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.

Sadly yes!

This is something that gets missed in the risk/benefit discussions with WLIs at times. If you're already obese, there is no zero risk option available to you. So, for those who have the funds and aren't contra-indicated, the choice is simply about which set of risks you're most comfortable with.

I'd take lumpy breast over being severely obese any day!

Obviously we are talking about non cancerous fatty lumps here because no one is implying there is a breast cancer risk from Mounjaro........🤔

I think that he was saying that the apparent lumps were somehow caused by the fat disappearing too rapidly. This was a consultant who works in both the NHS and the private sector. He wasn't talking about malignancies showing up.

The other bit of advice that he gave me was to concentrate on my weight training, since - according to him - that was the most important thing for a woman of my years. I'm in my 60s.

My understanding is that he was absolutely referring to benign lumps. ETA His emphasis was on them being caused by rapid weight loss, not the Mounjaro per se.

So a doctor recommended someone stay obese to prevent against non harmful lumps? I'm not sure I'd put much stock in that.

I’m finding the comments very odd. No wonder so many obese and over weight people in the uk. The lack of knowledge is utterly staggering.

examples:

you need to take gnem for life, well like any other method of weight loss you need to keep doing it when you come off or your regain, it’s nodifferent.

you have serious side effects. Not one death has been directly attributed to the drug globally and over 50 million take them

we donf know tne long term data, well we have 40 years. And we do know the risk of obesity, the number one leading cause of cancer in non smokers, and the second leading cause of cancer in smokers. And that’s before we discuss heart attack, stroke, fatty liver disease etc.

you don’t learn anything on them, um well again, you need to diet to lose weight on them, it just enables this, the actual method of weight loss is no different to any other diet. The fat doesn’t just melt off, whilst you crack on over eating.

it doesn’t solve the physiological reasons for over eating. Um what diet does? That’s therapy not diet.

so I will revise my opinion, the reason people don’t take them are primarily cost. With a large spoonful of complete and utter lack of knowledge around them.

Seriously> he said people should risk their lives being fat rather than take a tiny risk of lumpy breasts which is a cosmetic issue? Seriously??

That may not be entirely accurate - research is ongoing, as it is into potential accelerated facial ageing caused by GLP1s.

https://onlinelibrary.wiley.com/doi/10.1111/jdv.20512

We need to understand both of those better.

Its not that easy. They don't just reduce your appetite. Those injections can cause serious side effects for some people.

i took the injection for four months. I had to stop taking it as it made me so sick.
It made me have severe nausea, constant foul smelling gassy burps, diarrhoea,

It made me lose control of my bowels.

when taking it, I was out with friends and I pooed my pants with diarrhoea. No bowel control on it

I also didnt lose any weight

Eh what> and your link is dodgy and doesn’t work.

wtf am I reading.

What do you mean wtf are you reading.

They are all known side effects of this drug.

This is why people should research it more before taking it! people like the OP seem to think its a magical weight loss drug, with no potential side effects for people

All that stuff can happen, but it usually happens when you don't change what you're eating.

It's not 'dodgy' at all. It's a peer reviewed publication in JEADV. Google it - freely accessible.

Exploring the hair loss risk in glucagon-like peptide-1 agonists: Emerging concerns and clinical implications

What a horrible goady OP!

If you genuinely used them you would know that they are really a dieting aid. You don’t lose weight just with an injection.

Weight loss drugs are expensive. Some people can’t use them and some don’t want to. For some people they don’t work. Some people simply cannot diet.

No, he didn't recommend that people should stay obese...

I'd explained that I was concerned about the possibility of oestrogen driven cancers exacerbated by obesity. (Apparently the fat cells store oestrogen.)

I'd recently got the all clear after suffering post-menopausal bleeding and I told him that I'd already lost about 30lbs but knew that I needed to lose about the same again.

He was pointing out that women who have lost weight rapidly have suffered health scares as a result and - as I said in a pp - advised me that weight training was the most important thing for me.

It goes without saying that, so long as you don't increase your calorie intake then if you're training, as well as strengthening your muscles and bones, you lose body fat (albeit gradually).

Maybe because they can't afford them. As your post states they're not free for everyone. If you're really offended by overweight people you can always choose to not stare at them and make judgements

I'm surprised that you don't realise that this can happen.

Look at the weight loss drug forum on mumset: lots of women describe experiencing these side effects

It’s weird that people can’t seem to grasp that medication with known side effects, can cause side effects in some people.

Its scary that OP and others are able to take a medication so easily when they’re obviously not the sharpest tools in the shed.

I’m sorry that happened to you and hopefully posts like yours may help some posters understand why everyone can’t simply medicate themselves into losing weight and perhaps they’ll stop being so judgemental.

Of course those things can be side effects, I know a significant amount of people using them and none have had anything like the experience you have. I think you have been very unlucky to react in this way but it's absolutely not the norm.

I nearly died from penicillin about 15 years ago, I had an awful reaction. That's not proof for not using penicillin as for the people who don't have that reaction - it's a wonderful tool.

Oh, so you have to be intelligent to take medication now? Or is it just medication for obesity that you think should have a minimum intelligence requirement?

I hadn't lost any weight, and I was too sick to get off the couch.

Once I pooed my pants I said I can't take this anymore.

These drugs are not a mild appetite suppresant. They affect your whole digestive system and can cause burps, nausea, diarrohea, loss of bowel control etc

I am the same - I am very very tempted but I’m in the ‘could do with losing a couple of stone’ zone rather than the ‘weight is impacting health’ zone.
For me, the risks of the side effects do not outweigh the benefits

There are a proportion of people described as 'early responders' who experience very rapid weight loss early (not saying this particular poster is one) - they're also likely to experience the more severe adverse events as they described.

I spent the majority of my adult life morbidly obese (maximum BMI: 48.5) with multiple large losses and regains. I was also on a GLP-1, Trulicity, for diabetes, for 5 years.

in January 2024 my BMI was 41.5 and my blood glucose was sky high despite being on Trulicity plus metformin. I believe at that point that WeGovy had been licensed for weight loss, but I don’t think it even entered my consciousness.

Another diabetes med was prescribed, but I didn’t take it. Instead I made a series of changes to my eating habits, over several months. Think real food rather than processed, reducing then stopping snacking, adding intermittent and then longer fasts. Eventually I came to understand that I am addicted to sugar and some other UPF’s, like crisps and have made peace with it.

I have been off all medication for over 18 months and my blood glucose is now in the prediabetic range. My BMI is 30, and my weight has been broadly stable within a small range for about 6 months. Perhaps a slight downward trend. I’ve been wearing the same size clothes for over a year - which has never happened before. Any large loss would immediately be followed by a large and rapid gain. In fact, I did start a regain last spring, which went on for 3 months before I got a grip of it again and worked more intensely on the mental/emotional part. I’ve lost 2/3 of the regain, still another 6lb to go.

I have become interested in WLI’s over recent months, largely due to coverage on mumsnet. On one level I would like to get down to a normal BMI….. OTOH:

1. It is a lot of money, potentially for life.

2. My quality of life is so much better, I feel I have already had the vast majority of improvement which is possible - so any further improvement would mainly be aesthetic

3. With the best will in the world, at my age (60’s) I am not going to have a flat belly and flawless skin. I would always have the body of someone who was once morbidly obese. So even the aesthetic improvement wouldn’t be huge.

4. I have already achieved something very difficult and rare and am quietly delighted with myself.

That all said - if, when I sat with the practice nurse writing me a prescription for a 3rd diabetes med, she had said “I can’t prescribe you WLI but you can get them privately, look into it” I might well have done. Because at that point, I had no hope. But now, having done the hard work of the mindset shift and the lifestyle change, which you need to make anyway to have long term success with WLI, I’m not sure how much they would add to the party.

I will say, however, that I have become much more conscious of how many very obese people there are around. Only because I used not to look at them, because I knew I was almost always bigger than them anyway.