to think more negative effects will come out from Ozempic use?

Whatever prescribing rules are out in place some people will obtain and abuse drugs which are unsuitable for them. The power of these drugs to improve the health of those who DO need them is immense. In the current system there are simply not enough medical appointments for face to face prescribing only without limiting access to those who actually need these drugs imo.

Nice idea but not workable at the moment - or any time soon. The NHS have already said it will potentially take a decade to roll the drug out because they don’t have the infrastructure to support the number of patients who need it. 30000 people a year die from obesity related illnesses, versus a small number of people who might manage to get a prescription for WLI when they don’t need it - something which is now much harder to do since the rules for prescribing the drug were tightened last month.

That’s what I think too.

The risk/benefit analysis is different depending on your weight and it’s too easy for people to get hold of weight loss drugs without stringent verification that they are obese rather than just would like to drop a few pounds.

And I also agree with @Gardenservant that it’s possible that more negative side effects will come to light now it is so widely used but time will tell I guess.

People who are significantly overweight and use WLI see health benefits, such as lower blood pressure, blood glucose etc. The risk of side effects is worth it given the health benefits. People who are close to normal weight don't see the health benefits, so the risk of side effects may not be worth it. People who have eating disorders may lose dangerous amounts of weight and should not be on WLI. I think we are going to have to see our GPs to be weighed and measured in person to get a prescription. The system of sending in photos etc. is too easily gamed and leading to people being harmed.

It's specific to the notion that you put forward, that because of Thalidomide (closer to 70 years ago than 50) there were changes in testing and licencing drugs. And yet many drugs go on the market, and take 5-10 years before enough serious adverse effects are reported, some only discovered in massive populations using the drug, and the drug is withdrawn, reformulated, whatever.

And it is relevant to this thread, which is titled "AIBU to think more negative effects will come out from Ozempic use?"

@lettyraines but that comment applies to all and any new drugs that are developed. It's not specific to GLP-1s or a particularly increased risk for these drugs. It's not something that specifically needs calling out in relation to these classes of medication.

And, @Gardenservant, whether you're cautious or not you won't be using a GLP-1 for weight loss because you're not obese, and so you won't meet the prescribing criteria. As you'll know.

Good luck. I know it is effective for many people.

Oh my god. I am merely pointing out that despite all those decades passing, as you wrote - drugs are still placed on the market and considered safe enough, until mass usage uncovers major problems.

Surely as a pharmacist you must understand the huge differences over the last 50 years in drug research and trials, as a result of the scandal around thalidomide.

@Gardenservant I have been using it for over 7 months now with no serious side effects, and very few minor ones. And like any medication that I take I read the available information about it and make an informed decision about risk versus benefit. So yes, I am well aware of the possible side effects and their relative likelihood.

Trials have changed for the better, I mention Thalidomide as it is so well known. There is no way trials can be as effective as widespread use in finding out unwelcome side effects. You go ahead and use it if you want to, I am more cautious.

I am sure you know that rare side effects include pancreatitis and retinopathy and many more listed in the warnings.

So what are the similarities between the development of Viox/Rofecoxib and the recent GLP-1s that is concerning you?

Let's go more recently and look at Viox/Rofecoxib. It was on the market for several years, and used worldwide by around 80 million people before it was withdrawn due to increased risk for heart attack and stroke.

No one here is suggesting that people who are slightly overweight should be taking prescription medication for obesity.

@Gardenservant I can't believe that you're genuinely referencing thalidomide as an example. Surely as a pharmacist you must understand the huge differences over the last 50 years in drug research and trials, as a result of the scandal around thalidomide. Do you actually think there are similarities or comparisons between the development and use of thalidomide, and drugs like semaglutide and tirzepatide?

If I was obese I would use it. I am mildly overweight so the cost benefit analysis is different. Many people for whom it is not intended are using it.

Thalidomide.

Ozempic was approved for use in 2017. Thalicomide was usedfor aprrox 10 years before it was withdrawn.

I think it is already pretty obvious that most people using these injections will need to be on them for life, as most people who've lost weight using these injections have regained a substantial amount of the lost weight once going off the injections.

I have been told it's 'common knowledge' you can't stay on them, and then that you can stay on them.

I don't actually think that is 'common knowledge' - not the way you're understanding it anyway. Wegovy is currently approved for use for 2 years on the NHS but there is no limit on how long people can take it for as per its licence/approval. Mounjaro is also recommended for a maximum of 2 years by NICE guidelines but can be taken longer term if prescribed. The bit of my post you seem to be linking this to is where I said that it's not yet known whether this medication will need to be taken for life in order to prevent recurrence of obesity. It can't be 'common knowledge' that people will need to take Mounjaro for life because it's not known yet. However potentially people could take both Mounjaro or Wegovy for life if their prescriber will prescribe it and it continues to be effective.

@Gardenservant I don't think that 5 years on top of the decade that tirzepatide has been researched for is going to reveal any significant adverse effects. And, as someone who was morbidly obese, remaining morbidly obese for 5 years is most definitely going to cause me health issues. So it's a clear benefit versus risk situation, for me.

Semaglutide has been studied and used for longer than tirzepatide as well.

Somebody said this:

Yes I think it is common knowledge that wegovy is for two years and mounjaro for life.

I was surprised, as in answer to my question about what a person is to do once they get to a normal weight, you wrote what I felt at the time was a coherent explanation in reply, but it seemed from that particular post you were not aware of this 'common knowledge'.

Not to me either, but the ops loving it, 😂

So another 5 years will do it, when it’s been used for a couple of decades already? That doesn’t make a lot of sense…