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.

Some of my friends are taking it and some aren't, I’m not overweight. This what I can remember of the conversation around it.

Affordability
Overwhelmed with choice between brands
Is it actually safe?
Diarrhoea
Heartburn
Can afford it now, but will the price triple when we’re all hooked?
Is it proven safe? What if I develop issues from it in 20, 30, 40 years
I don’t want a face like a prune or Sharon Osborne
I don’t want loose skin and tucking it in my jeans like dough
I enjoy food, it’s one of life’s pleasures
Pancreatitis risk
Can you ever stop taking it?
Weight gain after stopping
It’s cheating
Edited - I forgot hair loss

Absolutely
It’s like a weird club that you aren’t a cool kid if you don’t use them, whatever that reason - money, health, not trusting them, body confident, choice.

The side effects are well documented - have a look at the clinical trials for tirzepatide and semaglutide for an idea of how frequently common adverse events occur. GI events probably affect around three quarters of patients, particularly during dose escalation.

I was talking to a GP friend a she said the NHS is catching up and it will be a different story in 18 months and probably available to all over a certain BMI via NHS

One, because a lot of people think it's the easy way out and it's cowardly.
Two, because it's come up that there can be long term side affects (I'm not talking about the horrendous immediate side affects that in my mind makes it absolutely not worth it) and organ damage.
I don't really have a problem with number one. I don't have a problem with shortcuts. I love shortcuts. If there was a good one, I'd take it. I think losing weight is good but some diets do an enormous amount of organ and health damage. Which is why I lean on number two. I would just say to these people who are injecting these toxins into them, we'll be here when you get very sick from what you've taken and hopefully not to many of us will say I told you so. To me, injecting yourself with this crap is like vaping to stop smoking. I speak as someone very overweight but the Pope would turn into a Satanist before I would inject myself with that garbage.

OP is using them and is very much judging people who don’t use them.

@Dragonscaledaisyfor those of us taking these medications, the side effect frequency is noted in the patient information leaflet quite clearly. As is the relation to dose escalation and the initiation of treatment. I think my own experience is fairly typical, some manageable gastric side effects in the first couple of months and then nothing at all after that.

I know three people who’ve had awful side effects from them and we have autoimmune conditions in our family which would make me too scared to try them. i’m only a stone or so over what I should be, but wouldn’t be tempted even if I was much bigger.

She is, and it's a stupid premise for a thread, but I think the pp meant that the scales weigh very much towards greater judgement for those of us who use them. Even in this thread that's the case.

I think that sounds pretty healthy tbh!

Similar

don’t eat breakfast, yes I know it’s unhealthy, childhood trauma, never going to change.

Lunch - something like pate on toast, beans on toast, ham sandwich and a piece of fruit, ham salad.

Dinner - tonight is a massive pot of turkey bol which will make about 10 servings. Tomorrow is mushroom and truffle soup, last night was aubergine schnitzel and pesto pasta. Friday is probably going to be prawn fried rice. Some nights it might just be spinach and chick pea curry or daal and rice. Lots of super cheap dinners can be really tasty

generally don’t eat much meat or fish as it’s expensive, we eat a lot of veg based meals, which cuts down our shopping bill dramatically.

Not necessarily. Some people experience significant side effects early on in treatment and some may continue to experience these. As we understand more, we know that these may be the people who are losing weight very rapidly early on. People may also be willing to tolerate GI events because they're so desperate to lose weight rather than accept that a dose reduction may be the best approach. It very much depends on the individual.

@Dragonscaledaisy fair enough. I’m not going disagree that each person will have their own individual response and reaction to that response. I think that’s pretty typical of any prescription medication.

The thought of injecting myself is scary. Also i cant afford it.

I cut food back alot on my own. But I felt like I wanted something to help more. . I take mysimba. Your meant to take 4 a day . 2 in the morning 2 in the evening. But i was just taking 1 day because it's been working . I have been taking 2 for the past week. I have lost 4 stone since mid November

@Tacohill and all of the people posting judging those who do use them. A quick peruse through the last 15 pages alone and users are accused of "pure laziness", "stupidity", "being in a weird club", "vain", "obsessed with being thin", "gambling with their health", "ozempic face", "naive", and "crazy" just a few of the accusations on this thread levelled at those who used WLI. How is that ok?

Skipping breakfast being unhealthy, is a myth. It was actually Kellogg's who came up with breakfast being the most important meal of the day. There is no research at all that supports their claim. If you're not hungry in the morning, don't eat. That's fine.

I eat breakfast because I like to run in the morning, and I know my run will feel better if I am fuelled. That's also how I talk myself into eating porridge and a banana instead of sausage rolls for breakfast. I will feel a lot better during and after my run, eating the porridge instead of the tasty sausage rolls.

OP didn’t say they weren’t aware of side effects. She’s been on them. Theres no possible way you’ve got a prescription for GLP1s and not been made aware of the side effects.

They cost a lot, in the region of a couple of hundred a month. Some people suffer a lot of side effects & decide it not worth the bother whereas others can't use them due to allergies etc (in my case pre-existing angioedema). If you want the. Prescribing on the NHS then prescribing guidelines are very restrictive, although from what I can gather this is set to change.

Apologies my last post was very jumbled.

Also, money aside, worries about side effects aside (for what is still a fairly new medication) some people are fine being overweight.

I am literally making a saving. I’ve never paid anything like £300 though, I pay £113 a month and appreciate I’m lucky not to have needed to increase my dosage but I am without question spending less on food.

Thank you
I have historically got a lot of shit for my anti breakfast behaviour, this is refreshing.

I am never going to be able to stomach it, don’t know why people are obsessed with it, and me eating it, like the nutritional value of that food at that time far outweighs the trauma of eating it when you feel sick at the sight of it.

also, sausage rolls for the win sometimes ;)

Wrinkles and obesity can not be compared.

The former does not threaten to bank roll the NHS, the latter does .

I take your point though !

Show anyone who mentions breakfast to you this article

https://www.tastingtable.com/1922048/breakfast-most-important-meal-kelloggs-marketing/

The food industry has a lot to answer for when it comes to our attitudes around food.

My friend is very overweight and has trouble walking due to arthritis in her knees. She needs to lose a certain amount of weight before she can have knee replacements. Her GP will prescribe WLI but she won't take them as she's scared of the possible side effects and she enjoys food too much. It doesn't make sense to me but it's her decision. Maybe lots of people feel like she does.

What do you think about Champix for stopping smoking?