see if the weight loss jab will pay for itself through increased return to work force.

Being obese is often linked to mental health and neuro divergency. If you have ADHD you are 5 times more likely to be overweight. Dr Stephen Porges has spoken extensively about the interaction of chewing and the vagus nerve in relation to calming the parasympathetic nervous system. Professor Van Del Kolk in his ground breaking research into PTSD notes the strong correlation between attending a surgical weight loss clinic and experiencing child abuse. Interestingly there is increasing anecdotal evidence of the drug easing ADHD symptoms.,

Many who are overweight suffer from various eating disorders.

Those clinging to biblical notions of deadly sins being the cause of the obesity epidemic in this country are as out of touch as someone recommending leeches or balancing the humours.

The problem is that those who don’t experience the many barriers to losing weight often demonise those who struggle ( quite literally). Those same people then don’t want to admit the obesity epidemic stems from causes other than being lazy and greedy.

Limited mobility due to NHS delays or failings is not a separate issue. As the article says, it leads to obesity due to lack of or delayed diagnoses and treatment. And as the article says people in poverty often have less access to timely and effective healthcare.

As you say below
Walking is free.
Except it's not always possible due to the issues above - limited or delayed access to healthcare. So, people with health conditions that limit mobility and/or cause pain are unable to walk or can only do a very limited amount. So they gain weight - due to waiting too long for the right NHS diagnosis and treatment.

Also re the links to poverty. One reason for less walking is, as the article said Unsafe neighbourhoods

I'm not claiming the above issues are the only causes of obesity. Nor am I saying nobody should be offered the weight loss drugs.

What I am saying is that no issue, obesity or anything else, is solved by only treating the symptom and not the cause. And also that lifestyle is often not the person's choice.

The need is for a holistic approach - including, when relevant, the environmental/social causes and issues.

I've spent time with a friend and her family of 5 who love junk food, she needed masses of cupboard for the multipacks, packaged food takes up way more space.
Anecdotes aren't the same as statistical facts. Many people have tiny flats, some with limited kitchen facilities and almost no storage (cupboards, freezers etc).

A 'big' supermarket has it all. Online delivery is available in most of the UK

Not everyone lives near a big supermarket. Some deprived areas in particular have only small convenience stores nearby. These stores have limited stock and it's often mainly unhealthy processed food (and the food they stock is sold at higher prices than large supermarkets). Not everyone is able to drive or can afford to. Online deliveries often have minimum order costs.

The point about food restriction and deprivation then overeating, is that a) it affects metabolism, b) it's not a choice - people are literally unable to afford regular stable meals so get trapped in that cycle. Of course people who face periods of limited food might overeat or eat cheap unhealthy processed food when they do have some food.

And also psychological impact is relevant. Human beings are not feelingless robots. So yes sometimes people in horrible circumstances and who are suffering chronic stress have a psychological crutch, which is for some people junk food.

Address the causes of people's horrible circumstances and chronic stress,whether poverty or other trauma, and that addresses the symptoms (obesity, or whatever other symptom someone might have).