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.

Firstly, I fail to see what business it is of yours what choices strangers you pass in the street are making about their diet and lifestyle, I am unsure why on earth you feel qualified to make moral judgements on people based entirely on their weight, it is neither a kind nor productive use of your time.
Secondly, how on earth do you know these strangers you're judging are not using weight loss jabs? Unless you are going so far as to stop people in the street and grill them on the subject then you surely have no way of knowing this for sure. Maybe they have just started using them, maybe they are part way through their weight loss journey. Equally reasonably, maybe they are comfortable with their weight, regardless of whether it bothers an unknown nosy-parker passing by or maybe for health reasons the medication is unsuitable them. Also, as many other posters have pointed out, maybe they cannot afford it, a concept you seem to be struggling with despite paying lipservice to it in your original post. Whatever the explanation, one thing is for sure, it is absolutely none of your business and the fact you spent your day out thinking nasty thoughts about strangers and then coming onto MN to share this unpleasant post in the hope that fellow posters will join you in condemning the shameless fatties you were apparently forced to examine in great detail says far more about you than the poor people you were judging while they minded their own business.

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

This is the only way to lose weight. I know that wasn't the point of your post, but it does irk me when people say eating less and moving more doesn't work for them because X, Y, and Z. Yes, it does. It might not be easy for you; you might not be able to stick to it because of X,Y, and Z, but the only way to lose weight is to consume less energy than you expend.

Oh come on - nobody really believes that the pair of them look like that because they overdid WLI and somehow magically can't regain weight, contrary to every other human on the planet who stops taking them and either can't avoid gaining weight or has to work very hard not to?
Those women have both had fat sucked out of their faces and Sharon O has had a gastric bypass. I wouldn't be surprised if they both had eating disorders and we can confidently say that if their low body fat is due to WLI abuse then it's current abuse not because they stopped using them and somehow can't gain weight, because that's arrant nonsense.

I love it when I get medical advice over the internet.

My pancreatitus was not caused by being overweight, it was caused by a medical procedure. It was fucking hell, when you're admitted to the ward via a&e and ask how long the stay is likely to be and the Dr says could be a week, could be a year. Yeah, not something i'm willing to repeat.

The risks of pancreatitus are higher when taking glp-1. I'll take my chances being fat (and trying - failing - and trying again to lose weight without them).

Because it's their own body and they can decide to be on medication or not, with a side order of "mind your own business wtf is wrong with you"

Expense is a big one for most but also they're not suitable for everyone.

My GP advised me against getting them, I'm slowly loosing weight by diet and exercise.

Cost and route of administration. Injections and having to deal with dose, needles etc is very off-putting for many potential patients. Oral Glp1 with a with similar efficacy to injectors will be the next big wave and money spinner. These are on market as effective for diabetes, but the weight loss seen is a fraction of injectors. There is a furious race to find and launch better oral formulations to get and equivalent or close to equivalent efficacy.

Is there really really any excuse

Your hatred is showing OP

If you have not already tried it (and you probably have), weight lifting and eating to fuel this rather than to lose weight specifically, is very effective (for those that can stick to it).

Eat lean proteins and aim to reach your protein goal rather than aiming for a calorie deficit. You'll probably find yourself in a deficit anyway, because protein is filling, but recent research has shown that people can lose fat (fat, not weight) while eating at a slight surplus.

There are body recomp calculators online that will work out your macros for you.

The 'medium' people are going after them, some of the posts on here wittering on about food noise (which by the way the vast majority of people have, fat to thin) whilst having a bmi in the 20s, now that is pure laziness.

I have had the same issue. Although the injections havent helped me lose any weight so that’s a tad annoying

I am worried about the side effects. I would rather lose weight with another method. I’d rather be fat than have stomach paralysis.

My best friend is obese (BMI of almost 50) and is against the jabs because of the health risks. She is seemingly not bothered by her obesity and I would guess a lot of others are the same.

Yes you are completely correct.

And there is no difference between OP walking around judging other people for not taking the injections to lose weight vs people judging her for simply not eating less calories and moving more and she wonders how she’s coming across as goady.

Actually what OP is doing is worse because eating less calories and moving more does not cost money or come with side effects yet she couldn’t even do that herself but yet she’s judging people for not doing something which cost money, has side effects and doesn’t work for everyone.

That’s not really comparable. Antidepressants like Fluoxetine and Sertraline have been studied long term. The issue is more that they were sometimes overprescribed and not always regularly reviewed, not that they suddenly turned out to be unsafe.

With weight loss injections, they’re treating a chronic condition & we already have growing longer term data.

Otherwise, you’d never take any medication, because nothing starts with decades of data, it’s always about balancing known risks against known benefits. For example the risk of obesity vs the risk of WLI.

I am six stone over the top of my ideal weight and don't use them, though have considered it. The reasons are:

1. cost, I cannot easily afford them, though I could make it happen, but I am not willing to forgo what I/those around me might need to give up to do so
2. I'm not totally convinced that we know the potential longer term impact (but I did have the Covid jabs without a second thought, so perhaps this is overly cautious)
3. I know why and how I am overweight and I know I could and should say no to snacking/portions etc and am trying but I feel strongly that I should do this with willpower. I have agency and choices and I am making the wrong ones. I know this.
4. I think that long term (forever) change has to come from within.
5. I have lost 3 stone before by other means that I consider combat all of the above and therefore I can do it again.

All that considered, why am I not doing it is a really good question and one I am working through right now and i hope to get on with it over the next few weeks, starting with activity and cutting my snacking.

All of the above are personal to me only and in no way reflect what I think anyone else should or shouldn't do - in fact I don't have an opinion at all on what others do.

One of two reasons:

a. Expensive

b. Only been in mainstream use for a couple of years and they do not fully trust it.

From what I can see, the patents are expiring, and the market will grow as "me too" drugs go on sale. Also the tablet forms will probably improve and be even cheaper. Millions of people are already users so we will learn more about the overall health effects.

If they were as cheap as aspirin and became widely socially acceptable, makers of chocolate cake and sugary drinks would be diversifying into selling carrot juice and celery snacks. I don't know what would happen to Macdonalds, KFC and Gregg's, but I wouldn't be investing in them.

Already I have seen Lidl and Aldi selling high-protein foods which I understand are aimed at people who are eating less.

It will be interesting to see if antivaxxers can think of a reason to take them.

I do actually find it irksome when people refer to eating less and moving more as an alternative to WLI. You have to reduce your calorie intake on WLI in order to lose weight. The injections just make that less difficult to do.

It is money, but i do see wealthy people with many of the trappings of wealth - eg. multiple families on holiday in very expensive hotels - and they dont seem to be on it!

The food industry is already adapting to WLI, hence the rise of "high protein" foods (which, for the most part, are not high protein). I mean, I'm enjoying this as I eat a high-protein diet atm to build muscle, but it is a reaction to WLI, and most of what is being pushed as "healthy" is junk food with added whey protein.

They're also, more worryingly, employing food scientists to create "food" that is more flavourful but less satiating.

They make it really easy!
My dh lost 11lb in his first week!
Just wasnt hungry.

He lost 3.5 stone only ever taking the starting dose, came off them, and he is staying down.

He hasn't been this weight since he was 14!

My friend had a balloon which did help somewhat. The jabs aren't making any difference. It doesn't work for everyone perhaps.

I've got two friends who are overweight, possibly in the obese category, who both seem pretty unbothered by their weight. It's definitely their perogative to be able to eat whatever they like, and be any weight they choose. They seem happy. But I do worry they will get potential future health problems when they reach menopause and all the joys that comes with the weight changes there.

I've never once looked at my friends and thought about if they should be taking WLI, snd I very much would never do anything to upset someone by asking them!

Agree. That's what I said. They do make it easy. But he's lost weight because he's taken in less calories. So its not an alternative to eating less - it is still eating less - just without the struggling and obsessing over food.

I just think when people don't understand that, there's the idea that WLI allow people just to continue as they were and lose shed loads of weight and that isn't the case.