Why are many severely overweight people not using GLP-1 treatments?

[Donteatmychips]

Just a pondering when I was on a day out yesterday. I know of course that there is an economic cost to GLP1s, but is there really really any excuse to such widespread obesity these days? I was walking around a seaside town and a National Trust property, and I would say a good half of those around were still large. I understand they are not that easily prescribed on the NHS, but I believe you can shop around and find deals from various online pharmacies. Is it just more that people don’t want to?

For full disclosure, I am on a GLP1 that I acquired elsewhere by walking into a pharmacy and just asking for it. Yes, it cost a lot of money and I know I am lucky to be in a position to have done that. I fought being on one for a long time and it’s not a magic bullet, but it does help and I’m grateful for that.

I know that modern versions of obesity are skewed, but I am talking really about people maybe 250lbs or over now, not just a stone to lose.

I mean, I don’t think it’s widely prescribed on the NHS and even then, the NHS can’t force people to take prescribed medication. There’s issues with people with a myriad of conditions not taking medication as directed.

Beyond that, private prescriptions are not guaranteed and have their own limitations eg cost.

I also just think generally people who are morbidly obese don’t care about their health or their appearance enough, hence getting to the point of morbid obesity. My BMI is normally about 20, I’ve gained weight recently that might push me to overweight BMI but I wouldn’t be eligible for the injections. I’m still trying to tackle it normally and stem the issue before I get to overweight BMI, let alone morbid obesity, purely driven by my health and how I look.

It costs a fortune. I pay about £270 a month, every month. Then, because I was one of those exceedingly fat people you find so utterly reprehensible, OP, I have had to spend loads on new clothes - knickers, bras, coats, suits for work, everything. The only thing I haven’t needed to replace is my socks. Even some of my shoes have become too large. There are huge cost implications.

Not just money. My friend won't take them because she loves food too much, she wants to eat.

Another friend doesn't and could easily afford them. I don't know why not, but I do know she has said in the past that being fat (and she's 18 stone, 5 foot) is her identity.

I also just think generally people who are morbidly obese don’t care about their health or their appearance enough

Fuck off.

As well as the many reasons already discussed here as to why people may be unable or unwilling to take WLIs, I'd expect that quite a lot of the overweight people that the OP saw on her day out are on them. I mean it's not like you have one injection and wake up a size 6 is it? And WLI users don't glow green or something to identify them to casual observers.
I have a friend who has been on mounjaro since last year and she's lost 5 stone so far but she is still morbidly obese. A few weeks ago we went out together (to an NT property in fact - maybe the same one where the OP judges people) and we walked a mile. This was an absolutely massive achievement for my friend, both physically and psychologically. It's a very long time since she has been out to such a busy place and even longer since she's walked that far. She is doing fantastically well and really turning her life around, not just by taking the medication though it has been key. I am really happy for and proud of her.
But yes, she is still a very overweight woman who can only walk a short distance quite slowly and she's acutely aware of the fact that other people judge her. I wonder how many people were, like the OP, thinking "Oooh, look at her, what a fatty, why doesn't she just get the jabs" without knowing anything about her, the struggles she's been through and the massive progress she's already made. OP, since you are on weight loss medication I assume that you are also overweight (or at least have been) so don't you think you should have a bit of empathy for others? Maybe thinner people are judging you in the same way.

💯

I mean 👏

If only it were that simple. I eat healthily, work out 3-4 times a week, but I also have an extremely slow metabolism, diabetes (for which I already take a lot of medication) and a family history of pancreatitis. Money isn't always the issue, neither is poor eating habits.

Ugh, aren't the poor fatties ghastly

My BMI is about 32, I have a family history of heart disease and so I could definitely benefit from them. The trouble is, I started losing weight by calorie counting and upping the amount of veg I eat in January 2025. I lost about 10lbs and then fell pregnant.

I'm now breastfeeding a 4 month old, so wouldn't use GLP-1s as there's not enough safety data for breastfeeding women. Also I don't have the energy or time right now to do the careful dieting and exercise you need to do in order to keep the weight off, again because I'm breastfeeding a 4 month old who is up every couple of hours in the night.

If I can afford it after I go back to work then maybe.

All obese people are sick though. An obese body is a diseased body. Thats just fact. He may not see or feel the effects of that disease yet but he is.

They have not only been tested on rats 😆

It's concern re long-term side effects that would put me off.

They may well be put off because of side effects.

I am overweight although not obese and trying to lose weight. It's a struggle and taking a long time but no way would I use the injections even if offered for free.

To be fair, your monthly food bill pre WLI was very high! Most people aren't spending that kind of money on food every month. No shade, but it's not representative.

me too, I've lost 2.5 stone and still obese, but my diabetes is under control now.

Nailed it.

See this is the kind of science denial HAES stuff that keeps obese people trapped in obesity. You ARE metabolically unwell. Your body is diseased. I'm sorry to put it so harshly but obesity is a disease. You may not be aware of the effects yet but of course you're unhealthy.

Do tell us about your medical qualifications Rose? And your ability to airily pronounce that everyone with obesity is diseased? How about non-obese people - can you intuit their diseases too? Do tell!

How do you expect people to have £250-ish ‘spare’ a month to pay for them. They can’t get by eating dust when they start the medication , to paraphrase Marjorie Dawes

I mean I’m paying £270 a month at the moment, that’s just not accessible for a lot of people.

Money is the obvious one.
You do realise that most obese people are from lower income households.

Obesity is also a disease.

Some people become overweight purely because they are greedy and lazy.
The injections work well for these people.

But many people become overweight for other reasons and being less hungry is not going to suddenly make them lose weight.
The injections are not going to work as well for these people.

Its like asking a smoker why they’re not vaping - perhaps they want to quit in a more natural way that will see longer lasting results.

I think you’re forgetting how many have been on them and have come off of them and they’ve regained the weight.
Or they’re still on them and they’ve acclimatised to them and so they’ve slipped back to their old habits.

I refuse to go on them because for me, being hungry isn’t the issue.
I am an emotional eater or eat through boredom.
My friend is on 10ml and eats loads because her body has acclimatised to it and she’s now confused about what to do because she genuinely feels hungry all of the time.

Also, some people do not care about being overweight.
Why should people decide to lose weight just because now you’ve decided to lose weight.

Imagine a couple of years ago a person eating very few calories to maintain a very slim figure telling you why don’t you just eat less and lose weight - it’s literally none of their business.

You need to check your privilege and attitude.

https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
obesity is a disease. If you have obesity you have a disease. If your body is obese then it is diseased. I don't need a medical qualification to be able to read and understand mainstream scientific publications.

My friend has a needle phobia and would not be able to inject himself. He had to have dental work recently and begged the dentist to do a root canal with no anaesthetic as the phobia is so severe he felt that would be preferable to being injected (of course dentist said no). He thinks therapy won’t work and therapy is expensive anyway, so he then would have to save up to be able to afford the drugs. Very sad as he has been obese since he was a child

I am afraid of the side effects. That’s my reason.

If her body is diseased, then why are her bio markers within normal range? How come you know better than medical testing?