AIBU to seek a consensus on who is a socially acceptable recipitent of Mounjaro?

Research into why the obesity crisis is happening and the reasons behind it is not to prove obese people are helpless, it’s to work out why it’s happening so there’s a basis to identify who is at risk and how to prevent it in the first place.

The next part of your post is making assumptions that fat people are all the same and making bad choices - I only drink water. I avoid UPFs. Many of the people I know are the same, obviously we don’t represent the whole of the group, but some of us are very aware of nutrition and health, and work very hard to not be bigger than we are! I know where my obesity stems from and it’s impossible to get the acknowledgment through the NHS because the way it’s handled is to first blame the patient and assume they’re sitting on their arses guzzling chips. Perhaps if that first port of call wasn’t so judgemental and dismissive we’d be a healthier population.

There’s a lot of normal weight people experimenting with these drugs for various conditions in the US, especially among those of us using it to treat infertility/PCOS.

You can get them for quite a reasonable price from compounders. It seems the market is not quite so developed in the UK but with these price increases that people are talking about, they are sure to pop up to fill the gap in the market.

@Digdongdoo I don't want to disagree for the sake of it, I am trying to understand your point of view and those with similar views. You seem to want to advocate continue doing what we've been doing for the last 40 years, which as far as I can tell is a spectacular failure. My definition of failure is the national and global increase in obesity.

Obesity and all the side effects that come with it currently costs the NHS £6.5 billion a year. If every obese person took WLI the cost to the NHS would be £3.5 billion.

Research in the US of 215,000 who had taken WLI published this January showed that after an average of 3.68 years, people taking GLP-1 agonists had a lower risk of developing 42 different diseases than those given their usual medicines.
This included a 22 per cent lower risk of a cardiac arrest, 11 per cent lower risk of heart failure, 9 per cent lower risk of a heart attack and 7 per cent lower risk of ischaemic stroke.
As well as heart and circulatory diseases, people taking GLP-1 agonists were 24 per cent less likely to have liver failure, 22 per cent less likely to have respiratory failure and 12 per cent less likely to develop Alzheimer’s disease.
GLP-1 agonists were also linked to a lower risk of some mental health issues, such as substance use disorders, suicidal ideation and schizophrenia.

I therefore think that the NHS could save itself a huge amount of money by rolling out WLI to all obese people.

So, I'm not disagreeing just to be obdurate or difficult, I just want to try and explain why I think WLI are an incredibly helpful tool in the treatment of obesity.

Most countries in the world were subject to rationing (or enforced starvation) 1939-1945 and beyond. Relatively few of those countries have an obesity epidemic today, and the obesity epidemic in the UK didn't hit in the 1950s or 60s, 70s, 80s or (largely) the 90s.

Epigenetic mechanisms are also reversible. There's believed to be a close link between obesity and epigenetic dysregulations - and there is, I believe, research going on in a number of places around the world into how these dysregulations can be resolved through natural compounds in certain raw foods - ie, following a "diet" which incorporates these foods.

Just expand the quote history for the context. I wasn't on about leaflets or whatever...
There's obviously never going to be a consensus here. Almost everyone thinks that their particular circumstances are most important and unique, but the NHS can't afford it so it would be daft to create that dependence. I wouldn't want to put myself or my kids or grandkids in that position though. We've had more than enough short termism, it's time for radical change. Bu you're welcome to disagree with me, I don't really care.

@Digdongdoo I must have misunderstood what did you mean by this?

Digdongdoo · Today 10:25
My proposal is promoting healthier diets and more active lifestyles.

My proposal wasn't "diet and lifestyle advice"...

@Digdongdoo the worldwide prevalence of obesity has more than tripled between 1975 and 2022. Obesity is now recognised as one of the most important public health problems facing the world today. In 2024, the NCD Risk Factor Collaboration (NCD-RisC) published findings that estimate that more than one billion people in the world are now living with obesity, nearly 880 million adults and 159 million children and adolescents aged 5-19 years.

Again, I ask, why is your diet & lifestyle advice that has been in place for 40+ years failing?

But there is evidence! Not everywhere has an obesity epidemic like we do. There are obviously changes we could make that would help. It's a modern, western phenomenon and it isn't something we can medicate away. Normalise it, and lifestyle changes won't happen which means the next generations will down exactly the same path. Such short termism is expensive and short sighted.

I do understand a lot more than you think.

Research is going on but in the wrong direction. Most Research quoted on these types of threads is about how the obese person can't help themselves because of genetics or metabolism or whatever.

What about doing Research on taste buds & their links to the brain that in return will tell the digestive track to get ready for whatever is coming?
Think about it: 1 glass of diet fizzy drink v 1 glass of sugar fizzy drink.

Diet fuzzy drink: you fool the taste buds that sugar is entering your system... but what happens in your digestive track when the sugar isn't there? How does the brain respond? Asking for more sugar!?
Sugary drink: the taste buds, brain and digestive track have received what they thought they would get.

And then you have to think why you reached for a drink in the first place. Would it not have been better to drink water? As both diet & sugar drinks will make you drink more. One because you fooled your body and the other because sugar does draw water from the body.

Recognising and acting on these types of traps is far better than the lies we tell our bodies through diet and medication.

I think NICE/the NHS are far better placed than I am to make cost benefit analysis (and health benefit analysis) on who should be getting WLI on the NHS than I am.

So I think the people it is currently prescribed to is the right population, but that this should be kept under review and we better understand what the long term picture looks like for those taking the drugs, innovation in this space and the future cost changes both for the drugs themselves and the other NHS costs associated with the potential patients.

I have a modicum of sympathy for those who think they should get it on the NHS but don’t (the same as when I hear about the NHS won’t fund a multimillion pound drug to save one life), but I trust them to make the right decision based on the information available to them that I do not have and am not qualified to interpret.

But you proposed it as an alternative to WLI.

There's no evidence at all that it works on a societal level to tackle obesity, and there is evidence that formerly obese people regain the weight at lower rates when using WLI than when attempting to diet. This is known. You're advocating for something on the basis that you'd like it to work. No more than that.

Relying on wishful thinking over treatment with superior evidence like WLIs will hasten the demise of the NHS.

@Digdongdoo I think everyone knows what a healthy diet and active lifestyle looks like. The question I always come back to is why that has failed and continues to fail on such an epic scale? Why has global obesity increased so significantly if everyone knows this and there is evidence it works. There may be evidence it works, but the global obesity epidemic that is only getting worse suggests that in reality it isn't working!

Shouldn't we regret having our head in the sand and being in denial about the clearly failing strategy that you are advocating?

I am not overweight and I am not jealous I can’t take a GLP1. You might see a few people who work hard at weight say this - I do work hard at it but I assume it’s the same as someone on a GLP1, watch what I eat and exercise, isn’t this what most people have to do? What’s to be jealous about!

My proposal is promoting healthier diets and more active lifestyles. There's more than enough evidence that these things are good for us. WLI is an unaffordable dependency. The NHS won't be around in it's current format to fund it for long, unsustainable and individualistic. We'll regret relying on it in the long run.

Do you realise that GLP-1 can be increased naturually using food? Rather than relying on medication to microdose, up intake of eggs, nuts, unsaturated fats, vegatables. Decrease intake of foods that spike blood glucose (e.g. processed carbs, flour, starches etc). I completely cured my cravings by changing my diet. I am sure many others relying on these drugs could do similar.

I don't think normal weight people are in the slightest bit jealous of someone reliant on medication for the rest of their lives and at the mercy of drug companies putting up prices.

I am 5”3, 70kg. Don’t qualify for it on the NHS. I have PCOS and I’m from south-Asian mixed background as well.

We have more evidence for it than we do for your proposal. If your argument is that the evidence for WLI usage (since the 00s) isn't sufficient, you cannot argue for something has much less on the basis that hey, it might work. Your proposal is about ideology and vibes.

Mass WLI rollout, which is happening, isn't enough by itself because you're right that we do need to address diet and nutrition. Thin people can still have poor diets. But it's a necessary plank, and will remain so until the evidence shows that telling people to diet and improve lifestyle actually succeeds at tackling obesity. We can't indulge ourselves with wishful thinking when it comes to an issue of this importance.

Most people are paying for their own medication so I have no judgment (or opinion) on that, a prescriber has agreed it and they meet the criteria.

I do agree it is life changing drug, which is why I agree the NHS has started with people who need serious intervention due to significant health issues including known cardiac problems.

There is a difference between being overweight and obese (clinically) and I think there must be a cut off or a starting point.

Opening it up to everyone with a BMI of 27+ would crucify the NHS overnight it has to be slowly brought in. People do get enough side effects to be visiting their GP for help or guidance and monitoring would be involved.

For this reason I am also sick of seeing people complain about the NHS criteria. It is what it is. I would try to focus on what you can appreciate rather than demonising the broken NHS. There are many people dying or in agony waiting for surgery or can’t access life saving or life changing medication as it is. I know it’s expensive - blame the manufacturers for that, not the NHS.

Im not judging anyone for taking it or wanting to take it and feeling hard done by, but the continual complaining about not being able to get it on the NHS is creating its own narrative about who ‘deserves’ it. Yes, this is how the NHS works unfortunately it’s not a free for all for everyone. You aren’t the only group of patients who can’t get something you think you should be able to, and you won’t be the last. We just don’t have the funding it’s not an ideal world

People whine about it because they are jealous IMO that there is a solution for so many people which is inaccessible to them (it’s expensive).

im pregnant currently so not taking it but I was up until I conceived and will again once baby was born. For me it has fixed a lifetime of bulimia and disordered eating, if people have never had problems with food they couldn’t possible understand. I don’t care what anyone think.

Yes. There have been threads on here from people who struggle to stay slim and say they're jealous they can't access WLIs to make it easier. When it's pointed out to them that they could stop struggling long enough to hit the necessary BMI they usually ignore that.

I don't know how common it is though. People complaining about MJ on MN are probably not a representative group!

Couldn't care less if you are self funding.

The NHS funding is tricky because in theory yes because I believe in preventative health care but that is not what they NHS currently provides.

I also know the NHS has a finite budget and would like to see money spent improving other areas first. There are many drugs or treatments for conditions which the NHS won't fund or don't adequately investigate and diagnosis and therefore people not getting treated for.

Yes so did i have surgery privately but had i not been able to afford that i would still be obese and by now would more than likely be suffering from other health complications and costing the NHS an absolute fortune!

We don't know that mass medicating will work long term on a societal level either. Because that's never been done before either. It's just swapping one problem for another. It's a not a real solution for anyone other than the individual currently being medicated.