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.

https://www.bbc.co.uk/news/articles/cm24evgyyzpo

Would add this to the thread for reference also.
It is as yet unknown whether its rapid weight loss that are causing gallstones or the WLIs themselves - further research required.

"Ahmed, who is a consultant surgeon and also carries out gastric band surgeries, said: "We don't know whether it's the injections that are causing the gallstones, or is it because the injections are causing rapid weight loss, which then in turn causes the gallstones?
"Clearly this area needs further research to find out if it's causative or not."

I think its very much down to the individual to make their own risk analysis.

For me

Tesco Finest custard 500g £2.95
Vanilla and biscoff cheesecake 2 slices £3.95

Eat one slice and half the custard per day.
Cost for 28 days £96.60.

Cost of mj £90 a month

That’s just the puddings I no longer eat. I also no longer eat crisps, biscuits, chocolate, icecream etc etc.

And yes, I did massively overeat. That’s how I became obese.

Ahmed's not really saying much of anything here.

More people losing weight = more people with the weight loss related side effects that existed prior to the introduction of WLIs isn't much of a ground breaker for me.

Is there evidence out there that shows (some variation of) the following:

1000 people taking WLI vs 1000 not.

Both groups losing weight at the same rate (roughly).

The side effects mentioned present only in the WLI population.

At that point the issue becomes clear.

One slice and half the custard? Actually that’s quite impressive control

That's what I was thinking. If I buy two cakes and a tub of custard, I am eating 2 cakes and a tub of custard, and if anyone tries to take one of my cakes from me, they'd best be able to run fast.

This is why I don't buy cakes and custard. They are much less tempting when they're at the shop than when they're in my fridge.

@MyLuckyHelper
Yes, I'm inclined to agree.
Be interesting to see the number of gallstones cases linked to WeightWatchers or Slimming World etc.

Well exactly 😊 I may have eaten both slices at times. Plus other snacks. My calculation is a huge underestimate of my food savings, just to show how little you need to save per day to match the cost of wli.

nb Everyone is different, I ate nutritious meals when obese just plus too many puddings and snacks etc etc. Other people may not save as much etc etc.

I lost six and a half stone, nearly 7. I lost on average 1.5 lbs a week, no one needs to do rapid weight loss to the extent it fucks their gall bladder, you chose to keep injecting.

there is a personal responsibility required, instead of stating it was wli induced. And gall bladder issues are caused by rapid weight loss or being fat.

so to blithely announce it’s the drugs fault and was induced by them is mind boggling. As at any given time you could have stopped injecting. Any given week.

you chose not to.

Just to check I’m on the right page here..

Fat people need to lose weight.

If they don’t lose weight and/or still appear overweight whilst they’re in the process of losing it, people will be (ahem) “curious.”

If they lose that weight too quickly and get illnesses related to that, that’s their own fault for losing weight.

But also, fat people need to lose weight.

Christ. I think America Ferrera had it bang on, there really is no winning.

Just for the record: obesity is one of the most significant risk factors in developing gallstones. It is the obesity that was the issue in the first place, exacerbated by rapid weightloss. It is not the jabs that cause gallstones it is the obesity followed by rapid weightloss. It has been a well known issue following bariatric weight loss surgery for years.

I feel like I'm not getting through to you, or that you're occupying some very weird position that is incapable either through determination or a level of gobby stupidity which prevents you from absorbing anything I've said without attempting to skew it to suit whatever odd little agenda you have.

I have not, at any point said that it was the drugs "fault", becuase I'm an adult who made a choice and my presenting the facts is as dispassionate as it could possibly be because I have absolutely zero regrets.

I said that my rapid weight loss was WLI induced - because it was.

I have not made a drama about it, I have not offered a judgement or a warning against WLI because of it. I have noted what happened to me, which is not unfair given that I have direct experience of using WLI and having the side effects of gallstones.

I chose to take WLI's, and if i had to repeat my choice to use WLI's even knowing as I do now, that they are linked to gallstones - I would.

I note that you haven't yet managed to tell everyone reading how long my weight loss took, or my dose, or anything else regarding my use of it despite clattering on at me like you know all about it btw.
A startling silence given the rest of the noise you're managing to make.

Your persistence in attempting to coerce either me or others that I believe myself to be a victim of WLI's rather than a willing and active participant is hyperbolic and odd.

Are you alright or is there something wrong with you thats fuelling this?

I know - that’s how I got mine.

But it is also common for larger people to lose weight more rapidly, in the early stages certainly. Which would therefore exacerbate that problem.

I’ve lost half a stone since March 29th, which if WLI would usually equate to 1-1.5lbs per week when used “properly,” is actually quicker. That however is because of my starting weight, it will level off.

I just resent the idea that it’s your own fault for being overweight, but also your own fault for losing it.

Our bodies are already punishing us enough for gaining and then losing weight, or gaining and keeping it. I don’t think forcing strangers into inescapable accountability either way is of any use whatsoever.

Er But how can you tell just from looking at people walking around that they’re not on it?

maybe they’re on it but just started?
maybe they’re on it, lost ten stone but were really heavy to start off with?
maybe they’re fact that they’re now able to walk around a National trust property represents massive progress?

but if they’re not on it I’d guess…
couldn’t afford it
don’t feel they can inject themself
tried it and it didn’t work/there were too many side effects.
have too many health conditions so aren’t allowed it.
take medication that it interacts negatively with.

honestly I find Mumsnet absurd at times that people can’t come up with reasons why a person might do something slightly different from themself!!

@ChunkyMonkey36 Exactly right.
Initial weight loss for people who have more to lose is faster than those who don't because big bodies burn more fuel hauling themselves around and a calorie deficit comes as more of a shock to the system.

I had rapid weight loss on Slimming World when I did it back in the day. That was an 8 stone loss in the same number of months.
No gallstones on that though that I was aware of, although I couldve had them for years and not known about it until symptoms presented on WLI, which comically was a way more gradual loss thanks to a slowed peri metabolism and despite what my expert dietician by the fireside may have to say about it. 😂

@Verv

I would never have know I had mine, I’m completely asymptomatic, they were found during an ultrasound for my liver because I had slightly raised ALT. If I hadn’t had that scan, I still wouldn’t know now.

The main advice for both is to lose weight, work in progress. But losing weight might actually make the gallstones worse, and apart from not actually dieting and losing it, I’m kind of out of options and stuck in a catch 22 situation.

Nice to know that if they do worsen because of weight loss, it’ll be my own fault for losing weight; despite also needing to!

It’s absolutely not all to do with costs. I have been “allowed” to get them on the NHS for years, and I won’t. I’ve done my research, looked at the risks and made an informed decision it’s not for me and I’ve put in hard work to lose weight the natural way.

I’m “obese” due to a dated calculation, and actually over 50% of my weight is muscle mass. So no, some of us don’t go on GLP1s just because someone somewhere has decided we simply can’t afford it.

Yes I think that pretty much sums it up 😂

i think it only applies to women though, men can be fat if they want.

Wow, 50 percent muscle mass is exceptional , you’re elite body builder level and male I assume as thays the only way that can be achieved, I’m utterly shocked ghe nhs want you to go on weight loss injections. Do you have health conditions that’s causing that?

obese people usually have lower muscle mass percentage as they have high body fat percentage but male body builders at the elite end have the opposite. High muscle mass and low body fat. Female elite body builders usually are about 40 percent.

it just goes to show how utterly ridiculous our system is. Did you retire, is that why you’re dropping weight and I assume muscle?

Yes I’ve been told 50% muscle mass is exceptional, however I am by no means an elite body builder nor a man.. I’m not sure if you’re being sarcastic or patronising tbh.

I’ve been diagnosed with a heart condition that I’ve had from birth, which has only recently started causing me problems and now needs surgery to repair so yes, I’ve been told to stop weight lifting, do more cardio and try to lose both fat and muscle mass to be a “healthy” BMI in preparation for surgery.

Honestly being a woman is absolute bullshit.

In what world is it normal to judge someone for being overweight, but also for being stupid enough to lose some of it.

I think we bring most of it on ourselves, moaning about other people’s bodies and judging other women for breathing in and out.

If everyone just minded their own business, didn’t get so invested in other people’s body fat, and cut the snidey crap, I think we’d all be better off.

Couldn’t agree more but it’s the same with everything for women. Can’t do right for doing wrong…

make up - slutty, no make up - slovenly
sahm - lazy, working mum - bad mum
fat - fat, lose weight - shouldn’t have been fat in the first place.

and repeat until death 😭

No I wasn’t being sarcastic. 50 percent muscle mass is extraordinary and seldom seen outwith male elite athletes.

And it’s women on women. It’s not men attacking women. It’s not men attacking men for using them. It’s women attacking women.

Mounjaro perfect for you then, cuts fat and muscle mass the studies will tell you 😜