Labour should invest in weight loss medications immediately

[HowToSaveTheNHS]

AIBU to think the Labour government should seriously consider rolling out weight loss drugs to the obese population, to tackle obesity, diabetes and cut NHS waiting lists? Traditional public health measures to tackle obesity are not working.

We spend so much money treating disease associated with obesity and it’s only going to get worse as increasing numbers of people are living for decades with multiple health conditions associated with obesity. Even dementia’s leading cause is Type 2 diabetes.

Looking at the Mounjaro thread on here, huge numbers of Mumsnetters are successfully losing weight and improving their health. But people on lower incomes won’t have access because the drugs are expensive.

A course of drugs for a year will surely be money well spent if we can reduce heart disease/ diabetes/ dementia/ cancer etc… even hypertension.

Before reading this thread I knew it didn’t cause weight gain but it did change how and where fat was stored. There’s quite a lot of research into this. I’m over forty so obviously interested in this for my personal health reasons.

Thanks to MN I know it’s not the case.

Im living with this, I think the point the poster was making was that it doesnt appear by magic, you do need to eat in excess of your body needs in order for the gain to take place

As you rightly say, as you age your calorie requirement reduces dramatically - dramatically! - and therefore a person is overeating if they dont reduce their intake to match

Its not by magic, it is unfortuantely eating more than we need

I suggest you try re-reading the thread a little more closely.

Initial weight gain may come from poor diet, medical conditions, medication, lack of exercise etc.

However, weight gain can cause the body’s self regulatory mechanism to malfunction meaning it becomes increasingly difficult to lose the gained weight. Fat is not metabolically inert, it is metabolically active. There is a point where the weight gain becomes self sustaining.

This podcast is really interesting on the damage obesity can cause to the body’s weight regulatory mechanisms.

They also recommended puberty blockers to young children, so.....

Do they? For what condition? Early menarche?

NICE has hundreds of different committees. Was this for guidelines or the ones that evaluate medicines and other interventions?

Where is the moral judgement in suggesting that everyone should take personal responsibility for their health?

I appreciate it's hard to do, as struggle myself.

The NHS is on it's knees. Something has to change...we can't fund everything.

Perhaps we should all have human equivalent to black boxes on us,.like they have in cars?!

My DC had cooking classes at school, as did I. State schools How did those asking for this miss it?

This is a good argument for making upfs more expensive and healthy food cheaper, getting children more active, and other preventive measures. Help the next generation to maintain a healthy weight and those already in the overweight range from gaining more.

The Cass Review said that NICE had not found sufficient evidence to form a policy so what recommendation are you referring to?
https://cass.independent-review.uk/nice-evidence-reviews/

@HowToSaveTheNHS it isn't actually a government decision. Medicines are inherently complicated and have to go through rigorous testing for both safety and efficacy first. Then get assessed in multiple populations. And then assessed for cost effectiveness. Often medication comes with side effects too which mean introducing a whole new layer of complications which required medical support. Therefore we have multiple agencies and clinicians etc involved in decision making on these sorts of drugs which takes time and resources. It is never the political party that makes the final decision. Rightly so. To prevent/reduce patient harm. In countries where pharma companies have much more lobbying power you end up with things like the Oxycontin crisis in the US.

The checks and balances we have in the UK are important.

Policy makers looking at specifically this issue. But again. Not a government decision. Sensible practical advice based on expertise of the many. Not just the few. So it will take time and time to operationalise once decisions are made.

@S0livagant

I agree completely that obesity prevention is much better than obesity management. However, the obesity crisis is already here so a two pronged approach is needed.

It's the same as smoking.
First- stop people ever starting
Second - help smokers quit
Third - treat smoking related illness

You need all three, but the more of 1&2 you can achieve the less of 3 you will have to do.

I know fat tissue is a secreting gland but what do you mean by “self-sustaining”?

@CortieTat
Issues like damage to the hypothalamus and leptin resistance means your body no longer regulates hunger effectively. In an ideal world, if you have sufficient fat stores you should feel particularly hungry. However, if your brain isn’t adequately responding to the feedback signals you still feel hungry although you have a sufficient calorie intake.
Until the GLP-1 receptor agonists like Semaglutide came along the only method for resetting some of the hormone imbalances was bariatric surgery which has its own risks.

The Zoe podcast I linked to above is interesting on this topic.

@HelloMelloo mine went to state schools too they did 5 cooking classes , making a fruit salad, pizza and cakes . Not all schools offer the same , state ir not . Phyisical education is less than it was in schools as well. But again some will do more than others

No
ww need to tackle the food industry, ultra processed food, and learn about importance of fibre, the dangers of sugar and actually eat better !

Indeed. We need serious regulation

@ChazsBrilliantAttitude some don’t want to learn or understand why others may struggle. Its much more easy to just accuse people of being greedy or judge them that it is to actually be nice for some people, especially on mumsnet it seems , brings out the worst in some people who privately say it on here but would not say it to someone in real life. Whilst they are perfect and do everything right. You cannot fox an issue without understanding it in the first place .

How about the drugs are subsidised. So the person makes a financial commitment but the NHS also invests in their healthy outcome. I'd happily pay at least half price for the jabs but the full price is a lot for most people and they're so worthwhile.

I will qualify my previous comments by saying that I am currently overweight.

Certainly not perfect by any means. I do know the struggle to get into the right mindset in order to lose weight and keep to a certain regimen.

I have also previously been anorexic so I do understand how the mechanics of weight gain and weight loss works.

I still say handing out weight loss drugs willy nilly is a bad idea.

Most people do not need these drugs - there is no quick easy fix to weight loss. It simply cannot work without the individual commitng to healthy and consistent eating habits.

The jabs are made out to be a quick fix in the media but they are not for most people and if you're doing it as advised.
It still takes work, change of diet and determination. It just helps with the brain sending the wrong signals or no signal at all. It also helps to stay full longer and it helps with insulin resistance and blood sugar levels. The rest of the work still has to be done by the person. People who literally can't eat and therefor drop weight dead fast, should be on a smaller dose, it's not designed to do that to people.

Do you mean a separate obesity service? Something a bit like dentistry, ophthalmology, podiatry?

Would you look for a commitment from people on capped benefits (not exempt by reason of family members with disability, personal disability etc.) and in-work assistance such as UC?

Regarding the metabolic activity of lipid deposits in the body, does it not depend upon where the lipid is stored?

I'm happy to be educated on this.

Is there at least a requirement for people to lose a certain amount of weight, thereby showing commitment, BEFORE prescribed these drugs?

Because I believe that should be a bare minimum standard.

@SpudleyLass
They are currently only available to people with a BMI over 30 when they start or over 27 if they have a diagnosis of a relevant co-morbidity like hypertension.

They shouldn’t be prescribed “willy nilly” nor is anybody advocating for that.

It could look like that. Take the pressure off GP to assess and prescribe. Also yes I think like dentistry, people of very low wage and certain disabilities could have it free. Why not?