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.

It IS known that obesity can increase the chances of a person developing THIRTEEN different types of cancer.

I may be fat (and therefore stupid and lazy) but that kind maths is quite compelling

And to those that say diets don't work.

You are correct on some level.

Would a heroin addict resist heroin if each week they went to a room surrounded by vials of the stuff? Unlikely.

That is how I view the food industry. How did we get to a place where bread has more than 4 or 5 ingredients? And a place where sugar is hidden in everything... even savoury things. When you go to Tesco, the first aisle you go down is beer, cheap junk food, just absolute garbage, buy one get one free! I'll put those organic strawberries back, too much money.

We are taught that a couple of glasses of wine and "just" one takeaway a week is "being good"

It's insanity!

If we changed education and food as a whole then yes healthy eating could be way more successful.

But we won't change, we won t learn... because money. This is going to make certain people very very rich.

@YouAreEffluentKim

I get it... being fat is bad

But there are other options

It's not a) be fat forever or b) take the medicine

You can ALSO reduce your risk of cancer by reducing your calories and exercising.

The black box warning is only in the US and reads:

al: 2017
WARNING: RISK OF THYROID C-CELL TUMORS
See full prescribing information for complete boxed warning.
• In rodents, semaglutide causes thyroid C-cell tumors at clinically
relevant exposures. It is unknown whether WEGOVY causes
thyroid C-cell tumors, including medullary thyroid carcinoma
(MTC), in humans as the human relevance of semaglutide-induced
rodent thyroid C-cell tumors has not been determined (5.1, 13.1).
• WEGOVY is contraindicated in patients with a personal or
family history of MTC or in patients with Multiple Endocrine
Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding
the potential risk of MTC and symptoms of thyroid tumors (4, 5.1).

So out of caution, it is contraindicated for a specific patient subset. A recent study looking at this specifically found no risk: https://www.bmj.com/content/385/bmj-2023-078225

would expect Novo will conduct further research before pursuing removal of the warning.

Soon enough, everyone will know a very overweight person who suddenly drops several stone in weight and keeps it off thanks to these miracle drugs. Mounjaro has minimal side effects for most people and there are even better drugs coming soon. Ozempic is old news.

My PostMan asked if my medication package had ice in it (out of curiosity) and I said yes, it’s to keep the Mounjaro cool, a weight loss drug. He had delivered several of these packages that day - he’d never seen them 2 months ago - and now they make up a large proportion of his packages! He couldn’t believe how popular they are.

I’m telling you - SO MANY people are going to be taking these drugs in 2024/25 and slimming down dramatically. The NHS will be saved!

I can’t help thinking this will really bother women like the OP, who take delight in others being fatter than they are, as it makes them feel better about themselves. If you’re overweight but your BMI is under 30 you won’t be able to access these drugs, so you will be bigger than your “fatty” friend. Ask anyone who has lost significant weight and they will be able to point to someone or comments made indicating this attitude. I don’t actually think like this, but if you do, that’s a scary prospect isn’t it… that you could be the biggest person in your circle now that others have access to drugs you don’t. But hey, just use your willpower to lose weight OP!

I also think it scares the shit out of women who have been able to maintain a slim figure for years and place a lot of self worth on the social value this gives them. Sad but true.

Personally I’m doing this for health reasons. There is a lot of cancer around me and I want to minimise my chances. But I’m also looking fantastic- and my skin is glowing. I believe maintenance will be sorted by the time I get to a BMI of 23. I’m not worried about being on this for life.

It really is a miracle drug. If you have a BMI over 30 and have failed with diets previously, I recommend taking this medication as you really have nothing to lose except lbs and £s!!

We're correct on every level, alas.

The ideas you have about how we could change food and education, we'd be more successful, are guesswork. That's all. You haven't the foggiest if they'd work. They don't ultimately deal with the problem at the heart of this, which is that we evolved in conditions of scarcity and now live in abundance. That abundance is not going to change. All we can do is tinker around the edges.

We should tackle our obesogenic society anyway. Its a disgrace that people are priced out of the most nutritious food, for example, and still would be even if nobody was obese. But there's no reason to assume that'll be enough.

Because early studies showed a rise in a pancreatic tumours IN RATS. Not humans. Rats. Subsequent large scale reviews have found the semaglutide does not increase the risk of cancer in HUMANS. https://www.sciencedirect.com/science/article/abs/pii/S1871402123001303

Wow @Moretti76 aren't you just lovely! You know fuck all about me thanks. I don't take delight... what utter nonsense. stop making this personal about me.... and putting words into my mouth

If you are on it & had a BMI of, say, 30, what’s to stop you thinking I can stay on it until I have a BMI of say 20 & Margot Robbie’s body or Geri Halliwell’s etc? A bit of gym & suddenly in your grasp. Not knocking anyone. If you’ve been called ‘the fat controller’ like the poor woman upthread that’s potentially very empowering.

This is a very good point. People are taking control and using their own hard earned money to tackle an issue, rather than expecting the NHS to sort it out for them. I think this is something to be commended, not derided.

I don’t think anyone is saying it is a binary choice - a small proportion of obese people manage on diet and exercise alone, which is great for them. There is bucket loads of data showing this doesn’t work for most people, though. It would be like refusing to take hypertension meds or t2 diabetes meds because some people manage to control their disease via diet and exercise alone.

It is fine to try diet and exercise first as it might work for you, but when an intervention doesn’t work for 80% of the target population I don’t know how you can say it should be the only intervention available?

I had to laugh at the outrageous suggestion that not approving of a drug /injection for weight loss has become a 'FAR-RIGHT' conspiracy - are you for real?

Is everything to 'blame the far-right' for you that you cannot see how ridiculous that sounds.

I agree it's ridiculous subject for conspiracy and hard right polemic, but yet here we are, with weight loss injections already firmly ensconced on the docket of right wing talking points online.

TBH, if face masks could become the focus of such extreme rhetoric, anything could.

If we see a big shift in the numbers of people who are overweight or obese then obesity will cease to become the norm and fewer of us will feel it's okay to just relax and eat whatever we want.
I think it could be a game changer on multiple fronts.

Again, the way that semaglutide and terzipatide work IS by helping people reduce calories. You cannot lose weight on these medications unless you do. Exercise is pretty useless at helping people lose weight but helpful for weight maintenance. People usually find it easier, more comfortable and less socially stigmatising to exercise when they are not obese.

Saying that diet doesn’t work is not true, however there is an element of addiction and the difficulty with food is that you can’t eliminate it completely as we need it to live.
IMO this justifies using medication. However it should be temporary until the person is ‘weaned off’ the problematic food : high in sugar / fat, alcohol, etc basically the ones that led to obesity. These should not be re-introduced in the diet! So no more crisps, forever. Same as what is advised for alcoholism: don’t have a drink, ever.

Your body still has a natural set point and will resist weight loss after a certain threshold - typically your body starts to really fight you at 20% loss. I’ve personally seen a real slow down in my weight loss as I cross this threshold. I would like to be a bit more securely within the ‘healthy’ range, but it would be seriously hard work (and probably some disordered behaviour) to get to a bmi of 20.

@AnitaLoos yeah but exercise is great for bones, mental health, cardiovascular health etc.

Imagine if people took the tablet and just thought "nah sod the exercise" because they can get thin on the drugs.

I bet a proportion of people would.

Talking of bones are there any studies about bone density and these drugs? I'd imagine if you took it forever and you then only fancied a small amount of food forever it might have an impact on bone density? People down thread chat about only wanting one meal a day and no snacks etc.

@Babadoobiedoo that’s so interesting. So effectively it’s a clever body reset? If I was happier & happiest at 54kg pre kids I am likely to settle back there on the drug?

Not recently, but I have had it checked before and it’s fine. I think my metabolism is just fucked from years of yo-yo dieting. Plus I have PCOS so insulin resistance.

I’m sorry OP I shouldn’t have made it personal to you… you are right.

However I genuinely don’t understand what motivated you to start this thread as these medications are approved and safe for a medical condition (obesity).

It is exactly the same as criticising people for taking statins - which vast swathes of our population take - cholesterol can also be controlled by diet. So what is the difference? I genuinely can’t think of a reason why you are so bothered.

Ask yourself honestly why you care?

Can you really F your metabolism? I thought this debunked (?)

I do not underestimate my calories. I count everything. I weigh everything. I cook everything from scratch. Not everyone has the same metabolism.

For the record, I took Saxenda for two three month periods back in 2022. The rest of the weight loss I have done without it. Believe me, I know what works for my body. I can maintain on around 1300 calories. But for any kind of significant loss, I need to aim for 1000.

Some people are super responders and their weight can go on down (sorry Sharon Osbourne to use your name, but she is the known example). But I do think most people lose more slowly and then plateau well above a BMI of 20. Jeremy Clarkson hasn’t waisted away although he has lost weight.

on what basis do you dispute the MHRA, EMA, and FDA guidelines for use?

Er, when did I ever say I "dispute" anything? I said I was surprised someone would turn to an injection for this sort of loss, which to my mind would be more like 2.5 stone. Perhaps you were considerably more than a 30 BMI, given the 4 stone you mention losing. (Not disputing that either, by the way.)

The drugs only introduce a negative effect if those people were prolific exercisers before the drug and stopped because of your ‘why bother’. I can’t see that happening very often - my women’s only gym is full of ladies of all sizes who exercise for the health benefits, none would stop if they miraculously become thin.

If someone never exercised before and continue not to exercise they are still better off for the weight loss.