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.

To be fair, I agree with @RoseField1. Obesity, in and of itself is a medical condition.

From a personal perspective (anecdata, I know), I was a "healthy" obese person. I walked my 10k steps every day, my bloods were fine, I did not have heart issues, etc. Only, none of that was true. I'd just forgotten what healthy felt like.

The biggest revelation for me when I lost weight was how much better I felt. I was sleeping better, I had more physical energy, and less brain fog. My memory improved, and the aches I had from "over-exercising" vanished. My depression improved to the point I was able to reduce my medication. I wasn't constantly thirsty...

Which, considering I initially lost weight because my ED was triggered, and I was eating 350-800 cals a day, is quite a feat. I felt better when I was literally starving myself than I did when I was obese.

I'm not saying anyone has to lose weight. If you're happy as you are, more power to you; your body is not my business, but don't kid yourself that you are healthy, because you're not.

Because I don't have the money. And because I'm on other meds that rely on a certain rate of absorption, which the jabs would affect, and could therefore be more harmful to me than being overweight.

I'm in my late 70s and probably 3 stone "overweight" but the only medication I'm on is the lowest possible dose of one BP drug. No diabetes, no statins. Hardly unhealthy for my age by any reasonable metric. Incidentally it's actually healthier for women to be somewhat overweight as we age than the reverse, especially if we carry the weight on our hips and thighs, rather than our bellies.

Other reasons I can think of include;

1. Preferring to try to loose weight naturally
2. Lack of information about the medications, there has been a huge amount of scaremongering in the media which has no doubt put people off.
3. Frightened of potential side effects
4. Lack of support from family and friends
5. People believing that they are healthy despite being obese
6. Perhaps like their bodies and have no desire to loose weight

OP if you are overweight then why have you waited until now to lose weight?

Scientists and doctors have been telling you for years to lose weight and giving you the information on how to do it.

You are financially in a position to eat healthy and so you can’t use that as an excuse.

You’re saying to pay £100s a month to simply eat less - why not cut out the middle man and just eat less?

You are judging people for not losing weight but you would have been judged for the same thing too.

Luck and genetics probably. Thankfully that poster has decided to lose weight before the disease of obesity starts to manifest in observable health impacts but that doesn't mean that she's healthy at 20 plus stone regardless of blood test results. Cancer can grow before it's detected, as can liver disease and many other serious health complications. The 'my blood work is perfect' argument is often touted by HAES activists online and it's dangerous and ignorant. By age 50, 2/3 of morbidly obese people have an obesity related health condition. That percentage increases the older you get. Morbid obesity is an almost guaranteed path to serious health issues and early death.

I was expecting this opinion for judgy pants to use this as another stick to beat overweight people with but not for a couple of years at least, be better OP.

I would expect that the costs of the meds are exclusive for many people in a cost of living crisis. There is an effective campaign of scaremongering news articles of how dangerous the meds are and it is still viewed as lazy to take a magic potion that helps you choose healthy foods - we must suffer (and mostly fail) for our beauty, don't you know.

I'd like to add that not all slim people are healthy people, lots of disorded eating amongst slim people but they are not fat so their unhealthiness is not easily visible.

Slightly overweight, yes. Not obese. And you are one of the lucky ones, statistically speaking you are an outlier.

Because the insulin I take alongside the GLP-1 encourages weight gain so the fact that I’ve only lost a small amount of weight is an achievement.
People buying WLI means that sometimes I can’t get them which means using more insulin to keep blood sugars down so I gain more weight that I have to lose again when I can get the GLP-1 again

I think you’re a little naive if you believe this wonder drug has just come about that’s making people lose weight and there will be no hidden or unknown risks with it. Yes being overweight is a health risk in itself but putting drugs into your body isn’t always the best resolution in some people’s eyes. It’s really no different to vapes being better than cigarettes or margarine vs butter. We were always told butter is the enemy and to use the alternative instead. The truth is no one gets big or overweight from just eating salads/ vegetables and some protein. No matter much you dress it up “I hardly eat, I diet but don’t lose weight” again if you actually ate what was genuinely good for your body then nobody would be overweight. All these dressed up chocolate caramel latte protein bars and powders are pushed and people actually believe they serve an overall benefit to their health. It’s crazy. Instead of weight loss injections and pills why don’t people just address the actual problem which is what they’re putting in their body. Keep food simple and basic and view it as a means to fuel your body and fill yourself with vitamins and antioxidants, not to satisfy an urge to eat. Argue all you like but if you were eating eggs, tomatoes, spinach and some fresh potatoes if you wanted to push the boat out for breakfast and then again something similar for lunch if necessary and dinner then you wouldn’t be overweight. Obviously not just eggs spinach & tomatoes before someone gets sarcastic but the point is keeping food simple and basic = healthy weight and healthy body. Cutting out all fizzy drinks regardless of diet or zero and eating watermelon and drinking water instead. This is only examples that you don’t need all this extra fancy stuff to lose weight. It’s basically changing the way you view food and
your body rather than putting yourself on a diet.

I am type 1 diabetic by the way and when I eat the things mentioned above along with other salad options, I don’t restrict to tomatoes and a plate of leaves 🙄 my blood sugar doesn’t spike. When I start having regular everyday normal foods like garlic bread or some quiche or ready baked jacket potatoes (even alongside the salad/veg) I have to inject a ton of insulin otherwise I spike ridiculously high.

I’m not sure you are correct, I went on mounjaro 12 months ago and was a diabetic weighing 20 stone.

I had my review yesterday and after losing 5 stone I was offered to increase it to 15 mg but we settled on remaining at 10mg for next 6 months.

as an aside I have noticed my food bills have decreased by £50 per week which if I was buying the medication would offset the cost of buying it privately..

I cannot express how much the weight loss has increased my mobility and other serious health issues.

There is no impact on medications prescribed for diabetes as a result of WLI. The supply issues were resolved in 2023. Production was scaled up to allow for separate lines of supply and this is simply not an issue now.

So you judge them for being obese AND you judge them for not being able to afford the 300 a month plus of mounjaro?!

Are you KIDDING?!!

Not only do you sound like an enormous arse but you are also hugely ignorant.

Many people have awful side effects that make it almost impossible to carry on with day to day life.

For some, GLP-1's simply do not work. It has little or no effect on them.

People with certain thyroid disorders and history of some cancers can be refused the drug whatever their size.

Take your judgment and stick it right up, OP.

I can afford them. But the long term side effects are still to unknown for me to be comfortable taking them.

1. Can't afford it
2. Concern about side effects, particularly as I have had a kidney removed.
3. Don't want to lose weight really quickly and end up looking like a melted candle.
4. Don't want to have to take it for life or face the weight piling back on again when I stop.

I have just been diagnosed with pre-diabetes and have signed up for the NHS Diabetes Prevention Programme and will hopefully have more success with this than silly cults like Slimming World etc.

What an awful post. I mean really did you need to ask?? you clearly don’t get it and no you won’t be saving much money from your shopping bill if you have a household to pay for anyway.

The other thing is side effects, 2 friends have been in hospital one vomiting and had to be rehydrated the other with pancreatitis- which is incredibly painful. Both now stopped the jab.

Yes, I'm hoping the next jab they work on is an IQ enhancer.

I have a morbidly obese friend who has a whole raft of health problems caused or worsened by her weight, but she still does t tick the boxes for the jabs on the NHS because they’re not the “right” health problems. She cannot work so is on benefits and therefore can’t afford them privately.

Money isn’t the only reason though. They have nasty side effects to for some people and many don’t want to risk putting them into their body. I certainly wouldn’t want to take them unless my health was severely impacted by my weight.

Also, not everybody has a burning desire to be thin. It’s not the be all and end all.

Technically BMI of 31, though over 65 BMI doesn't really work properly as we lose muscle and replace it with lighter fat as we age - hence flabbier, but not heavier. And I don't think eating sensibly, not smoking and drinking very little alcohol has anything to do with luck, just good habits. Sadly the good habits don't include much exercise, thanks to knee ligaments badly damaged in an accident years ago.

An article from the Lancet said that obesity isn't defined as a disease in the UK, although it is by the WHO as per your article linked.

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(23)00139-6/fulltext

I wasn’t under the impression there shouldn’t be overweight people anymore ?

Come and join me, I have a two 5-packs of Cadburys Creme eggs, we can nosh them together like the big fat fatties we are. 😂

Why not just eat less calories and move more - this is the simplest and cheapest way to lose weight.

Why not get a personal trainer and dietician or personal chef?

Why not just get liposuction?

Why not have a gastric bypass?

I can’t believe there are still overweight people when the above have all been around for years and apparently cost and side effects are no issues for anyone.

Did you read that article? I only read the into but it's an interesting debate but less about whether obesity is a disease or not, and more about whether it's helpful or expedient to classify it as a disease, considering whether the classification has an impact on obese people's behaviours, and what impact the classification would have on the NHS (ie resources)
the royal college of physicians classifies it as a disease.

Seeing what it did to Osbournes. No thanks