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 wish someone had told me that before I had the horrid antipsychotic that injured me permanently 😪 I am so much more cautious of anything that has quite serious adverse effects now, and a staunch advocate of being extra careful.

Once bitten, twice shy I guess for me regarding medication.

@hahabahbag there isn't a lack of testing for the use of GLP1s for obesity. They have to go through the same clinical trials and acceptance process as any other medication, and these have been approved by the UK MHRA specifically for obesity.

If Im a carer, on £500 roughly a month to cover all bills apart from rent, tell me how I pay out the private prescription charges for GLP-1.

Do you know what the waiting list is? Do you know how overweight you have to be for a prescription, and what other health conditions.

I have conditions which would definately be helped by it, my GP would love to prescribe it for me, but he cannot.

I was around 5 stones overweight. I'm now 3 stones overweight. I've mainly lost the weight through exercise and some calorie watching. (I'm just over 5ft 8.)

I would gladly have used the injections to help me - I could possibly afford them in the short term - but I have IBS and gastro reflux which I have no desire to exacerbate.

Though i agree that there are many reasons why people don't do it. This is not a great analogy because wrinkles don't significantly, shorten your Life Expectancy.

Exactly, some people are so obsessed with being thin that they are happy to be unhealthy in the process of achieving that goal and society will cheer them on and claim the now thinner body is “healthy”.

Slightly off topic but somewhat related - I was dating this man. One day he asked if I would ever use GLP, I was so caught off guard I just no but didn't ask why he was asking me.

He then said he saw female friends from school on Facebook using it and he could understand why since he has seen some great results, it’s a struggle for women with weight and society is so harsh to women who are overweight. He was talking about society but he is part of the harshness as he had previously expressed fatphobic views.

It was only later I realised he was saying all that to hint I should take them. It wasn’t about empathy for his female friends, it was just him trying to push them onto me.

I had been on, and still am on, a weight loss journey and had been very slowly but steadily losing weight. I was absolutely fine with my weight and the progress I was making .

The fact that he thought it was ok to influence me to take GLP so I could attain what he deems as an acceptable body shape/ size at a quicker rate disgusted me.

It wasn’t even about being offended I was just shocked by the fact he didn’t care about my health and was only focused on aesthetics.

I had been dating him for 2 months and that was the last weekend I ever saw him. I decided we were done after that.

The irony is he is fatter than I was. He was more or less my height but looked about 2-3 stone heavier. Had man boobs and a fat stomach, thigh and bum area. He had the figure of a lot of plump woman tbh . And that’s another thing, women are much more pressurised into feeling like they need to take WLI despite many men being overweight too.

May many reasons. I’m sure they all know they are obese and know about these drugs but they will have their own reasons that’s nothing to do with strangers on an internet forum

I can't afford it. I'm 'losing weight very slowly without help. 4st down since January 2020, about another 7 to go.

The reasons why severely obese people are not on GLP1s probably pretty much limited to -

• Financial reasons

• Medical reasons

• Do not want to lose weight / do not see their weight as a significant issue as it is not practically impacting their health/mobility yet

• Do not feel they have exhausted other unmedicated options yet

• Did their risk assessment of benefits vs risks and decided the balance did not fall in favour of using (the facts that assessment was based on may have been correct or incorrect)

• Overwhelming shame/embarrassment from exposure to stigmatising social media narratives or media dramatic scare stories around individuals using GLP1s

Not for everyone. I took them for 2 years, have been off them for 18 months. Maintaining my loss.

For me, it reset me back to "normal".

I'll add to my above post.

I finished up paying to see a private breast consultant when I found a tiny lump*. I got the all clear, but when I mentioned that I was still trying to lose weight he warned me never to use Mounjaro - he said he'd had an upsurge of women self-referring for check-ups because they'd lost weight very rapidly and been left with lumpy breasts.

*I was going abroad for a wedding and couldn't get travel insurance without a diagnosis. Fife NHS had a waiting list of 18 weeks.

@Lostin2046

broadly safe because it’s positive effect was better than the negative in type 2 diabetes monitored by drs is not the same as fully tested for mass use with minimal oversight, no dr seen in person, no ongoing monitoring by the practice nurse and increasing dosage to encourage weight loss so rapid it increases the risk of gallstones and other complications. Used under medical supervision it’s a game changer but I know of several people who have ended up in a&e with gallstones and others who piled the weight back on when they stopped taking them. No thank you unless my gp actually prescribes them, monitors me etc

I’m not disputing that Ragen Chastain looks at published data or that people do discontinue these medications. That’s well documented. The issue is how that data is being interpreted.

“Dropout” isn’t the same thing as the medication being ineffective. It includes cost, supply issues, personal preference, side effects & people who stop for reasons unrelated to efficacy. That’s why it can’t be used on its own to conclude the drugs don't work.

But yes, if we interpret the data differently, you're right we won't agree.

My friend is similar.

She’s on 10ml but is constantly hungry and eats more than what she used to, so is putting on more weight.

She lost weight too quickly and now her body has adapted to the feeling that it provided of being less hungry and now she’s gone back to boredom or emotional eating.

Most people aren’t overweight because they’re constantly hungry, it’s much more complex than that.

Unfortunately the WLIs don’t get to the bottom of that and so many people end up going back to their old habits even whilst taking them.

If people use them improperly, that's on them, just like any other medication.

As I say, you can get gallstones with any type of fast weight loss, and of course, obesity in itself is a risk for gallstones too.

If you don't want to use them, don't, but I would say they're definitely a net good.

Again, not for everyone.

I know a lot of people on them. Some no side effects at all, most have very mild side effects. Only 1 (of 12 or so) had such severe side effects they didn't want to continue on them.

Yes, my cousin and Aunt both got severe gallstones from losing weight on slimming world about 10 years ago. My uncle got them from being obese!

Surely that’s a reason to use them, if the fat hides lumps get rid of it. No?

I’ve heard of saggy boobs but lumpy ones is new and must be a tiny minority. Anyone with lumps in their breasts needs to know they are there and get them checked out.

Yes, they really are one of those things you can't win with. Well, unless you never get fat in the first place, and even then, you can get them depending on your diet!

@BeardofHagrid I guess I'd have to question the integrity of her supplier/her sanity at that point, why on earth would you pay such vast sums of money for the highest dose of a drug that is having not only no effect, but you're actually gaining weight?

How does this differ from any other diets? It’s a way to lose weight, not a course of therapy…?

Money.
Horrible side effects
Being on it for life because once you stop the weight piles back on

I’d love to have the jabs but I’ve had pancreatitis and this is a known side effect of the jabs.

OP, maybe you need to read around the jabs to find out they are not the panacea the media presents them as.

I have two friends who have stopped the jabs because of expense. Yep, their weight is creeping back on. Who has the money to stay on the jabs for ever? That’s a better question, OP.

I’m not allowed to because I have other medical conditions

Money

HTH

@MyLuckyHelper any reputable pharmacy would stop prescribing after 6 months or similar if you were on the highest dose and not just plateauing but actually gaining weight. One wonders where this person is getting the medication from and if it is legitimate.