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.

Exactly this. People who have always had wealth/the time/education to cook and buy healthy have no idea, NONE.

Interesting discussion op. Do you know how certain countries in Europe have lower obesity levels than the UK? Are they prescribing weight loss injections regularly and at population level? If not, what makes them different from the UK?

Or better yet - British public should start taking more responsibility for their own health

The world’s gone mad …..

I think if people know they can get weight loss drugs or surgery on the NHS they will just eat themselves into oblivion.

Does that include mental health? Or just certain conditions?.

Only as part of a total package that includes making highly-processed meta-food more expensive and difficult to access than healthier options, and a restructuring of society to reduce the pressure and stress that we have come to accept as normal so that we all have plenty of time to take regular exercise and the leisure to cook healthy delicious meals because we aren't knackered from work and have a 15 minute window to feed ourselves.

Why is it that it's so difficult to get hold of fresh vegetables at 9pm on a Thursday night but easy to get an unhealthy meal full of fat and salt?

I lost half my body weight during covid when I was on furlough and had time to cook and take daily exercise. I put it all back on once I was working full time again. I am not remotely lazy but my weight, while important, is a lower priority than dozens of other things I am responsible for.

I agree with changing the ''obesogenic'' environment.

Which is why I propose putting that money into mental health services instead - it would serve a wider range of people and deal with the psychology behind rapid weight gain :)

Anything less than that can be treated on an individual level and not be a financial strain on the NHS

Is this about the Diabetes medication that's getting hard to find because it's supposed to keep weight down?

Diabetics should be given 1st priority - vanity and looking for an "easy" weight loss regime comes a long way second.

Besides, as one poster has pointed out, if this medication is stopped or becomes unavailable and is strictly only allowed for diabetics then would those using it for weight control just go straight back to being overweight?

If people want to eat masses of crap, it is right and fair that they are paying more into the NHS in advance.

What's your source for that? A lot of the clinical research with which I'm familiar reports that the majority of people regain and regain to a greater weight.

Interesting overview of rebound after The Biggest Loser.

In May 2016, The New York Times ran a front-page story on the findings from a study out of the US National Institute of Diabetes and Digestive and Kidney Diseases: fourteen reality show contestants had been tracked for half a dozen years after appearing on the program The Biggest Loser. Through dieting and very intensive exercise, each had lost at least 50 pounds during their time on the television series—and a couple had shed more than 200—but the follow-up study found they’d regained about two-thirds of what they’d lost, on average. A handful ended up even heavier than when they first appeared on the television program.

This weight rebound came as no surprise. The tendency of dieters’ bodies to creep back toward prior weights has been among the most reliable and replicable results in the study of weight loss interventions. Research suggests that roughly 80%of people who shed a significant portion of their body fat will not maintain that degree of weight loss for 12 months; and, according to one meta-analysis of intervention studies, dieters regain, on average, more than half of what they lose within two years. Meanwhile, follow-up care that is meant to stave off this backsliding via behavioral or lifestyle interventions appears to be effective only at the margins: across several dozen randomized trials, the benefits of these programs—in terms of minimizing regain—were pretty small at two years, and undetectable thereafter. In short, we’ve known for quite some time that while it’s hard to lose weight, it’s even harder to keep it off.

https://www.scientificamerican.com/article/unexpected-clues-emerge-about-why-diets-fail/

In a meta-analysis of 29 long-term weight loss studies, more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained

Hall KD, Kahan S. Maintenance of Lost Weight and Long-Term Management of Obesity. Med Clin North Am. 2018 Jan;102(1):183-197. doi: 10.1016/j.mcna.2017.08.012. PMID: 29156185; PMCID: PMC5764193.
www.ncbi.nlm.nih.gov/pmc/articles/PMC5764193/

The point he makes is that weight loss drugs don't tackle the underlying issue, which is that a lot of the food that is marketed to us is extremely bad for us and that if people are taking Ozempic or whatever, but still eating junk they aren't actually improving their health long-term

Being fat by itself is linked to a variety of life-limiting conditions, so the weight loss itself is desirable from general health perspective

These medications would work for some but not for all. I agree they should be available to the obese but you also need lifestyle change alongside that and many would require education, mindset change and even counselling all of which is expensive and hard to deliver. It is also unlikely that it will be hard to change the food industry. The new labour government are very much in bed with the corporates (Starmer has apparently accepted freebies to the tune of £43,000 since he has been leader of the labour party, where as Corbyn during his whole time as leader only accepted free entry to Glastonbury and that was only because he was invited to speak there, so he was essentially the same as all the other performers who has free entry also).

I suppose people paying for it privately have the means and have probably thought and planned long and hard prior to paying which means they are having good results if it becomes first line treatment then it might end up given to people who aren't prepared to change how they eat or move and in that case it could do more harm than good. There is also a danger it becomes seen as an easy fix and people just go on and off it without ever getting to grips with their habits. There was also a study in the press this week tentitively linking glp-1r agonist medications to sudden blindness, it isn't known yet if this is a serious concern but it does require further study.

While these medications are a great tool and I am mostly positive about them they are just a tool and probably shouldn't be first line treatment or handed out to everyone.

Also, we know that most people who lose weight without drugs or surgery put it back on.

The problem with taking steps as a society to tackle addiction is that there is a moral component in our thinking which makes it hard to agree how to even talk about the problem. And food is especially hard because unlike alcohol and drugs, you have to consume it in some form to stay alive!

personally I feel that fighting fire with fire, ie fighting the food industry with the pharmaceutical industry, would be an experiment worth trying.

And on balance I’d prefer ‘my taxes’ be spent on interventions that work, not lifestyle advice plus the massive cost to the NHS of obesity-related illness.

People should not be shamed, but encouraged to take responsibility for themselves. There is no reason medication can’t play a part in that.

Finally, I do agree that the food industry ought to be better regulated. I would like to see much clearer food labelling, including total calories per packet in large print and none of this ‘only xx calories per portion’ bullshit. I’d like calories to be mandated on menus etc provided this could be balanced with input from advice on eating disorder experts. There are also some ingredients that should probably be banned.

The NHS is currently paying for me to use the Second Nature app, which encourages you to build healthy habits. I’d much rather that than a quick fix with drugs, unless it can be shown that the drugs create some kind of body reset, which permanently removes some of the cravings.

Encouraging weight loss is a great idea. Giving out drugs which may prove, in time, to be either very beneficial, or otherwise in the longer term, would not be my first line.

It’s not just that the waiting lists are long. In every trust within reach of our home +/- 3 hours drive, the waiting lists for tier 3 are now closed to new referrals.

I would love to at least try these drugs because I am someone who cannot exercise due to dynamic lumbar instability that has made me pretty much housebound for the last year. I can barely stand up to prepare a meal, can walk no more than a few metres, and combining this with redundancy last August and a number of hideous family events has meant that the weight has piled on.

I am one of those who qualifies for a tier 3 referral and would genuinely benefit from it, as the extra weight certainly doesn’t help my spinal problems, but there is no hope of getting on there for the next year.

At the point at which we have good info about long term effects, then I’d say go for it. If the day of long term ozempic usage is less than the cost of treating obesity, then it will be an actual magic money tree, won’t it?

No,

I think instead the investment should be in banning foods containing certain levels of sugar.

Labour should deal with some of the underlying issues which imo contribute to the obesity crisis:

High cost of living
Limited recreational spaces to walk, play etc for adults and children
Wages insufficient
Culture of long hours

If you work 12 hours a day at a job you're stuck in which pays you badly, and then need to commute 1h + to your poor-quality home where the nearest shopping amenity is a corner store, the odds for eating well and being healthy are stacked against you.

And based on the current issues the NHS is suffering financial / staffing / resources what other treatments would you stop providing ?

@StickItInTheFamilyAlbum A big issue with the biggest loser diets and many diets in general and glp-1 agonist medications are no different is that people lose weight too quickly and do not eat enough. They lose fat but also muscle, bone density and other tissue meaning when they reach goal weight and inevitable start to eat more and even exercise less they gain weight because the number of calories they need has reduced. If people lost weight more slowly and ate enough good nutrition as they lost weight they would likely has better long term results. People find fast results motivating though and struggle when the weight comes off too slow.

Exactly.

My daughter has been using it. Her diet (which caused her to gain weight in the first place) has not changed at all. It's probably got worse tbh

She eats considerably less because she has little to no appetite but when she does eat it's pizza/crisps/beige buffet-style food/chocolate etc

So fundamentally, nothing has changed within her, she's just losing weight. She might start eating healthily afterwards but there's nothing to suggest this is likely at the moment

In all honesty I think it would be a complete waste of money - people are just going to pile the weight back on soon after they stop taking it. And why would they make the effort to eat well and exercise when they can get a drug to make them lose weight for free or a very reduced price?

@GrumpyInsomniac It took three years for me to even get a sniff at Tier 3. Hang on in there. Do you claim PIP? Can you use some of that money for a private prescription? Mounjaro would cost around £139-£150 a month.

I think any investment should be directed towards Sure Start, public health promotion and mental health services, not medicating swathes of the population.

How about people stop eating themselves to death and take more exercise?
Ffs ive heard it all now. I don't want taxes spent on this.