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.

@Dragonscaledaisy I welcome additional research into the side effects of these medications, not least because I am taking the myself. I have also experience hair loss whilst losing weight on them. It was temporary and self resolving. If this was highlighted to me specifically as an issue before starting treatment I would have still started. I was morbidly obese and the chance of some hair loss would have been an insignificant risk in comparison to remaining morbidly obese. I really hope that people that are significantly or morbidly obese are not put off using these life changing medications due to disproportionate concern over hair loss.

@curlywurly1111 they had that effect on you. Not me, nor the majority of users. Yes, people have side effects, but not many have such extreme ones. Otherwise there wouldn't be millions of people taking them. Orlistat that you can buy over the counter is well known to make users shit themselves or suffer from anal leakage, but I don't see everyone suggesting that should be banned.

Would all those people tell you if they had diarrohea though? I didn't tell any of my friends as it was embarassing. I only told my family that I was stopping taking it as it made me sick

If you do a quick look at the weight loss injection forum, lots of women on there have side effects after taking the drug,

So even though you personally don't know anyone that experiences side effects, you can see online that women DO experience side effects

Where are you pulling 'not the majority of users' from?

What survey and sample size are you using?

Thank you for sharing your experience. It's very important that people are fully informed about the potential risks and benefits to guide their decision making. I've worked on GLP1s for years so know that hair loss isn't temporary for a small number of people, and that can cause significant distress.

I think its important to talk about side effects.

i think I was sucked in myself by the marketing of 'this wonder drug'. I didn't research it enough.

I thought it would simply dull my appetite.

It made me severely sick.

The tablets i am on make me put on weight and i have just about come to terms with my size. I cannot take these new weight loss pills and injections they do not agree with my other tablets. i have tried all sorts of diets including slimfast which meant a hospital visit

The diet that works for me best is the poverty diet!

I used to spend a lot of money on junk food. Energy Bills have become higher and I have less money. I realised how much money i was wasting on snacks and junk food.

I now restrict my spending, and the weight is coming off.

We absolutely would tell each other, yes. They also presumably wouldn't continue to use them, as you chose not to.

I’ve already acknowledged that side effects do happen, I’ve not denying that. My point is that all medications have side effects (as in my own experience with penicillin) and if a drug doesn’t work for someone, they stop taking it. That doesn’t make it inherently bad or unworkable for everyone else.

With WLIs, we’re talking about tens of millions of users globally. If what you’re describing was the typical experience for most people, there wouldn’t be the level of continued that there is, or the outcomes that have been consistently shown in trials and real world studies.

So I’m not saying they’re perfect or that nobody struggles with them, just that individual negative experiences don’t override the wider evidence.

Unknown long-term effects

My mother is eligible on nhs but they won’t as she has polyps in her gallbladder. They won’t remove the gallbladder because of her weigh so she can’t win. She eats like a sparrow, constantly on a diet but with limited mobility.

Quick google on the internet is where I got my "majority" from. If you want specifics @curlywurly1111 , according to research published on the National Library of Medicine in September 2025, looking at a total of 48 randomised controlled trials involving 27,729 participants on GLP-1 receptor agonists, overall incidence of gastrointestinal adverse effects was 11.66%.

The cost. Obviously.

I've been trying to lose weight and keep it off for the last twenty years. Not an HAES activist. Obviously at higher risk of certain cancers, I do not need you to tell me that and am not sure why you would think I did. Also worried about my knees and mobility as I grow older and potentially less able to be active. But also not currently showing and never have shown any signs of metabolic illness, which is a specific cluster of symptoms that I do not have (most recent bloods last week!) and have not so far had. Let's hope they don't develop.

I do see that you're doing a sort of hunt-out-and-lecture-the-fatties thing here and I for one don't really need it.

Yes but the OP asked: why doesn't every overweight person take them.

That was a bit naive to write, as obviously the same drug will cause different side effects in people.

As we have said: not everyone can use the sane drug and experience the same effects.

My sister tried one of these drugs and it also made her very sick.

One of my friends was the same - it also made her sick.

It didnt make you sick - great.

people experience it differently

You articulated this better than I did. The risks don’t outweigh the benefits for me either.

If I was morbidly obese, or had eg diabetes, I might reach a different conclusion.

I also don't like that doctors/ pharmacists seem to put absolutely everybody overweight on this drug regardless of medical history.

All that is required is to be a certain weight and enough money.

I'm not talking to the OP.

I'm talking to the person I'm replying to (which I've just realised is you, so is even more bonkers of a reply). And you're not making any points I haven't already addressed. Yes, people will have side effects & if for them they outweigh the benefit of no longer being obese, they should stop. But that some people experiencing side effects is not a reason they are dangerous, in the same way me having a serious allergy to penicillin is evidence that penicillin shouldn't exist.

My answer to the OP was because they either can't or don't want to.

Studies show that over 90% of users put the weight back on once they've stopped using them, more quickly than dieting alone.

https://www.theguardian.com/society/2026/jan/07/weight-loss-jabs-regain-two-years-health-study

So maybe it's not just spending hundreds of pounds every month till the weight is gone but hundreds of pounds forever.

And some people use food as an emotional support so maybe they don't want to lose their appetite.

or because they tried, experienced severe side effects, and stopped.

which would fall under can't or don't want to.

Medically unable to continue - can't

Side effects unbearable enough to make reducing their weight with WLI's not a net postive - don't want to

@curlywurly1111 I don't know what doctor or pharmacist you spoke to but I had to complete a comprehensive medical history before I was prescribed WLI. Who are the GPs or pharmacies dishing them out without this? It is a prescription medication. If you know of pharmacies or GPs prescribing without a proper consultation you should report them to the General Pharmaceutical Council asap.

@PracticalPolicy to be fair that's similar to any other weight loss approach, regain is a significant issue regardless of how you lose the weight. I would never suggest that people should not attempt to lose weight for fear of regain.

Yes, I also have to give my provider access to my medical records, which I know they have checked.

Exactly and when they no doubt come back with "people lie to get them" - that's really only evidence to make them more widely available on the NHS. Not evidence that they don't work, or are unsafe. Anyone accessing medication they don't need is at risk.