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.

When I first came to live in the UK in the early 1980s (from Canada) I was ASTOUNDED by the fact that there were NO fat people. (so few that it was as good as none). How times have changed.

1. Money - the highest dose costs about £300 a month and even with a reduced food bill, that is still out of reach for many.
2. Side effects - some people can't tolerate the medication.
3. Non-responders. There's a proportion of people for whom the medication doesn't work.
4. Free will - if someone doesn't want to take a medication, no one can force them whatever your thoughts about it. We don't make vaccinations mandatory despite the proven benefit to public health. We still give people the choice.

Of course that would be her choice to make. I am just saying that it is important to treat the underlying cause, for some conditions. That will not be the case for every obese person. There can be lots of factors involved, not just trauma. Most people would have an insight into why they overeat, I assume.

Exactly and now the average size of a women in the uk is fat at a size 16.

There is lots we still don't know about GLPs so shopping about for an online pharmacy seems cavalier. Also - not everything has money and they don't work for everyone.

Maybe they’re happy as they are.

After years of yo-yo dieting my eating is pretty disordered. I’m pretty good at losing weight because I get very obsessive about it. If I were to take GLP-1s at the moment, I run the risk of becoming obsessive about it and not eating enough. For me there is work I need to do mentally before I can take GLP-1s in the hope that when I do take them, I’m not taking them for life (and I’m not an insufferable wanker because I get that there are multiple reasons why people are obese and if it was an easy fix, there wouldn’t be an obesity problem).

Well if this isn't a goady post, I don't know what is!

The simple answer: they don't want to.

Why people may not want to? What do you think some answers may be? Consider why people don't do other things and apply that knowledge. To help you, here are some options:

1. it's too expensive
2. it's too painful
3. side effects are reportedly awful and long-term side effects are unkown
4. fear of needles
5. they are happy with themselves the way they are
6. they have too much on their plate to worry about this at the moment

My dh is obese (25 stone). He also has diabetes. He has been offered the injections on the NHS and we can also afford them privately if necessary, however he refuses to even consider them because of the potential risks and side effects. I think he’s also disillusioned by them because two of his friends pay for WLD but still eat atrocious diets. They both initially lost weight but have now plateaued, are still paying for the drugs but aren’t changing their lifestyle at all and can’t shift anymore weight. My dh has lost 10 stone twice in the 20 years we’ve been together so he knows he can lose the weight if he tries but he needs to learn to manage his stress better once he’s at his desired weight in order to maintain it (he’s an emotional eater unfortunately). So he’s slowly plugging away at his weight and gradually getting it down but it’s a struggle and I do feel the injections would be beneficial for him. But anyway, in answer to your question, OP, some people want to do it purely through diet and exercise, and money isn’t always the issue.

Thanks fireside, you realise the final stage of testing is putting out to the public and waiting for side effects to be reported right?

You also realise many people are taking these medications privately, and in many instances deciding their own schedule and dose?

The only winners with WLI's are the pharmaceutical companies who have got millions hooked on using them, knowing full well that the user will need them for life. Same with antidepressants and pain killers - get people hooked, change the chemistry of their body and boom - lifelong dependency. These companies are run for profit, not end user welfare.

Our food bill used to be £800+ a month for 3 adults. 2 adults now on mj, splitting doses, cost around £120 a month each. Food bill now around £500 a month.

Obviously this wouldn’t work out the same for everyone, but in our case we save money.

If pancreatic problems increase are we going to be looking at a huge surge in transplants for this organ in the future due to long term wlj use?

So maybe they even out

You haven't thought this through have you OP?

I'd say money then side effects. I'm obese but not significantly. I can afford it but justifying that cost is hard. When you take into account the starting prices, which increases as doses increase then you have to taper off (not a hard stop) its a significant amount of money which I can't justify spending when we have other more important things to do with that money.
I'm taking the slower, doing it without them approach.

Money. Contraindications. Controlling partner who likes them fat. Psychological reasons. Sexual abuse where being fat is an attempt to put off the abuser like a friend of mine tried to do. Intelligence to navigate the system and use the medication correctly and understand how it works. Not wanting to be on long term medication. Fear of needles. Fear of judgment. Maybe they like being fat. Take your pick.

Personally I actually would choose therapy if I had a choice between that and WLI. So much of my overeating stem from emotional issues.

What I did in fact is change up my diet to more wholefoods and good quality protein which for me led to a slight increase in my grocery bill. But it didn’t lead to a £200 monthly increase so it was still cheaper than GLP.

I had to do a lot of other free therapeutic practices to work on my emotional eating such as journaling, reaching out to friends more, deep breathing, allowing myself to cry and dancing it out.

I now have access to a counselling service free as part of my private health plan where I can access ad hoc short phone sessions with counsellors.

Yes, it cost a lot of money and I know I am lucky to be in a position to have done that

You have answered your own question, in your own post. It’s money, and not everyone is in a ‘lucky position’ like yourself to be able to afford it.

@tamade but I didn’t say that at all. I did very clearly say that I am on them myself. Which clearly infers I also have issues with self control.

I also outlined in my OP that I suspected it was financial. I hadn’t, of course, really considered the side effects in-depth. And that is because I am lucky too. I don’t suffer those. Although maybe my hair is falling out…

@Donteatmychips your attitude really worries me about these medications

otherwise, I don't care what people do
I don't want my doctor badgering me about it

I don't know how overweight you'd consider me to be

I'm not taking them. We have a serious problem with everyone living far too long in my family. I've got to die of something. I'm not removing enjoyable food and my only means of dying of a sudden heart attack. That would be ridiculous. I don't want to be the wobbly 90-year-old with nothing to do and nothing to say. There's been plenty of them in my family and it's horrible.

Let me die in peace before I get crazy old

I'm quite happy to die from cheese and chocolate.
That's what pisses me off about injections. Once the NHS get a hold of them, it'll be a nightmare.

I haven't seen an NHS doctor for about four years now

I don't think I'm a problem for you. I'm not sure. I don't take up two seats at the theatre or on the bus. I have lost a bit of weight so I'm not sure if I'm still in the obese category. In the current landscape, I look quite normal cause so many people are overweight.

I'm not sure who you're looking at and thinking they are horribly big.

I was in A and E for about a billion hours last summer, and got talking to the two women either side of me. Both 50ish, both in with terrible stomach pains (pancreas stuff being investigated and treated), both on WLI. It really put me off the jabs tbh

There’s nothing worse than a smoker who’s quit
A Glaswegian who has left Glasgow
Or, someone on wli, who now sees anyone overweight as a fatty who should also be on wli. Let’s see how you feel when you can no longer afford them and the weight goes straight back.

I mean OxyContin was also brought to market and look what happened there!

Same here, We spend at least £50 a week less now on our food shop. Less take aways, smaller portions, more leftovers.

Its not hard to work out that people can and do save a significant amount on their food bill

What a horrible post OP. You are being incredibly judgemental and nasty. Either that or you are very naive.