What do we REALLY think about the weight loss jabs?

@MidnightMeltdown You could consider that obesity is always a health condition as it increases your risk of very many other health outcomes. It isn't a healthy state for your body to be in even if you are currently metabolically healthy.

WHO definition of overweight and obesity: "Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health"

You said: "The question is, should people who are metabolically healthy be taking these drugs, and to what extent do they risk destroying their healthy metabolism?"

Surely the answer is yes, because it prevents damage from happening and reduces the risks of very many other health issues. I am interested in why you think they might destroy their healthy metabolism?

The next point you made - "I don’t doubt that weight loss medication is useful for some people under some circumstances, but making it available to buy for anyone with a bit of weight to lose is a whole different issue."

WLI aren't available to buy for anyone with a bit of weight to lose. It must be prescribed and there are criteria. Even for off licence prescribing, people must be overweight and have some justification for taking a weight loss medication that isn't simply cosmetic. I am surprised that people do take the risk of taking a prescription obesity medication when they are not BMI 27 plus, but I don't think it's necessary to prevent them from doing so if that's what they think is the right course of action.

I’ve been offered them/had them mentioned by the NHS 3 times since February, despite having started losing weight in April and being 2st down. I have raised that I’ve been lead to believe that losing weight at that rate would be considered healthy use of WLI, so surely it’s a wasted resource. Hopeful it won’t be mentioned again when I have my next review in December.

Otherwise, I did mean WLI users encouraging me to use them, in a less than gentle way. To put it politely.

I get that for many they are a wonder drug, but I don’t need to be told that Sue from work lost 7 stone in 4 months so actually your 2 stone is shit and could be more, if you just used them.

I’m, rightfully I think, proud of how far I’ve come over the last few months, and I never accept it being minimised by the people I’m referring to, who don’t seem able to accept “I’m good thanks” as a complete answer.

But they are not just for morbid obesity, obesity and over weight can be very damaging for health, my bmi was 32, the doctors couldn’t control my blood pressure, I was on max of two meds and they thought I may have adrenal gland cancer, I also had sleep apnea and insulin resistance, my blood pressure is now healthy at bmi 2o, if I’d become even close to morbidly obese I’d likely have died,

As I’ve mentioned - I don’t take them and have no intention of doing so. For context, I was almost 17st earlier this year.

The risk of being that size is far higher than taking jabs to get rid of that weight, I can absolutely see that. It absolutely wouldn’t class as a “bit of” weight to lose. I’m 1lb off 2st lost and probably still have another 2 to go before I even think about maintenance.

For people in the position I was, totally get it.

For people with “less to lose” I feel that they have in them that “stop” already, because they didn’t arrive at morbid obesity, so that just seems like more of a vanity project - and I don’t believe it’s right to treat a condition you’ve never developed.

This is because obesity isn’t always a health condition, and the blanket branding of obesity as a ‘disease’ is unhelpful.

In some cases, there may be a hormonal issue causing the obesity, but there are also many, many people who are overweight or obese but metabolically healthy. The question is, should people who are metabolically healthy be taking these drugs, and to what extent do they risk destroying their healthy metabolism?

I don’t doubt that weight loss medication is useful for some people under some circumstances, but making it available to buy for anyone with a bit of weight to lose is a whole different issue.

Interesting.

i just personally had a pattern that whenever I restricted calories below a certain level, and it really wasn’t that low, I got a migraine of the type where I couldn’t do anything but lay in a black room or I would vomit. It was incredibly frustrating. That no longer happens.

@ChunkyMonkey36 I will mention WL treatments on online discussions where someone is asking for help with their obesity and outlining their struggles with it. I wouldn't push it if they said they weren't interested. The only other thing I might go on to do is to correct any misunderstandings about WLI if I thought that was relevant to their decision making process.

In real life I don't discuss weight at all, my own or anyone else's, and if someone starts that kind of topic I will shift the conversation on or bow out. I agree it's tedious for people to repeatedly offer their own weight loss "insights" in whatever form that takes, whether its WLI or WW, SW or whatever.

Are you offered WLI regularly at medical appointments? Or do you mean in another context?

@Stormyrose I can relate to what you said:

…I am on a low dose to maintain my weight, it could be argued this is lifestyle, as I do not wish to spend my days feeling hungry, deprived, focused on food, guilty if I eat, worried about fitting into my clothes. I want to simply eat healthy, not focus on it.
my mental health is also important. It is not just physical health. Why should I live like that if I don’t need to. I’ve done decades of it, it’s miserable, I don’t wish to be miserable. I want to enjoy my life. And not have my weight and food as an overwhelming all consuming cross to bear.

After being on WLIs for just 3 weeks I have realised that my MH has improved.

I’m not in a constant cycle of trying not to give in to the food noise, hating myself when I do and then getting in a doom loop of overeating because I feel bad about myself but getting comfort from eating nice things.

The top and bottom of that is that many people don’t believe it is a health condition, hence the debate.

Anyone who isn’t obese and never has been, or doesn’t find it hard to lose weight, would assume that eating enough to be obese isn’t compulsory and if you want to lose weight, just stop it.

My only “gripes” with them are:

I don’t believe they should be used if your initial start point wasn’t obesity. You shouldn’t treat an illness you don’t have. I don’t take chemo, I don’t have cancer. I don’t take blood pressure tablets either - etc etc.

I also don’t appreciate as a fat person, being offered them so regularly, or have people who do use them give me their selling points what feels like every 5mins when I’ve made clear that I don’t want to. There’s one woman I know on them who every time I see her goes on about how my loss would be easier, they’re the best ever, it would speed it up, blah blah blah. On, and on.

I appreciate that’s not necessarily a MN issue, but it’s definitely irritating. There’s far less “you don’t have to take them” when they’re being rammed down your throat every day by reformed fat people.

Thank you, I had missed your earlier post. I’ll take a look at that and it may be useful for my “imaginary” brother as well. Really helpful info - thanks.

@LifeOnEnceladus Yes, I agree with you, I am talking about the treatment of a health condition. As I said, people don't talk or post about other treatments in the way they do about GLP1s or with the frequency.

I have posted info about the actual scientific research I did. It is summarised in a podcast on radio 4 called The Hunger Game with Giles Yeo. He is really a top scientist in obesity and supports the use of WLI, not for any personal gain but for the science. I recommend his podcast. Each episode is only about 15 mins long.

He talks about the food noise and lack of satiety some people have being due to hormones and that's why the GLP1/GIP meds are so impactful. It's not an even playing field when it comes to people just eating less and moving more.

As much as I don’t disagree with many of your recent comments explaining what’s being said, I think lifestyle and health overlap, they can be one and the same,

i Will use myself as an example, I am on a low dose to maintain my weight, it could be argued this is lifestyle, as I do not wish to spend my days feeling hungry, deprived, focused on food, guilty if I eat, worried about fitting into my clothes. I want to simply eat healthy, not focus on it.

my mental health is also important. It is not just physical health. Why should I live like that if I don’t need to. I’ve done decades of it, it’s miserable, I don’t wish to be miserable. I want to enjoy my life. And not have my weight and food as an overwhelming all consuming cross to bear.

but it’s also for health, I cannot regain for health reasons, I will become unwell again, my body cannot cope with excess weight.

so my choice is stark, struggle every day to not regain, go to bed hungry, feeling deprived, struggling mentally, risking ill health. Or live happy and healthy and take a low dose of the medication.

i pick the latter, in line with the health authorities recommendations and my gps recommendation.

is it lifestyle or is it health, it’s both. And of all the people I know on it, it’s the same. No one takes the drugs for fun. They cost a lot of money, every single person taking them now leads a healthy lifestyle, and studies show that the drugs are more successful in real life than trials. And it’s felt that in part the fact peiple need to pay and pay handsomely to take them underlines the seriousness they take their health,

this isn’t take them and eat what you please. This isn’t gorge on fatty foods and have an injection and the fat melts off. That’s not how they work.

That’s not equivalent. The thread wasn’t called “what do we REALLY think about obesity?”. It is about a treatment for the health condition. Not the health condition itself.

And regardless, plenty of people seem to feel perfectly entitled to give their opinions about what they REALLY think about autism all over this site, despite knowing nothing about it and not having been asked.

Your post epitomises what I’ve been saying.

If you had read my posts you’d see I am very much not “anti the drugs”. I’ve repeatedly stated that in many cases it’s clear they have a hugely beneficial effect. That doesn’t mean that it’s not legitimate to also have concerns about significant side effects which, while rare, are well documented and the prevalence of which in various different groups of patients is not yet fully analysed.

I love my brother a lot, and have always been extremely supportive of him in ways that you probably couldn’t comprehend given we grew up with abusive parents and as his older sibling I protected him. I suspect our childhood is the root of his issues with food. So yes, I am worried about how he deals with this because I think a lot of the problem is psychological in his case. Just like my other older sibling turned to alcohol.

People aren’t going to become “knowledgeable” about a topic which they’ve previously had no reason to learn about through you and other posters insulting them when you know nothing at all about those to whom you are directing this nastiness.

I’m not angry at all, thank you. It appears from many of your posts here that you may be projecting. I am simply disappointed at the level of discourse and constant hurling of personal insults at anybody who asks questions. Certain particular posters on this thread have repeatedly insulted other posters on the thread who have put forward opinions (which is what the OP asked for) that they do not like or asked legitimate questions. It’s interesting that all of this spitefulness seems to have come from one side of the debate.

I am on no side of it, I was simply interested in the discussion for the reasons I’ve explained - concern for the family member that, allegedly, I don’t give a damn about.

I’m done. There are too many toxic people on the thread for it to be worth continuing to engage.

@LifeOnEnceladus I think if someone started a thread called "what do we REALLY think about autism" or even CFS/ME that MNHQ would probably delete it once reported, even though they are usually terrible at removing ableist posts.

But those are conditions, not specific medications that are legal, approved and already subject to prescribing criteria which is what I was referring to. I repeat my belief that people don't post about other medications in the same way as they do about GLP1s.

Oh yes they do.

Have you not seen many of the appalling threads on this website about chronic pain conditions like CFS/ME and fibromyalgia etc? People writing posts saying that these a “fake” conditions and that people suffering from them are inventing it. I suppose at least nobody can dispute that an obese person is obese so they don’t have to endure that.

Have you not seen the appalling comments made about conditions like ME and autism, even pretending that they are invented or overdiagnosed or “just part of personality”? “We’re all on the spectrum” and other laughable nonsense?

Obesity is by no means the only health condition about which people make uninformed comments. What is egregious, however, is when people who are not making false assertions and are actually looking for information are insulted for doing so as I have seen happen to numerous posters on this thread.

@Gettingbysomehow the way this case was referred to makes it seem like this unfortunate Australian woman was trying to drop a few pounds. In reality, she had lost 16kg or 2st 7lbs, so she was not just a little overweight. She was likely obese when she started taking Ozempic before swapping to Saxenda.

She also had gastric symptoms and went to her doctor about it "a few times" yet continued taking it because she wanted to lose further weight. The implication from her husband's comments is that she was advised to stop but didn't. Furthermore, the GLP1 medications weren't listed on her death certificate as a cause.

It's a very sad case, but as an individual situation it doesn't tell us anything meaningful about the risks of GLP1s.

Not sure how much the eating is relevant, GLP1s have been found to improve migraine https://www.verywellhealth.com/glp-1-drugs-migraine-11969393

Thank you. That is a very helpful and actually statistically valid contextualisation.

It seems clear that overall these drugs are a huge medical breakthrough and very effective for many, many people, and as you say for those in the tested categories the risks overall are small compared to the benefits across the population. It’s the widespread adoption beyond these tested usages and long-term duration of dosing that seem to be untested and while one hopes that the benefits would still outweigh the risks the assertions people have made that this is the case don’t yet seem to be supported by any evidence. I hope that we will collect that evidence so that more people can benefit from it, safely.

As for the poster who made disgusting comments saying all I care about it calling my brother greedy (I did not) because I expressed concern about his weight gain which he himself states is due to eating portions that are much too large, it is exactly these kinds of unnecessary and spiteful comments which have made this thread so unpleasant. It seems to be an almost cult-like hatred of anybody who dares to question safety and is looking for factual data like that provided by @Allisnotlost1, even when like me they have expressed kindness when responding to other posters personal stories about their specific struggles.

I know - I should have been clearer ‘we all know people at BMI 27 without a weight related condition or ethnicity adjustment’.

Ive no doubt private pharmacies have policies on clarity on side effects and risks etc. But as has been discussed and we all know from our own life experience, patients don’t always follow the rules and neither do pharmacies. People can make their own choices, I just don’t agree with the pretence from some in this discussion that this has become, for a great many people, a lifestyle and not a health drug.

@LifeOnEnceladus the 2000 claim in relation to Nurofen is inaccurate, as you say. There is widespread reporting of anywhere between 700 to 2000 additional deaths a year due to NSAIDs or aspirin in general. That's mainly from stomach ulcer bleeding. Hence the advice not to take these long term without seeking advice from a doctor.

If you forgive the inaccuracy, which you may not of course, the general point being made is that there are specific risks associated with an OTC medication which annually causes a not insignificant number of deaths. Yet people don't start threads or comment on threads where people talk about managing pain, in the way that people post about pancreatitis or gallbladder issues on threads about WLI. And that's for an OTC medication with very limited checks on who can buy them, to treat pain. Compared to a medication that's already a prescription med with specific criteria that effectively treats a serious health issue. It's a comment about double standards or people having an overreaction to the idea of medication for obesity which they don't have about other medications.

How did she get it if she only wanted to lose a few kilos. I had to jump through hoops to prove I was clinically obese.It must have been a black market one.
Or she lied and sent someone else's photo in because you don't need a face on it.
If you do either of those things you will probably die.

An absolute miracle.

trying to eat healthy before always resulted in debilitating migraines. I used food plus medication as a way to control the headaches. The strong migraine meds alone were not enough.

with the jabs, I can eat like a normal person, take my migraine meds, the headaches are stable and I’m losing weight.

I don’t have diabetes, but I 100% believe that these shots are treating something wrong in my body. The change in my migraines is dramatic.

It’s an old statistic from a study in 2000 on adverse effects from all NSAIDs. The number is lower now and is about 0.027% of users. To be fair the rate of GLP1 deaths is lower, around 0.013%, but the adverse event rate is higher, though generally less severe. However, the risks for NSAIDs are generally well known and established over time. Less so for GLPs and we can see now expansion of the user group beyond what was clinically tested, an increase in overdoses and an increase in long term use, the effect of which is obviously not yet known. On balance probably still better than staying obese, but I’d still rather we tried to stop people getting obese!