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 respect your decision, tho life being less overweight is easier, in my view.
63 mid stage Parkinson’s, lost a bit of weight, due to low protein diet, to aid meds, lost originally just over 2 stone at 50, never to return.
Life is easier being lighter, I don’t carry anything extra I don’t need these days

Of course you do what you can with limited funds, and hopefully stuff in your cupboards/ freezer

I think it must be very frustrating to see people successfully losing weight on these meds but not be able to access them, be It due to cost or contra indications.

very few people enjoy being fat, most given a choice would be slim, so I can see why it would cause a huge amount of resentment and envy, and I think it deeply unfair the cost is so high and the goverment should be dealing with it, all governments should, requesting price drops for market access, making them widely available. Right now I think price will only drop when more products come to market over the next 18 months, I think there are 8 more in development/trials.

the amount of misinformation, we’ve seen a lot of it on this thread alone, is a concern though, I don’t know if people are just ill informed, or scare mongering as they are unable to access them, and ir would be awful if someone could access but doesn’t due to reading misinformation.

take side effects, we know 80 percent of people have none. Those who do it’s minor gastro, and that’s usually as the person keeps eating as they did, too much fat or sugar, very few have them on a clean and healthy diet, yet we have posters claiming after one dose they developed pancreatitis as if the drug caused it. Other people claiming you will shit yourself and get lumpy boobs. Someone even posting a random survey about how people at risk of not getting their nutrients, like fat people are thick and when you take the drugs you dong have a choice as to what to put in your mouth.

even the regain comments are bewildering, unless there is a cost issue, no one needs to regain, if you come off and find your weight goes up. you just buy another pen or two, you’ve up to a year and just need to show you started off obese. It’s not like you come off tnem have to wait till you’re obese again, or you’re banned from using them.

no one should feel pressured to use them, not being able to access due to cost issue unfair, and no one should not use them due to misinformation being spread on line.

Even the "common" side effects are something like 10% chance. So if people are claiming otherwise that is fearmongering. But I don't think it's unreasonable to seek to avoid using them based on side effects. These are literally listed on the box (elevated risk of thyroid tumours for example). To say so does not come from a place of envy.

As well as fear mongering, I suspect some of the benefits are sometimes over egged by people who love using them and are very protective of them. The person saying "you can't lose heart muscle because your heart just improves on these drugs" [paraphrasing] for example.

Defending the drugs doesn't do anyone much good except some already very wealthy people who sell the drugs.

This is what happens when people read an op like this one though. You will get the strongest opinions on both sides. Some of those views are poorly thought out, ignorant, bullshit on both sides. The truth is somewhere I the middle.

But it is just about to be approved to treat cardio vascular disease, so correcting inaccuracies is required. The poster who commented on heart health is correct. Of course it doesn’t damage heart muscle, they are about to start prescribing it to treat heart disease.

https://investor.lilly.com/news-releases/news-release-details/lillys-mounjaro-tirzepatide-gipglp-1-dual-agonist-demonstrated

your words “defend” these drugs, is very telling. Defend means something is under attack.

no one is over egging the benefits, no one feels protective over a drug. I understand the benefits seem so good it can cause envy, resentment, and disbelief, but folks are not all lying as some form of conspiracy to get random fat people to use them. The idea is bonkers.

It can do both things - it can protect the heart but rapid weight loss with higher chance of muscle loss...

https://www.drugs.com/medical-answers/ozempic-cause-muscle-loss-how-you-prevent-3578660/

...can also lead to muscle loss in the heart as the heart is a muscle.

The two things can be true, so no, that person was not correct to say "heart muscle loss does not happen on these drugs". It is more nuanced than that.

I used the word "defends" because yes, people do attack them! Some people are morally against them for some odd reason. "Just do it the natural way", usually said by someone who has never really struggled with obesity. I think that is ridiculous

However, my point was, that I also find the heartfelt defense of drug companies by people who probably earn about 1% of what the people who actually benefit from that defense do, topsy turvy and a little silly.

If you really want to get into it, (and lord knows you do based on your posting), your comment that people must be so envious and that's why they go on the attack is also telling. Surely, people on the drugs must envy people who have never needed them too.

I am pretty neutral. I don't need them (lucky me) and I don't think people should be attacked for using them or not using them. But to claim they are magic beans which don't cause any problems and you must be mad and a bit jealous if you don't use them, is as much an insult to the people who use them and work hard to lose weight with them as to the people who are severely overweight and who based PURELY on their appearance, the op has decided must be lacking, knowing nothing about them other than that they are too fat for her, (a 'reformed ' fat person).

I suppose if that is TL:DR^^, what irritates me about all of the many debates on here about weight loss drugs and weight in general, is when people take a look at someone heavier than they are and decides they must be stupid, not know enough about WLIs, too poor (the horror) and just well jell hun (which you inferred) to still be fat.

And in op's case, she was actually that same weight herself not so long ago, which makes it all the more ludicrous. Weight sn't a moral failing and low bmi is not a moral attribute. It may not be "misinformation", envy or anything else which means they don'tuse the drugs. They may have their own reasons for not wanting to or not being able to use them, and it's nobody's business but theirs.

Did you quote the wrong article? The one you linked says nothing about heart muscle it’s the very well known impact of muscle loss due to weight loss.

you understand the difference right?

@TakeTheCuntingQuichePatricia i guess you and I have very different attitudes to money. And that’s ok

Yes, thank you.

Rapid, intentional, weight loss can cause heart muscle wastage. Because sudden weight loss can cause the body to break down muscle tissue, including the heart muscle.

pubmed.ncbi.nlm.nih.gov/31530572/

The article I linked earlier pointed out that there are high levels of muscle wastage in people losing weight with WLIs.

The heart is a muscle. As is your brain, fwiw. The body does not distinguish when it starts burning muscle for food.

To make a general statement to those saying that I am being judgemental. I am not. I am being curious. They are vastly different. People would be so much happier if they weren’t rushing to take offense when there is no offense there to be taken.

i think we are all fully aware of this, cardiac muscle is very different to smooth or skeletal muscle.

i think you’re assuming it’s the same. I’m not sure, but what you’re posting is erroneous. Howver if you can link to something valid that says glp’s damage cardiac muscle I stand to be corrected.

i can link multiple to say it strengthens heart. I can’t see anything to say it damages it as you’re proclaiming. Which makes me think you don’t understand the difference between cardiac muscle and other muscles.

to save me linking multiple studies to prove again. I attach a ai overview of if glp’s damage cardiac muscle. I’ve already linked to it about to be approved for cardio vascular disease and the improvement in heart health and muscle/

I’d disagree, your comment to me about whether my mum knows to eat less definitely at least implied you were being judgemental.

But, now that we’re this far into the thread, have the responses helped answer those “curiosities”?

It may have come across a bit judgemental. But it's not wrong & lots of people seem to not know that you still need to eat less on a GLP1 in order to lose weight. Otherwise they wouldn't be seen as a magic fix and you wouldn't have page after page of people telling you they know someone that injects them and lives exclusively on Maltesers and McDonalds and has lost 12 stone in a week.

Rapid dieting might be the cause of muscle loss, GLP1s don't directly cause it themselves and that's the key difference people leave out, either intentionally or unintentionally. Same with links to pancreatitis/gallstones/hair loss.

If you're big and you rapidly overhaul your diet, whether through the use of WLIs or not, you are at risk of these side effects.

https://www.sciencedirect.com/science/article/pii/S2452302X24002869

https://pmc.ncbi.nlm.nih.gov/articles/PMC6881987/

Why you are demanding evidence as if we are yor students is honestly questionable, but here are a couple which point out the nuance. Nobody said there are no benefits to the heart, we were saying there are also downsides. The point I and someone else was trying to make was that the person who said "you don't lose heart muscle on GLP1s" was not correct.

Anyway, I don't have time to do more research for you, so you can stop hopping around, being passive aggressive and belittling. It is really unpleasant

There are other products available its just WLI are all the hype at the moment. I think it will be a long time before they go down in price if they do at all.

I have enough food but I certainly don’t have enough for weight loss medication as I don’t make enough money for them. That’s one answer to why everyone isn’t taking them.

My food bill wouldn’t alter that much!

Depends what you mean by a long time. They will go down in real terms, as the patents aren't permanent and there are dupes being brought out all the time.

I wouldn't be surprised if it took a few years to filter through here though. The MJ UK patent doesn't expire til I think 2031, and while people starting out now are more likely to try Wegovy, there's still a lot of us who were on it before the price increase and might prioritise continuity over saving money.

Becoming abusive because you don’t like the fact I’m pointing it out is not lending its self to credibility. And did you even read your links

the mice one has not translated to humans, as I showed earlier, it’s the opposite. And the heart failure patients, then I’ve no comment, I’m clearly not talking about heart failure patients taking the meds, nor is anyone else.

🙄

I have not been abusive in the slightest.

You are missing the point that I and others have tried to make, despite it being explained and repeated to you. I think probably it isn't worth our conversation continuing today as this is like talking to an angry brick wall tbh. And the point wasn't even all that critical in the first place but you have made it an absolute hill to die on while implying that everyone who doesn't share your view is just terribly silly and thick.

Why is it always people with cosy names like Firesidechatter? Smh

I'm confused by what you mean. Different attitudes how? People can't magic money out of thin air, so it's not different attitudes, it's literally not having enough money.

Respectfully, you've only proved the point I made about people not understanding "evidence" they believe shows GLP1s are dangerous themselves and therefore trying (either with good intent, or bad) that people should be scared to try them.