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.

Look mate I’m not engaging in some daft argument about rare side effects of the drugs with some random on mumsnet.

I simply dont gove a crap. Take them don’t take them be fat don’t be fat, I don’t know you and I don’t care.

This.
Although I think the National Trust is also expensive, so may not explain why the particular people OP saw aren't using it.

Our NT subscription is £15 a month, you’re looking at least 6x that for WLI.

Also one of those (2.5mg before anyone jumps in 😂) prevented a work colleague from eating more than half a yoghurt for lunch and 1/4 of her dinner. The other is a decent day out.

Why is it always assumed that people who have concerns about the way this medication is being prescribed and marketed are fat?

I'm not fat. Atm I am very satisfied with my body. I wish I could improve my fat-to-muscle ratio, but WLI won't help with that. The poster this reply was to has stated she is not overweight.

Not everyone who has concerns is coming from a place of envy; some simply have concerns about the way the medications are being marketed and the lack of support and supervision users are offered.

Understood. I think this is one of the biggest pluses of the jabs, that they help with regulating quality of eating. I've been able to cut down a lot on junk food myself, though my diet's still by no means perfect.

'Just how fat everyone is'? Please don't exaggerate. It's not everyone. Are you one of the 'we've lost sight of what a healthy weight looks like' brigade, by any chance?

that’s very defensive, as if you re read, you will see I didn’t say you were fat. The fact you jumped and didn’t even read it properly, shows a deep underlying issue you don’t wish to disclose. I get you want to argue with someone about the injections. I’m not thay person.

Thank you. It is totally crazymaking.

Tbh my experience is usually that people who have such loud opinions/concern about these drugs aren’t overweight, which is why it always baffles me so much.

I’d imagine it’s easier to have an opinion about how to lose weight healthily when you’ve always managed to do it, or don’t need to.

Apparently they are just concerned citizens who like to haunt threads on weight loss injections deciding fat people need more support than the jabs.

doesnt matter what us fatties need or want. Nope. They just want to show their concern for us and decide we need help.

I would imagine the motivation was love and care not vanity. Extra money for something unproven a totally different matter...especially when it impacts family budgets and has an 85% drop out rate.

I abandoned this thread when someone asserted there are no deaths linked to GLPs when, despite under reporting there are UK MHRA Reports: Data from the Medicines and Healthcare Products Regulatory Agency (MHRA) showed 82 deaths linked to GLP-1 agonists (such as semaglutide and tirzepatide) as of January 2025. By May 2025, reports had risen to 111. Some reports from early 2026 have mentioned figures as high as 168 in the context of rising use

Imagine how many deaths are hidden by 'ah well they were fat' judgements by the people on junkets from this industry that targets women.

The weight loss industry may target women, but I don’t think it’s a feminist act to remain morbidly obese just to stick it to big pharma.

I don't "haunt" WLI threads. I don't post on any thread where a user is looking for support in managing the symptoms or the weekly check-in threads, honestly, in a wider context, other than wishing VOY et al would stop constantly advertising to me, I spend very little time thinking about WLI.

OP asked why someone who is obese would not take them. I came on to state my reasons for not taking them when I was obese. Will everyone OP saw that day have the same reason as me? No, but obesity after ED recovery is not uncommon, so I'd be willing to bet at least one of the people she saw had that reason.

And, and I mean this in the nicest possible way, you do need support to manage your eating habits. If you didn't, you would have lost weight already. I don't think that support should be a lifetime of medication when there are other ways. There's also the worry of what would happen if you could no longer afford the medication or that the lack of support might lead you too far in the opposite direction. Long-term calorie restriction is a known trigger for disordered eating and ED.

I suspect the reason you aren't offered more support is that the WLI companies want you reliant on them. They don't want to help you resolve the deeper issues you have or find healthier ways to manage "food noise". They want you to keep, unquestioningly, handing them your hard-earned money.

Couple of things -

Firstly, I’ve certainly not said no deaths linked to. Must have missed someone else saying it.

But I would absolutely stand by no deaths proven to be caused by them at the moment. All the studies I’ve read explicitly state that the underlying risks of obesity and rapid weight loss mean that proving the drug itself is responsible is very difficult.

Secondly, it’s not about vanity. Obesity is a killer. It’s a health issue, not a vanity one.

Lastly, whatever you think of it, it’s not unproven is it. It works for the intended purpose in the majority of users.

Imagine how many deaths could have been prevented if people weren’t being fear mongered not to try something that might work for them, by people who by their own admission have no vested interest in the drug.

i have lost weight in the other way you champion. It was not more successful. I didn’t retrain my brain. As soon as I lost the weight and stopped restricting myself, I went immediately back to gorging. But the obsession with food never vanished. This is the alternative to a life of misery for me. It was never going to be WLI or unmediated weight loss. It was going to be obesity or WLIs.

Wow. Just wow. I don’t need support and it is really absolutely none of your business my medical issues and why that’s the case.

and quite frankly coming onto a weight loss injection thread, declaring you love your body, and then telling people they need support is simply embarassing for you. My toes are curling.

what else do you like to do op. Gp onto low income threads are tell people how much money you make? Renters forums and tell them how much your house cost.

or is it just fat people you think need your advice.

@Frequency I find it extremely patronising to be told that I am “unquestioningly, handing [WLI companies] my hard-earned money”, like I am a brainwashed idiot who can’t think for myself. You have no idea the amount of time and thought that goes into people’s decision making processes.

Also @Frequency you know why I keep handing over my money? Becuase it works.

The same as I would if I were prescribed literally any other medication that I needed.

But we all need help and frequency is here to tell us how much help we need. Us thick fatties.

Lost 8 stone and seemingly haven’t shed the fat from my brain. Just cake and nothing else up there 🤷😂

And, and I mean this in the nicest possible way, you do need support to manage your eating habits. If you didn't, you would have lost weight already. I don't think that support should be a lifetime of medication when there are other ways.

Thing is @Frequency, there is no evidence that there are in fact any other ways to make and keep an already obese person a healthy BMI. Obese people who lose weight through diet and exercise, even when they shift enough to hit a healthy BMI which of course they don't always, mostly don't keep it off.

For whatever reason, lots of people are very attracted to the idea that there must be some non-drug alternative that would work, and some of them share this faith with us. But there's no proof, and no getting round that lack of proof either.

This is very important when those people, in their often genuinely well meant ignorance, feel the need to tell us that we shouldn't be doing the thing that actually does work.

I genuinely don’t get that. Surely the things that people do without WLI are exactly the same as you, just without the medication, and forever.

I think most accept that what is needed is a lifestyle change, in most cases, and people who aren’t using WLI are just changing their lifestyle and having to ignore the “food noise” rather than eliminating it. Success depends on how long and effectively you can ignore it for.

I have just asked ChatGPT (because bugger reading a load of studies myself!) and apparently the highest success rate comes from bariatric surgery, then from staying on WLI once at target, then from other methods. By success it meant over 10% loss, maintained for 5+ years.

Not using surgery or WLI is obviously harder. You’re not being prevented or biologically discouraged from eating. But I think the idea that it isn’t possible is wrong.

The cost is probably the most obvious reason plus some people cannot use them such as those with thyroid issues. There are also dangerous side effects such as thyroid and pancreatic cancer. Pancreatitis and gallstones. A medical friend of mine said they are seeing a lot more gallstones in patients on WLI. Most people I know taking them have hit a plateau and they don’t adopt healthier eating habits, they eat the same crap just less of it.

It isn't impossible, no. The number of obese people who get to and remain at a normal BMI long term through diet and exercise is above zero. But the clear majority don't. On a population level, there's no evidence that it works and lots of evidence that it doesn't.

Yet people will insist on recommending it, sometimes in favour of the demonstrably more successful long term WLI usage, whilst showing no indication they know this. Support sounds nice, particularly when not specifically defined, but again there is no proof of it actually doing anything for the majority of people.

I wasn't actually thinking of bariatric surgery at all, as it didn't look like that's what the poster I was replying to meant (apologies if it was and I've misunderstood).