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.

@BlueShoeGlue if you actually took the time to read what I wrote, you would have read that I absolutely did not mean you. Brush that chip off your shoulder and celebrate your amazing achievement.

£300 a month is a LOT for most people to find though. I'm fortunate that we can afford it (and I'm on ozempic which is cheaper) but I know lots of families who don't have £300 and wouldn't be able to find it without moving house or selling an organ.

Yes true but not when you have a family. You can’t use what you don’t have

Obviously i don't know your medical reason. But have you thought about mysimba? Its a tablet works on the brain to helps block food signals. Some people it works for,others find it awful. I didn't have a good start but I pushed through it. And its worked well.

My mother is deciding at the moment wether to get WLIs. She easily fits the GP criteria and could afford it anyways. She is just still weighing up the pros and cons of benefits Vs potential side effects.
Some people are more cautious when it comes to new medications.

@Usernamechangingi didn’t do any of those things so I’ve not saved that money. I guess I’m spending the same money on different foods. 1200 calories of food a day doesn’t cost much less than 2000 calories really. It’s only a couple of slices of bread and butter, a bag of crisps and a couple of biscuits a day which cutting that out doesn’t cost £300 a month.

You can get it for cheaper than £300

@C152 not all of those reasons are ‘they don’t want to’

I mean , I could just as easily ask you, if you’re fat , why don’t you just stop eating (so much)?

It’s not that simple is it? Cost, side effects, for some people it isn’t worth the risk, plus you can’t take them, or they won’t be prescribed privately with certain conditions. Sure , people could lie, but I’m not sure that’s a safe or good road to go down.

But mainly cost, especially as you go up the doses, and for some people it means years/a life time cost.

I missed this earlier.

This is what I wrote in response to another person:

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).

That is exactly what I'm doing. I suffered muscle wastage 5 yrs ago following too rapid weight loss after a significant bereavement. Once I started eating again, a lack of exercise meant that I piled on fat instead of the muscle that I'd lost.

A scan taken about a fortnight ago shows that my bone density and musculature is now at the top end of normal for a woman of my age and my grip strength is normal for a woman 20 yrs younger.

My weight is continuing to reduce at a slow rate. I'm just over 5 ft 8 and a size 16/18.

I'm continuing to follow the advice of my doctors. It's great that Mounjaro has worked for you, but it's not suitable for everyone.

I’ve said it a fair few times now, but I existed solely on processed food and am saving a fortune.

If you weren’t eating large volumes of convenience food before, yes you likely won’t save anything. There will be people on both sides of the coin for whether they’re saving money.

Not always a money thing OP. A couple who are close relatives of mine, He weighs approx 160-170kg, his wife maybe around 100-110kg. They are certainly very well off money wise but they both adore bakery treats, snacks etc. Dinners are always loaded up with pasta or rice, and as much bread & butter as they like. They are well educated and certainly know about weight loss meds, but I think they much prefer the lifestyle they’ve created. For them, there’s simply too much pleasure in the eating and they don’t want to give it up.

This is a ridiculous comment to make. A lot of people can't simply 'find the money', no matter how important something is to them.

Money. They cost a lot.

DF was offered the jabs on the NHS. He said no. Food was his joy, and he had little of them.

I am a fat fuck (BMI is 36) but I am not eligible for them on the NHS, and I am on benefits so I can't really fork out £150+pm.

Why not have your DF get the NHS drugs and give them to you?

For one, that is really unethical and illegal.
And secondly, he died in Feb this year.

Everyone would absolutely not grab them if they could. I am 15 stone at 5 ft 7 and would never consider them even if I was told I needed to lose weight urgently. As quiet as its being kept, there have been numerous reports of people going irreversibly blind in the US from these weight loss injections and many lawsuits have been filed.

I think just like other new injections that were being given out en masse in 2021, we will come to learn about the long term side effects of these in years to come.

Oh my, at least read up on this eye issue before posting nonsense.

why do you feel someone would tell you to lose weight, do you mean a doctor? As it’s a personal choice. You know you’re obese, it’s a personal choice on accepting the risks of that or not. Your choice, no one else’s.

It’s understandable to be cautious about WLIs, but some of the more scary sounding claims don’t actually reflect the current evidence. Semaglutide (ozempic/wehovy) have been linked in a small number of reports to an eye condition called NAION. It has not proven to be caused by the drugs & already occurs more commonly in people with conditions like obesity and diabetes.

Both the FDA & EMA are monitoring the findings but there is no confirmed evidence that these medications lead to irreversible blindness.

And like has been said a million times, it’s fair to say that long term data is still developing for weight loss use but these drugs have been used in diabetes treatment for years, so they are not entirely new or unknown. And they work in the same way whether for diabetes or obesity.

There are always going to be risks and side effects with any medication, people just have to weigh up what is best for them personally and if they’re not for you that’s entirely your choice. But to pretend it’s being kept quiet when the information isn’t actually there yet is a bit conspiracist. It’s also a bit frustrating that WLI users are th ones grouped as too stupid to read up, but most of the claims being thrown at them arent as they’re presented at all, and it’s usually people taking them that are the ones that have already read these studies/reports rather than just the sensationalist headlines!

Exactly this.

But this still makes no real sense.

very few people lose weight rapidly on weight loss injections. Read any forum on here or Reddit and you will see it’s an average of 1-2lbs a week, how much weight you lose and how fast is based on whay you consume, it’s a choice. Yes some abuse it but it is ludicrous to suggest it’s rapid for the majority. I myself was 1.5lbs a week.

You understand the drugs don’t melt the fat off right?

i would say, for myself, the reason it took me so long to try them is that I understand they do not automatically change your eating habits, and that is what losing weight is all about in the long run.. somebody up thread certainly mentioned therapy and this is a valid point. There have been times where I have considered hypnotherapy and balked at the cost (oh the irony) and I’m sure this would have been better for me in the long run. Of course I am yet to see what happens when I come off them.

for those insinuating that I am smug and goady, I am not. I believe we are still allowed to be curious in today’s day and age. The upshot seems to be both cost and side effects, which is fair enough

I think it’s more fear of side effects, it’s well known 80 percent of people have none, and for most who do it’s minor gastro.

I also think they do drive a change in eating habits, as firstly if you continue to eat too much fat or sugar etc you’re going to be unwell. Have the shits, sickness, burps etc, and secondly you need to diet on them.

weight loss is very complex psychologically. Some will go on them, more as they think they should, and then eat wrong and say see, they didn’t work for me, I need to come off and go back to as I was. Food can be a crutch and a comfort. And as much as people think it’s easy on wli, it’s not for most. It’s just easier. We need to diet, eat the right food, workout, stay hydrated, and that takes mental focus. Others will of course not be able to tolerate, like any other prescription med.

what I’m reading here though is not “I’m not using them due to side effects”, that’s very few posters, more it’s “I’m not using them as I’m scared of side effects”. Which is very different.

the main reasons coming up seem to be cost and fear. With a lot of that fear steeped in misinformation. Look at the poster who proclaimed lots of people going blind and it’s being hushed up. Complete nonsense of course. But a prime example of fear based on misinformation and misunderstanding.

of course other reasons like contra indicated, or tried and didn’t work, I think they don’t work for 15 percent of people.

but the majority of responses seem to be cost and fear.

I believe they are.

1. it's too expensive - I don't want to take it because I'd rather spend my money elsewhere / not have to work overtime or get a second job to afford it
2. it's too painful - I don't want to take it because I don't want to cause myself pain
3. side effects are reportedly awful and long-term side effects are unkown - I don't want to take it because I don't want to put myself at risk of known and unknown side effects
4. fear of needles - I don't want to take it because I'm terrified of needles
5. they are happy with themselves the way they are - I don't want to take it because I see no need to
6. they have too much on their plate to worry about this at the moment - I don't want to take it because I'm coping with far more important things

You missed “I’d rather lose weight, but without WLI.”

That is still a branch of “I don’t want to,” but there are people who recognise they need to lose weight, want to, but don’t want to do it that way.