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

Yes, exactly. There isn't evidence of it, becaue it hasn't happened before. So you're guessing. You overstated your case when you said such societal change was 'certainly possible'. There's no certainty. And not one example of a society that's successfully managed obesity doing what you suggest, so it's not clear what you think we'd be studying.

Whereas we do actually know that ongoing WLI use works. There is one example of a country that has successfully reduced their obesity rate, and that's the US in 2024. It certainly wasn't because of food quality. Their WLI rates went up though!

The issue with WLI isn't effectiveness, as we know it works. It's with cost, which is going to come down over time. But what youre actually saying here is that we should reject something that we know works because of some idea you have with no evidence. That is not a risk we can afford to take.

@Periperi2025 brave post!

Personally, I think that if you are self-funding then it is entirely up to you and your prescribing physician and there is no moral judgement to be made at all. I don't even think it should matter what your BMI is, as that should be a judgement call by the physician, particularly as more people want to use WLI for maintenance.

I think there is a wider conversation to be had around the NHS. I think that obesity costs the NHS so much money it would be really, really sensible to get people on WLI asap. I really hope that the clever people at NICE will do their cost benefit analysis and this will become a no-brainer in a few years.

Despite what all the fat haters would want you to believe, people become obese for a very wide variety of reasons, not because they are scum of the earth sloths, who lack will-power, motivation etc etc etc. The causes are so deep rooted in so much of what is not working well in society generally that I think it will be harder to tackle all of it in the short term than just prescribe WLI. That is not to say that all the issues do not need to be tackled, but that is such a heaving, ginormous can of worms I don't see it happening any time remotely soon.

There isn't evidence of it because it hasn't happened before. Obesity is a modern phenomenon. There's no reason to believe that a push towards better nutrition and more active lifestyles wouldn't make a difference. We need to look at what healthier countries do that we don't. We can't medicate away problems- it doesn't work.

Hmmm people were literally starving to death in the final year of WW2 in Japan. It was a very very serious situation.

There are certain things they do now to avoid that experience—if you ever wonder why they have rice fields in inexplicably urban settings. If anything the Western countries (minus Germany) were very well fed at the time.

And before that, hunger was a very real problem. People often forget what a recent development it is to have whole societies with the resources to give their entire populations 3 meals a day for their entire lives- I realise that doesn't always happen in the UK even now but it's not because the food isn't available. Most of us probably are not very far removed from a malnourished ancestor.

There's also smoking rates. In the 70s, half the population were on an appetite suppressant drug.

Why don't you lie and say you have xyz and therefore you are allowed to have it?

I remember my grandmother criticising me for being treated for asthma 50 years ago. She felt it was weak spirited to need help in this way.

I think we’re seeing a similar reaction with GLP1s right now, compounded with the poor and judgmental attitude towards obesity.

@MizzeryGuts in 1950 the UK was still under rationing.

There’s an argument that rationing contributed epigenetically to the current obesity epidemic (contributed to also by access to cheap UPFs).
One of the things that comes out time and time again is that following a restrictive diet results in overeating and weight gain, even in the absence of junk food.

You conflate two different things here.

There is evidence that healthy lifestyles mean lower obesity. There is no evidence whatsoever that telling an already majority overweight and substantial minority obese population to adopt healthier lifestyles will tackle that. And there is evidence that long term WLIs assist formerly obese people to stay at a healthy BMI, in greater number than diet too.

Japan is not a relevant example here because they have never been a majority overweight society, unlike us. What we need to undertake is a reversal process.

I think people need to get over their hesitation here. These drugs are here to stay and will be used in all sorts of health applications in the future.

I self-treated my PCOS with GLP-1s (I get compounded versions in the US) and it really helped with certain symptoms that I had been trying to treat for years. There seems to be some anti-aging effects to them as well, I can well imagine that most Western people of a certain age will be using some form to extend their lifespan. Needless to say, I plan to micro dose these drugs for the time being.

72kg is ok if you're 5'7" though. I know as that's what I now weigh after 16 years of being between 79kg and 91kg. It would be interesting to know what the height distribution is like these days. Though I'm not doubting that there is an obesity problem.

Of course there's evidence that healthy lifestyles reduce obesity. Medication may be easier, but societal level changes are certainly possible. Japan is a good example.

In 1950 the average British woman was 5’2” and weighed 59kg.

By 1993 according to the NHS average height of a woman had increased to 5’4” and weight was now 66.6kg.

By 2019 the NHS reported average weight of a woman is now 72.1kg and obesity prevalence among the overweight has shot up to 29%.

There are lots of reasons why this happened, but there hasn’t been a genetic or evolutionary shift towards all of these complicating conditions that you mention in the OP. So it’s - combination of lifestyle choices and environment.

I am overweight and I absolutely know that I have caused this situation - not entirely by choice but certainly I could have done more to stay fit and active. I was clearly educated at school on the benefits of healthy food and an active lifestyle.

So I think that’s what there is judgement. It’s not that people don’t understand there are conditions causing obesity but that many people have made choices that trigger or drive these conditions to become worse.

Ah, sorry. I can't find my reading glasses at the moment. Also, well done on your weight loss!

I expect we all think they would be better. If they existed. But there's no evidence they do, whereas there is evidence that long term WLI use keeps the weight off. Your argument is essentially that there must be a way to deal with societal obesity in an environment completely different to what humans evolved in, because you want there to be.

We ought to address the obesogenic environment anyway, and improve access to healthy foods. Thin people can be malnourished, skinny fat is a thing, so MJ doesn't deal with that specific problem. Being a healthy BMI doesn't mean a person can access adequate nutrition, their 5 a day. But we also can't afford to indulge ourselves with people's vague ideals when we have a societal obesity crisis and a drug that actually works and will be much cheaper in a decade or two.

I think the reason why a lot of people view WLI negatively is because of how it started. It started with rich and famous people who carried a few extra pounds (if even that) who bought up medication (I think mainly Ozempic back then) that was desperately needed by diabetics who because of it had to go without. It was seen as a greedy, vain and quite cruel. The situation and production volumes have changed since then but I think the reputation has stuck with many.

I think any way to safely reverse the growing obesity crisis is good and needed. It will cost us all so much more in the end if nothing is done and if this is what works for people right now then great. Something else might come along eventually and then that will be seen as controversial and WLI will be the old trusted method.

@spoonbillstretfordi am 5ft2. I’ve lost 5st7.

I’m diabetic and use it, I wish it had have available before I became diabetic

YABU for thinking it’s any business of anyone other than the person either getting it for free on the NHS under their extremely stringent guidelines or paying for it out of their own pocket, and their respective doctors.
Societal approval/judgement is neither expected, welcome nor wanted.
MYOB people!

What about the people with severely disordered eating? As a society and a health service we deem it justifible and, hopefully preferrable to treat Anorexia Nervosa, including as inpatients at great expense (£500+ per day in the NHS), compared to treating an obese eating disordered patient with Mounjaro at a cost of approx £9 per day to the NHS for the highest dose. Presuambly in a civilised society we think that both groups of patients deserve a chance at a better quality life and improved life expextancy, and we dont think that Anorexics should just eat more and move less?!

you clearly know nothing about anorexia. it's a severe mental illness from which people (if they restrict eating) would die very quickly. Its a very very different illness. YABU unreasonable to link it to the conversation.