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’s not about being thin it’s about not being obese and reducing poor health outcomes in future. It won’t make me a size 8 my skeleton is bigger than an 8. But it might stop me having a heart attack at 50 like my dad

Lots of people die from obesity related conditions though, every single day. Here's just one link to look at, but there are literally thousands of articles about problems caused by obesity:
https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/bodyweight-and-cancer/how-does-obesity-cause-cancer

I think it’s great!!!!!

@Poppysmom22 it's a bit dramatic to call it hate.

I don't hate anyone. Far from it. If my daughter came to me and said "mum my friends are taking this drug to get thinner.I've tried eating healthy and diet but it was very hard work. Celebs are doing it too. And I feel fat at a size 12"

I'd be concerned. I'd want to know what a gp said. How much does it cost? What side effects? Is there any danger to my life (even if slim)? Any hint of evidence of cancer (even in rats)? Are there any other options here.

And that comes from a place of love... not hate

I'm not a fan just because I'm slim and I feel like people who use the injection are skipping over the self discipline needed to be thin. Good for health but it's quite wall-e esque that we're using drugs because we can't stop eating. Ready for every single person who uses it to have some unique disorder that means even when they live on a single slice of bread they keep putting on weight but the injection miraculously changes it.

And that was your experience of ADs and for many other people the small change in outlook brought about by the ADs put them in a position to deal with their problems themselves.

If able, read this transcript. This doctor believes you have to take the drug for ever but no against it.

From it:

”I'm gonna shorten the hundreds of thousands of years, but where I'm going with this, Jonathan, is that we are engineered to maintain our body in times of famine and starvation. So if you go back a hundred thousand years ago when normally you would have times of famine, the body developed adaptive ways to survive when there wasn't enough food around.

So we're very, very good at hibernating, if you will, and surviving without a lot of food. So our bodies adapt. It shuts down. You don't burn as many calories to get through those times when there isn't enough. So fast forward hundreds of thousands of years, and we don't have famine anymore, but our body is biologically engineered that way.

So will, if you go on a diet and you try to lose weight, you could do that. Pretty successfully early on by reducing your calories, as you said earlier, a calorie deficit, so you start losing weight cuz you go into an energy imbalance. However, from a biological point of view, our body thinks that it is famine time or starvation time.

So it goes into this down adaptation to get you through this period. the body is biologically engineered and wired to conspire against you. It does not want to have you lose weight, so it will defend what you weighed before you went on a diet. Interestingly, even though you had excess body fat or excess body weight, the body thinks that's where you ought to be.

So as you lose weight from time zero down, the body fights you, biologically that is, and the. You feel it is, you start getting hungrier as you try to keep your body weight down so food feels and looks more enticing. You're not as content eating the same amount of food you did before, so it drives you to eat more, and it is even more difficult than that.

Your energy expenditure or your resting metabolic rate, the number of calories you burn starts to go down. So you don't need as many calories as you did when you started. And we also now have identified that your muscles become more efficient. So as you're on a treadmill and you know, you're 3.5 for 30 minutes.

You don't burn as many calories cuz your muscles get more efficient in what you're doing. These are all the factors of the mechanisms the body puts into place to try to maintain where you were before and prevent you or make it harder for you to lose more weight. And at some point, individuals start to eat more and changed their diet to what it was and over time, Weight starts to go back up again.

So long-winded answer that. It's very, very difficult to take the weight off and keep the weight off because of the weight. We are biologically wired.”

https://zoe.com/learn/podcast-can-ozempic-semaglutide-solve-weight-loss

I work in a hospital that offers bariatric weight loss surgery (self pay) we have not had any new enquiries for this for coming up to two months.

personally I think that’s great, patients are turning to managing their weight with medication rather than forever alternating their anatomy.

@Poppysmom22 yes YOU are using the drugs to not be obese. And yes YOU might have a medical reason.

But I fear some people will use these drugs to get thin. I'll just start taking it before my holiday to drop a few pound etc.

Sharon osbourne wasn't exactly fat a few years back. Since her large weigh loss she's been slim

A family member who I loved very much died at the age of 57 from health complications related to being extremely obese. If this treatment had existed then they could very well still be alive and in their 70's now.

GLP-1's went through the same clinical trials before going to market as any other prescription drug this isn't a case of a quick fix being rushed out.

Whether you believe obesity is purely lifestyle related or more complex, compare to something like COPD which is often caused by smoking, should people with COPD be denied inhalers since they did it to themselves?
I personally believe that obesity is much more multifaceted than cals in cals out in a lot of cases but even if it was that simple I don't think effective medication should be unavailable to people because of moralising over the causes of their illness.

I don't hear anyone bemoaning the use of DRUGS or saying it's sad or concerning to use the medicine available to give people with (for example) COPD a better quality of life so it seems to me that contempt for fat people and a feeling that they should deal with the consequences of their perceived greed is cloaked as 'concern'.

From a financial POV, treating obesity could also reduce risk factors for other chronic illnesses, potentially saving money long term on treatment for that patient.

The existence of UPF's and the food industry is undoubtedly a factor in the rise of obesity just as smoking is for COPD, I just don't believe denying individuals healthcare that could help them is the answer to a much wider societal issue.
Regulate food industries and improve education on nutrition absolutely yes, but don't restrict access to potentially lifesaving medicines to make the point.

@shellswirl obvs if I were a size 12 I wouldn’t be doing it. You watch your whole family die early (sub65) because they are obese and then come back and tell me you wouldn’t do ANYTHING so you don’t go the same way.
it costs £160 every 4 weeks there are side effects as with any medication (google ibuprofen and you will wonder why you can buy 2pkts at a time) obesity causes cancer and significantly increases the risk factors for female cancers which I am genetically predisposed to. Obesity reduces the chances of positive outcomes for the treatment pathways for these cancers. Yes there are other options have I tried them yes I have do I want to feel hungry every waking moment for for another 30 years. Nope.

GLP-1s (the class of drug that is now being approved for weight loss) have been prescribed for over 20 years in diabetes. As the population of patients using these drugs widens there will likely be new things to learn, but it is hardly an unknown.

all drugs carry side effects (including potentially unknown side effects), but physicians and patients have to weigh that potential against the real risks of obesity.

I took Saxenda privately for a couple of months. I stopped because of constipation. However it taught me lessons in healthy eating and I managed to re train my appetite. I lost over six stone over all, mostly without Saxenda. But it was hard, hard, hard and involved swimming four times a week and writing down everything I ate plus regular weighing. Please don’t judge people who use these medications, it is easy to be smug if you are the type not to put on weight. I know my diet is for life now which means no alcohol, chocolate, takeaways, puddings. But it was worth it. I was a size 22 and now take between 12 to 14. Good luck to all those people out there trying to lose weight, it can be done, but it is a long haul. Took me from November 2022 to now . If I can do it so can you x

It is prescription only medication!

There's a huge difference between "viable solutions" and solutions that actually work for a significant number of people and result in sustainable weight loss.

If you're referring to diet and exercise as viable solutions, they work for some people some of the time, but obesity and eating disorders (like binge eating disorder and compulsive eating) are complex and demand different solutions. It's certainly not as simple as "eat less, move more" for many people, and the same goes for the "calories in vs calories out" line that people like to spout.

There are a lot of factors that feed into obesity that aren't simply food or exercise related, and I assume you're well aware there's what's being called an obesity epidemic in the Western world which indicates the current "viable solutions" are not viable for a lot of people for a whole lot of reasons. If we had less access to UPFs or exercised more as standard instead of having to work so many hours a day, or had less stress and therefore fewer instances of emotional eating to relieve stress etc, I fully predict there would be less obesity.

But the situation is what it is, and if people want to medicate because weight loss via medication can prevent or reverse existing health conditions that they have as a result of being obese, why would you question that as a solution? We treat a lot of conditions with medication, the key difference with obesity is that people want to blame obesity on being a personal failing of obese people and see weight loss meds as "cheating" somehow, or view obese people as "just not trying hard enough" and therefore they must be undeserving of medication.

I think we can agree there's a difference between

A) going to your gp and discovering you are diabetic. Carefully discussing the options and being put on one of these drugs

B) going to boots to ask for help and paying 160 quid a month to get the drug (I note they have this on their weight loss section now "Due to high demand we are temporarily closing our Weight Loss service to new patients. We are still accepting orders for existing patients. Mounjaro: Available in 2.5mg, 5mg, 7.5mg and 10mg strengths in the UK, 2.5mg and 5mg only in Northern Ireland. Wegovy: Available at all strengths."

@shellswirlit’s not that simple it doesn’t work straight away.

@shellswirl mounjaro IS NOT a treatment for diabetes it is specifically designed for weight loss.

@shellswirl you are absolutely bang on about the processed foods read ‘Ultra processed people’ by Chris van tulleken honestly it will blow your mind.

Just like some people have anorexia...some people have the opposite.. it's a serious illness.

The majority of obese people do not have 'the opposite of anorexia'.

Obesity is a disease involving having too much body fat. It should be treated, and while for some the cause is an eating disorder, obesity itself is not the opposite of anorexia.

Type 2 diabetes is often caused by obesity and inactivity. In theory, type 2 diabetics don't need any medication - they could reverse their diabetes with a low-carb diet. It may be better for those struggling to lose weight, to take these injections before becoming diabetic.

After all, many millions of people take cholesterol-lowering tablets because of the proven effects in reducing heart disease. Shouldn't they also be 'forced' to change their diet instead?

The problem is, it's not easy to make these dietary changes in the world that we live in - so if these solutions work, it's far better to prevent disease in the long-term, and reduce future pressure on the NHS down the road.

We don't know the long-term side-effects, sure ... but all medicines have side-effects, common and rare ones. Obesity in itself has negative effects down the line, so it's all about balancing benefits and risks on an individual level.

You say: "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." - everyone would agree with this. But in practice, how many overweight/obese people succeed this way (for good)?

We may be heading into a disaster with these injections, but to believe we're not already in one (with the current levels of obesity in the west) is a little naive.

OP, are you under the impression that boots/other private pharmacies just prescribe it with no screening process at all?

All the private pharmacies have a lengthy questionnaire you need to fill in regarding your medical history beforehand and many will ask you to submit a photo as evidence your BMI is 30+.

All your examples of people in other countries using it to get even thinner are not relevant for the UK.

You Need a prescription to get this drug, you cannot simply walk into boots and buy it. All of the online services require you meet the criteria of the approved label (bmi over 30 with no medical conditions).

As with any drug there will be ways to obtain it illegally (and potentially risk counterfeit product), but all the above board providers require some level of verification and physician oversight.

@queenparrot
'I agree. They are not "well-tested" medications. They have no known safety data for use (especially as weightloss treatments) beyond a couple of years,'

This could apply to literally any newly developed drug, there was a time when penicillin didn't have 10,20,30 year outcome data. By this logic no drug would ever get to market.
GLP-1's aren't actually a brand new drug regardless so there is data relating to them, it's the license specifically for weight loss not diabetes that's changed.

Kaftrio for example is proving revolutionary for cystic fibrosis, should we make those people wait 20 years for long term data or treat them now so they've a chance to be alive in 20 years. But that's different because obesity is seen a moral failing and CF isn't.

Yup, all DRUGS are bad... especially Calpol. Slippery slope kids.