All these weight loss drugs... surely we are heading towards disaster?

[shellswirl]

So as we all know there are various weight loss drugs that have become very popular in recent months.

It seems like the whole of Hollywood is using it.

Even regular people are spending huge amounts of money on it from online pharmacies.

I get that these drugs might be useful for certain people with real medical conditions, but really a lot of people are using it as a quick fix to be thin.

With no consideration to side effects or future health. And without thinking about what happens when you stop it?

Surely the best way to lose weight involves no drugs. No fad diets. But exercising more, moving more, eating a balanced diet. Retraining your brain and finding food and exercise you enjoy.

I say this as an overweight person too! Surely there are other ways.

If every other person is taking these drugs won't there be a huge pool of people to monitor side effects etc?

Aibu to say the whole thing makes me feel very uneasy.

"The way I see it is this… thin people feel, in general, vastly superior to fat people. They think they have more self control, are less greedy, more intelligent and more virtuous. They don’t want fat people to have what they see an an easy fix because a) then they can no longer feel superior to them and b) they think fat people should have to suffer for their previous greediness and lack of self control."

This is a bit of an unfair generalisation. I'm "thin" although I'd rather say slim tbh but whatever (at least you didn't say skinny!) but I don't think I'm better and have better self control than someone "fat". But you know what? Both fat and thin people think that about me because I struggle with alcohol.

But many people taking it are not morbidly obese. They just want to shift ~0.5-1.5 stone. Its being treated like a cure all quick fix, where it should only be given by proper doctors, under their supervision for extreme cases, if it has to be given at all.

That’s why I said ‘in general’. Obviously not everyone feels that way. You only have to read a few fat bashing threads on here though to see that a lot of people do.

First of all, 10 years of data is pretty fucking long-term in the world of pharmaceutical products. But as a class, glp-1s have been on the market for over 20 years, and have been studied for far longer. The oldest and largest data sets will be in diabetes, but given the relatively high overlap in obese and diabetic populations and the similar dosage and treatment duration, it is fair to weigh these into consideration when considering the safety profile. Furthermore the trials in weight loss were huge and very robust in design - the regulatory threshold tends to be higher for obesity than cancer - so about as rigorously tested as you can hope.

It is entirely possible (likely even) that as more people take these medications longer we will learn more about these drugs, both good and bad - data on additional benefits as well as additional side effects (in particular subset populations that might face greater risks). This is true for any medicine - I was reading a recent analysis of data for another medication that I take which has been on the market for ages which suggested changes to prescribing protocols, so the science will always evolve.

Basically, we could still be learning about these drugs (or any drug) in 20, 30, 50 years time. There will never be a point where we know everything, but at some point we have to weigh the potential known and unknown risks against benefits. typically we leave this to regulatory bodies to determine, all of which have determined that there is sufficient data to allow prescribing of these products for obesity. If these products are being used according to their approved label, I don’t see the cause for concern.

None, because I'm losing it the natural way, through proper diet and exercise.

If a healthy diet is eaten consistently, weight will come off.

If people just stop putting cigarettes in their mouths they’ll stop smoking. If being just stop injecting heroin they’ll stop being addicts.

We are happy to help smokers in their use of patches and we’ll prescribe methadone to help heroine addicts. But woe betide the fat person who wants help cutting down the (biologically essential) food they eat. Cravings for nicotine and heroine may eventually subside. Needing to eat will never, ever stop. It is a battle much harder and much longer than either of the other addictions. But society is so peculiarly determined to pretend it is much easier. Which is odd.

Sorry that was a reply to @Itsrainingten

I’m not qualified to say whether obesity is a disease or not. But it can certainly cause lots of diseases. I don’t think though that classifying something as a disease equates to people not taking responsibility for themselves. And blame isn’t helpful either.

Another question for all the doom mongers would you be saying to someone taking this for diabetes that they were headed for disaster in future?

That’s an interesting question, @Riversideandrelax . Many medications can work well together though so it might be possible.

Evidence please. In the UK it requires a prescription and the patient has to be either obese or close to being so but with additional health conditions. Nobody in this country is getting it to lose half a stone. What you said is a lie.

Posters upthread have admitted it.

Good God is that how it works ??

If only all us fat people knew that this entire time. JosiePosey you may just have saved millions of people from obesity.

You're missing one of the (blindingly obvious) benefits of these medications so let me help you out. These types of medications make it easier to maintain a calorie deficit thereby causing fairly rapid weight loss.

You feel fuller for longer due to delayed gastric emptying and cravings are lessened, food noise too, so it's much easier to choose healthy options.

Do you really think the reason you are overweight is simply because you "choose not to follow a healthy diet" ? There will be many complex biological and social reasons that you cannot/ do not follow a healthy diet. Insulin resistance, gut biomes, genetics all play a part. Mounjaro helps alleviate these so that you can choose healthy food.

No, they said it would let them check out, not that they were actually given it.

And are you going to tell me how many times you have tried to lose weight?

What is your evidence of this? I’m sure there are some using off label, but all of the people I know using it meet the criteria outlined in the approved indication. People I know who have tried to get these meds without meeting the criteria have ultimately been denied. I’m sure some slip through and get access anyways, but with a quarter of the uk population obese, there is a lot of legitimate demand.

just because you read a story in a tabloid doesn’t mean it is reflective of broader trends.

Sorry for the delayed reply, I missed it in the sea of responses!

Firstly, I don’t plan to do OMAD forever. Just until I hit my goal weight. Then I’ll go back to two meals and maintain. But I do make sure I get my nutrients. I cook from the Fast 800 cook book which is extremely well-balanced and prioritises protein. I use a collagen protein supplement and I also take Vitamin D, iron and a multivitamin. I am lucky enough to have a nutritionist in the family who reviews my meal plans! Getting enough iron is the hardest one for me as I don’t eat a lot of red meat so I have leafy greens with just about everything, and a lot of Greek yoghurt for calcium and protein.

I'm NOT judging anyone on here for being overweight, I'm just saying how can it be called a ' disease'? I smoked for years and now I vape. I'm addicted to nicotine. Would you also call that a ' disease '?

I'm just pointing out your self satisfied view of other people and their possible risk of issues cancer is weirdly placed, from someone who's 5 stone into the second biggest cause of issues cancers in the UK

Posters upthread have admitted it.

Tbh, I haven’t read the whole thread so I’m going to assume you are telling the truth. In which case, a couple of people on an anonymous Internet forum have claimed they’ve lied to get a prescription medication illegally and you think that means “many” are taking it inappropriately? I honestly don’t think you are foolish enough to believe that. “Evidence” in the real world means something measurable and tangible. Not “someone said it on the internet”.

Substance use disorders are diseases, yes.

Hate to break it to you, but the long term data for sustaining weight loss through diet and exercise is terrible.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

Because even the majority of fat people think the way OP does. They’re a special kind of fat person who could lose the weight by eating less and moving more, they just haven’t done it yet. They’re not like all these other fat slobs who just stuff their faces all day and make bad choices and are lazy and stupid. Etc etc.

I'm addicted to nicotine. Would you also call that a ' disease '?

Addiction is often recognised as a disease. Sometimes a disorder. But, really, it is increasingly clear that those who can use a drug without getting addicted are largely benefitting from lucky genes rather than magical willpower.

Yeah it’s a total balance, it’s a hard one to weigh up (if you’ll excuse the pun!)

Maybe I am just too much of a scaredy cat. I’m also stubborn to a fault and kind of want to do it ‘on my own’ so to speak!

They don't need to be morbidly obese, once someone becomes obese there's less than a 1% chance of that person getting back to a normal weight....presumably that means that there are also some who are overweight and just pre-obese who are also at risk of having only a tiny chance of reversing it depending on what's going on in their body. So there's a wide group of people that probably do need it if they want the weight to come off.

I don't think that people who only have to shift 0.5-1-5 stone should be using it, and I certainly don't think it should be easy for them to access it either, but people are always going to abuse stuff, that shouldn't mean that no one can use it even if they do need it.

@Babadoobiedoo There are plenty on it who barely meet the criteria esp in smart parts of London & home counties.