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.

As I have said, I am quite neutral about it. I don't think anyone should be berated or criticised for taking them or for not taking them. I am fortunate enough not to need them, so I have no skin in this game.

This whole "debate" with firesideberater came about because I said that the quote from another poster saying "you do not lose heart muscle on GLP1s. It only does good things for your heart, by melting away fat from your heart" [paraphrasing] was not strictly correct. And I am right. That isn't strictly correct.

It was a small part of a broader post where I was again being quite neutral saying that posts like op's bring out the more extreme views in people on both sides and then you get one poster saying GLP1s are delicious unicorn piss and they make you live literally forever (HYPERBOLE KLAXON) while other people say things like GLP1s are the devil's milk and will give everyone immediate pacreatitis and death.

The truth is somewhere in the middle. People can take it or not. But saying it is pure amazing and there are zero issues is as incorrect as saying they are always extremely dangerous and never even work.

I don't think anyone is saying people should be scared to try them. It's more than people should be aware that there are side effects, and those side effects mean they are not suitable for everyone. It's a balance; if your weight means you are in danger of developing serious health conditions and you have no contraindications, the drugs will probably be less damaging than obesity.

If you're only just tipping into the overweight category, then the drugs are not for you, and the health implications outweigh any benefit.

If you do have a higher BMI but are not yet experiencing health issues because of it, it probably is worth considering non-medicated methods first.

As someone who has struggled with ED on and off since my early teens, my first thought when I heard of them was how can I get them? Where can I get them? How many banks do I need to rob to afford them, and how many days can a human being live off nothing but a cup of bone broth a day before they die?

It was at that point I realised they are not safe for people like me, even if they do start at a higher BMI, because we will go too far.

@OldHattie you accused firesidechatter of "hoping around being passive aggressive, belittling, terribly silly and thick". I would describe name calling as abusive. You were very politely asked to provide evidence for your claim that GLP-1s led to heart damage, which is a pretty bold claim. I don't think it is in any way unreasonable to request that you evidence that claim.

Yes, this^^

I think for many people, even if they can afford the jabs, the potential side effects are off-putting until you are in a position where your health is bad enough that it is worth the risk. Even then, deciding for other people that they must use them is problematic and you do see that on SM sometimes.

Nobody should be coerced either way, but since this thread started with an op which felt very off towards fat people, comments in defense of people not wishing to use them will naturally be more robust.

I never claimed anything of the sort? I (correctly) stated that another poster's comment was not accurate and fireside did indeed start hopping around demanding evidence as if I was submitting a thesis and also making passive aggressive digs at anyone who disagreed with her. I stand by what I said.

You need to stop with the abuse. Up thread you called me fire side berator and have hurled numerous abusive insults at me.

i didn’t hop about or demand anything, i refuted your claim, accurately and politely and I provided evidence to back up what I was saying.

you then became abusive, and posted so called evidence that didn’t remotely confirm what you said.

so please stop now.

I missed this earlier and I absolutely agree with it. The reason that, (for me, not everyone), WLI use may be off putting, even if I felt I needed them, would be muscle wastage due to the rapid weight loss achieved by WLIs. I think I even said that...

I don't know if WLIs have some sort of magic ingredient which means muscle wastage is entirely different when using them, but if there are some medical papers you can provide which show that? (Not really. That was a wee joke)

If you do have a higher BMI but are not yet experiencing health issues because of it, it probably is worth considering non-medicated methods first.

What do you mean by higher BMI? I'm not sure here if you're talking about people taking it below prescription criteria or not.

Feel free to report anything you feel is abusive or a personal attack. I don't mind at all

Then you use a lower dose and don't chase rapid weight loss? Personal responsibility again isn't it. And the posters posting endless claims of serious medical complications never make that distinction (appreciate you have now). It's very much the tone of "I wouldn't take WLIs, they make you go blind, or they give you pancreatitis"

There aren't threads as far as I can see about people like me who lost 7 stone in less than a year without the use of WLIs, worrying about their hair loss, risk of pancreatitis etc? My calorie intake and overall rate of weight loss has been broadly the same.

Just in case this one gets deleted upthread!

As I have said, I am quite neutral about it. I don't think anyone should be berated or criticised for taking them or for not taking them. I am fortunate enough not to need them, so I have no skin in this game.

This whole "debate" with fireside came about because I said that the quote from another poster saying "you do not lose heart muscle on GLP1s. It only does good things for your heart, by melting away fat from your heart" [paraphrasing] was not strictly correct. And I am right. That isn't strictly correct.

It was a small part of a broader post where I was again being quite neutral saying that posts like op's bring out the more extreme views in people on both sides and then you get one poster saying GLP1s are delicious unicorn piss and they make you live literally forever (HYPERBOLE KLAXON) while other people say things like GLP1s are the devil's milk and will give everyone immediate pacreatitis and death.

The truth is somewhere in the middle. People can take it or not. But saying it is pure amazing and there are zero issues is as incorrect as saying they are always extremely dangerous and never even work.

Any higher BMI.

At my heaviest, my BMI was 43. I did not have any health conditions at that time. I would have developed them, and I was not healthy; my bloods might have been perfect, my heart might have been healthy, but overall, I was ill.

WLI, as I said, would be far more dangerous to me than living as I was. Even dieting without WLI is usually damaging to me and is something that should be done very carefully and under strict medical supervision.

No, I did from the beginning, not just "now".

I agree - WLIs aren't magic beans which fix everything. There is still work and personal responsibility needed. Equally they aren't the work of Satan.

Side effects are only 10% for the common ones. I said that in my first post on this thread in response to fireside.

But being concerned about those side effects, even if they are very rare, doesn't make anyone less educated than someone who is not concerned and happily uses WLIs and is happy to do so for life if needed.

It is the lack of respect for other people's intelligence which is irritating as fuck. From the original post onwards (from some posters).

Higher than what? 27, 30, 35. Sorry if you've said earlier and I'm missing it. I want to know because you spoke generally rather than just about yourself. Obviously I completely get why anyone with an ED history would need to avoid them.

Oh your last line could not sum up more perfectly how I feel. I think we're probably mostly fairly aligned.

Having concern for the side effects, whether common or rare is absolutely normal (I had them myself), as long as they're based on actual side effects, not cobbled together fearmongering.

I've spent £1500 in less than a year on jabs. It’s been a struggle financially but I’m now 9.6 stone (was nearly 14). Best money I’ve ever spent, I would have spent that on a holiday normally.

Any BMI.

Anyone with a high BMI, should consider non-medical methods before going down the route of WLI. There are side effects, it is expensive, and for the most part, it needs to be taken for life because you don't learn the strategies for managing food noise, etc. without them.

And currently, most WLI providers do not give enough support, supervision, or nutritional advice. If that changed, my opinion on them would probably also change because I can see that when used responsibly, they can be life-changing.

If you already have health issues, or your GP identifies you as being at a higher risk of certain conditions than other people living with obesity due to family history, then yes, WLI probably are the best route. Otherwise, I do think it is healthier to try without them.

Still not really understanding this, sorry. It makes a big difference whether you're offering this advice to people at BMI 26, 30, 35.

And the reason for this is that there's no evidence that people with any level of obese BMI are more likely to lose weight and keep it off than they are to regain it, when using traditional methods. Which is a concern because even obese people who haven't yet developed any health issues are at a higher risk of them than they would be if lighter. But the evidence shows there's only one way more likely than not to get them and keep them there.

It's a moot point at the moment anyway, because WLI availability is so new that nobody with a 30+ BMI hasn't ever tried dieting. But it might not be in the future, which is why I'm interested in the specifics.

Havent RTFT but Is the next trend going to be ex fatties berating current fatties for not spaffing £300 a month to become just like them (tm) ?
Cos thats going to be fun.

I lost 6 stone on mounjaro and then ended up in hospital with acute cholecystitis thanks to gallstones that had formed due to (WLI induced) rapid weight loss. Now on waiting list for gallbladder removal.

Im still overweight, but thankful for the push i paid for to get out of the obesity danger zone, and would probably do it again even though ive trashed my gallbladder for it.
The rest of the loss im doing by calorie counting and low fat (trashed gallbladder necessity)

I fully understand why people would swerve WLI's due to these side effects which appear to be on the rise. And MJ is expensive when you self fund.

This thread, OP, is shit.
You've clearly been obsese. You know how it feels for women. You probably also know the shame judgement self loathing and and hopelessness.
You and i injected our way out of it. Many women cannot.
What are you doing judging them, making them defend themselves over it, and contributing further to the misery of obesity.

"Im just asking, im just curious" head tilt breezy breezy.
Give it a rest. You're the ex fat girl joining ranks with the same kind of bitches that made your life hell.

Because @TakeTheCuntingQuichePatricia , if there was something of major importance to me, I would find the money. In fact, this is what I have done, at great personal cost, to make sure I could provide adequately and remain above the breadline. Two personal triggers for DCs early in their lives (one medical and one educational) made me certain money would never be the barrier to access to anything again.

to be clear, I am not saying that I am right and you are wrong. I am saying we are different.

Excellent post. As a current and hopefully long term MJ user I hereby pledge not to be this stupid.

That's a very odd thing to say. So people with vulnerable children for example who need extra support ...who can't magic up money...it must mean those children aren't important to them?
You do know the prejudice you display is the reason why larger people are less likely to be employed or promoted and are more disadvantaged by stigma?

@Verv maybe RTFT

What? If you are on a GLP-1 yourself you will be fully aware of what they cost. Do you seriously think bigger people are spending that amount on extra food?

Is it not more fatties berating ex fatties for taking rhe jabs and telling them how much they are risking, how old they will look and how they will have lumpy boobs, shit themselves and end up in dire consequences ?

and why on earth did you do rapid weight loss. Surely you knew the risk so should have dialled back the meds if on too high a dose or stopped them? I think every prescriber explains what to eat and to lose 1-2lbs a week?