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.

@WishIMite It has an effective life of 1 week (which is why it's taken weekly). Any excess that's pee'd out is ineffectual

People can keeping saying “eat less and move more, it works!” as much as they like, but it won’t make it true. Study after study after study has proven that the only things that reverse obesity in the long term are surgery or medication. Nothing else works.

The first GLP-1R was licensed for medical use in 2005 so we do have that data. It's still prescribed over 1,000,000 pa in the USA.

The only time I roll my eyes with these drugs are when normal/underweight celebs take them to get even thinner. Horrible.
Otherwise I think they play an important role in obesity management.
Diet and exercise for a lot of people isn't effective, the vast vast majority of people will regain weight. So that's not an answer either.

Why is it "better" to fix a problem without help? And if that improves impossible surely the wise person always takes the help?

Exactly. If someone was clinically depressed we wouldn't judge them for taking antidepressants or tell them to go for a walk. Why is this different?

I put 3 stone on during lockdown and when we moved to Copenhagen ( way too much wine, pastries, toasted sandwiches etc) and I want slim before that. I have now got down in 18 months from 16 stone 3,to 13 stone 10 but have eaten very well to do so and walked far more. At 62 it's hard, in the past I could lose a stone in 2 months if I was careful - now I just don't- even if I ate 1200 calories a day. I am tempted to try these for a couple of months whilst keeping up my new eating habits , just to keep me motivated!!

There's an interesting podcast episode about it, Honestly with Bari Weiss and Johann Hari (although this guy is a bit dodgy...)

Risks for health seem pretty limited, and known - some people with type 2 diabetes have been taking them for years.

Overall, if it reduce obesity and its associated health risks such as type 2 diabetes, I think it's very positive.
However, it doesn't make you eat healthier, just less, so there's still some education to do on how to consume food, especially for kids, before it's too late for them. Hopefully, one day we'll have a generation of kids that won't be relying on these medications in the future to maintain a healthy weight in adulthood.

For now, if some people rely on it for the rest of their lives, it seems to me that its still way better than developing debilitating type 2 diabetes and other life limiting conditions.

And it's not just better for obese people - but for society as a whole. Obesity-related health care costs a lot of money, and we should all be concerned and supportive, overweight or not.

We've tried to guilt-trip people into losing weight. It just doesn't work. It only alienates overweight people, which leads to an aggravation of obesity rates globally.
Now at least there's a way out, so as a society, we have some breathing space to think about how to change our relationship with food.

Obesity is hugely expensive for the NHS over a person's lifetime. The cost of these drugs will come down with increased production, patent lapse etc. They're a practical and effective investment in the nations health.

Yes but you still need to give your data and where I get mine from you need a photo too.

I think those drugs are revolutionary in as much as they clearly prove it's all about hormons. It's not that some people ale lazy slobs, it's the biochemistry in their bodies that drives the behaviours. Those drugs help regulate hormons which results in no appetite and the weight loss happens..I broadly support that and think it is amazing option for obese people as it can kick start a lifestyle change a balance hormonal system.
With that said I would be very concerened about long term potential side effects and would consider it as a very last resort.

Thare are other ways..
I have never been obese but have been overweight and lost 3 stone by changing my diet with no extra excersising. I went low carb and introduced intermittent fasting. I also completly cut out ultra processed foods. The fat just melted off..it was increadibly quick. I have not been hungry(except fasting days) as eggs, cheese, avocados, meat, nuts etc. keep you full. To really control the cravings the diet needs to be low carb to minimize insuline spikes.

Also I'm a bit annoyed when I read "it's cheating".

Would we say that to someone who needs anti-arthritis medications? Or insuline for type 1 diabetes? or dopamine for Parkinson?

Sure, obese people weren't born obese, but hey, they are now, so are we just going to deny them treatment options and write them off because we perceive their condition as "self-inflicted"?
Doesn't make sense to me.

I agree. And the majority of people are paying for it themselves.

Just read up on the main brands- mm I'm not sure if at 13 stone 10 I like the sound of the main possible side effects . The average weight loss on these is 2 stone in 16 months- I think I can manage that level of loss just by carrying on as I am without the risk of diarrhoea, vomiting, stomache pain etc- how common are these side effects?? Maybe if I hadn't lost weight purely by diet already and wanted a kick start then it would be more on my radar. If it was a 3 stone loss in 6 months with no or very minimal side effects I might feel more inclined.

I take a weight loss drug. When I started taking it, the effects were instant. Literally my whole approach to food changed the next morning. It's actually opened my eyes to the fact that actually, I'm not just greedy, lazy and weak. I contributed to my weight gain of course, but actually there was also a medical and biological side to it that I simply couldn't overcome myself.

Before, I'd be fantasising about food constantly. If I wasn't completely occupied or physically unable to get my hands on food, I would be eating. If a food popped into my head, I wouldn't stop thinking about it until I ate it. I never actively noticed any cravings when I was pregnant, because I had that level of craving all the time anyway. Having food in front of me, I was unable to say no. Mounjaro stopped that dead. I can walk around the supermarket and not pick up junk. I can take my son for a treat and not have any myself. If I consider having a treat from sheer habit, I can shrug and say it's not worth it.

And on a purely physical side, I don't feel hunger in the same way. Before, I'd be absolutely starving by 10am if I skipped breakfast. Not a bit hungry, painfully starving. I've always eaten dinner around 5pm because again I'd be painfully starving by then. After taking Mounjaro, I start to feel a little bit hungry around what most people would call normal meal times. It's just not even vaguely comparable to how I felt before.

I've spent 20 years of my life struggling with my weight and eating. The fact I can take an injection and start eating considerably less and considerably better shows that there was more going on than just my lack of effort.

It’s good if it reduces the burden on the NHS, but I certainly wouldn’t congratulate anyone who used them on their weight loss.

It’s a last attempt when people cannot lose the weight themselves. There’s nothing else ‘going on’, IMO

I think if they work for people it's a really positive thing. Obesity causes all kinds of illnesses and really impedes peoples quality of life.

I think part of what riles people up though is the insistence that 'moving more and eating less' doesn't work for most people. Especially when it's followed up by now I take mounjaro and I eat less and the weight is falling off me. I think it's OK to admit that you couldn't eat less without the help of the drug but it feels kind if gaslighty when people insist that actually eating less doesn't work unless you take these drugs and then suddenly it does.

Also when people insist that slim people can't possibly understand what it is like to feel hunger or how hard it is to say no to cake or whatever when lots of slim people work incredibly hard to stay that way. Always saying no, making the 'right' food choice when they would rather have a take away, exercising when they would rather slob out. When you do all of that and then get told 'well actually you have no idea how hard it is' it is bound to wind people up.

A society in which we walk into grocery stores and find row after row of junk, heavily modified, designed to increase consumption items - that's a disaster. These drugs certainly have potential for mis-use, harm, perhaps unexpected side effects down the line, but my main feeling is frustration that the underlying issue isn't being tackled. Most of us are putting absolute garbage into our bodies.

@ClonedSquare have you had side effects- ? they sound nasty if you read about it. I don't have any of the mental side of it that you have- I eat at regular times and don't have cravings, never feel mega starving etc - and don't eat junk - just find weight loss really really slow even if I eat like a saint

I disagree. Obesity and obesity related complications costs billions. You don't comment on people needing hypertension medication, cholesterol medication as a slippery slope. Medication which will take the strain off people and the health care system is a good thing, and obesity is not as simple as eat less, exercise more for most people. All medication can be 'abused' by those who don't need it, but this medication should be cheaper and more easily available to those who do, not those who are icy enough to pay

Totally agree. It annoys me that healthy fats, including animal fats are demonised, but these drugs are promoted. You're rarely hungry on a low carb diet because your body digests fat so slowly. It's also mainly unprocessed foods too. Why isn't THIS being promoted instead?

No, I've had no side effects other than mild constipation and the occasional headache because I wasn't drinking enough water. For some reason, people have found you have to hydrate more than usual on this drug. I've heard Wegovy (commonly called Ozempic) can have worse side effects.

Well, it's not just that. As the BBC article shared earlier explains, some people genuinely do have a genetic predisposition to gaining weight. This can manifest itself in storing more and burning less energy than seems feasible, and/ or simply being hungrier than most people. Ravenously, helplessly hungry. The "willpower" argument pisses me off, because I think a lot of people just don't understand what it means to be so hungry most of the time, and how much willpower those with unfortunate genetics are already exerting.

(Of course, these genetics would have been very fortunate when our ancestors were living a hunter gatherer lifestyle during an Ice Age!)

I heard a quote from Chris van Tulleken recently- "I've definitely got a couple of obesity genes- I'm always the one picking at my friends' unfinished meals in the restaurant " and I thought "YES! Me too! He gets it!"

The matrilineal line of my family has always been fat. There are photos of my mum in the 1960s showing her chunky thighs under her mini skirt, surrounded by a gaggle of skinny friends. Of my grandma looking pretty broad in the 1950s (not in the 40s- I guess rationing overcame even the most stubborn genetics). Of my great grandma looking like a tank in her WW1 nurse's uniform.

So, it's not all down to today's obesogenic culture. It's just that the constant marketing of ultra palatable food can be - sometimes literally- fatal to those with an inbuilt predisposition.

Why do you care? You don’t have to take them if you don’t want to?

Yes and it seems that someone can make money out of it !

@PearlKoala I don't think anyone is claiming that thin people don't work hard or understand how hard it can be to say no. But something being difficult or unpleasant isn't the same as it being almost impossible. It's essentially the difference between someone who takes drugs or smokes socially vs those who have an addiction to it.

And if you don't believe that a lot of obese people are essentially addicts, that's kind of the point I'm making. You don't understand it because it isn't how your brain works.