Why are the NHS making access to 'fat jabs' almost impossible.

[thefishingboatbobbingsea]

I cannot get my head around why the GPs are not being encouraged to prescribe the new weight-loss injections such as Mounjaro (MJ) . Instead, this NICE approved medication is only available via the NHS Tier 3 pathway for weight-loss .

I went down this road 4 years ago It is mostly a complete waste of time and smacks of making the 'fat people jump through hoops ' as a punishment for getting in that state to begin with.

Tier 3 for me , consisted of waiting 8 months for the referral appointment, driving an 86 mile round trip to the only hospital in the area with an obesity clinic. (Lucky I drive otherwise it's over 6 hours on the train).
Then being weighed. Then sitting in a 'workshop' where we are given amazing revelations such as (promise this is true) a pork pie has more calories in it than an omelette, that processed sugar laden food is worse for you than salad. That protein keeps you feeling fuller than a doughnut...(I can only assume that the NHS believe that old stereotype of Fat=Stupid. )

You have to do that every 6 weeks for about 9 months before you are eligible to go forward for your conversion with the surgical team to discuss the option of gastric sleeve, or gastric bypass. (Tier 4) then wait a further 6 months for the surgery.

I jumped through these hoops and had my surgery. I had gone from 19st to 21st while waiting to go /being on Tier 3/4.. so a complete waste of NHS time, my time and everyone's effort. Not to mention the massive cost of all the salaries of receptionist, nurses, dieticians involved.

I lost 7 stone. Which was obviously great . The difference in my health was astounding. Before surgery I was on medication for high blood pressure. A statin, metformin (type 2 diabetes) cortisone injections for painful knees. Thyroxine and associated clinics and monitoring.

Post surgery I am no longer diabetic. Have no knee problems. BP no longer high and the only medication I still take is Thyroxine. I was still 3stone 4lbs overweight. I go to the gym 5 days a week, I eat healthily, but I was only maintaining not losing. Probably due to being post menopausal.

However I am acutely aware of the health issues associated with obesity. (I was still obese with a BMI of 31 from 44 at my heaviest) and decided to investigate the new range of weight loss jabs. I settled on Mounjaro and am 19lbs down in 9 weeks. It's such an amazing tool for weight loss.

So my question is this. Given that obesity is the greatest single cost to the NHS why on earth are they not making MJ or Ozempic available from a GP. ? rather than the long winded and entirely pointless 'tier3 tier 4' nonsense. ?

Why is it that the wealthy are able to lose weight successfully without 'workshops' telling them that Pork pies are more unhealthy than omelettes. ? Or is it just an extension of that fat = stupid stereotype.. to poor=fat=stupid ?

AIBU fat loss jabs should not be available via the GP.

YANBU fat loss jabs work. The NHS will save a lot of money with fewer people suffering obesity related diseases. The benefit will far outweigh the cost.

Presumably it’s to ensure that lifestyle change and dietary choices are also going to happen. Injections arent a long term solution and if the underlying reasons for obesity aren’t addressed, the weight will just creep back on once the injections stop.

"If you are obese OP I don't understand why you can't.............."

You are right you don't understand and no one shouldn't give out ignorant and frankly offensive opinions on anything they don't understand.

It is impossible to explain unless you have lived it. Do you understand the difference between a drunk and an alcoholic? A dieter and someone who is anorexic? Someone who likes a flutter on the football and a gambling addict?

I watched my alcoholic FIL drink himself to death, he was a lovely, intelligent, previously successful man with an addiction he couldn't overcome. I would never even imply to any of those vulnerable people suffering from any of these conditions drink less/eat more/take up knitting! Something triggers these conditions, it could be environmental or genetic and it is something we should all have open minds about. An example, my niece has recently found out she has a serious condition that has been partially caused by damage in a certain part of her brain, visible on a MRI which they have recently discovered is related to past traumatic experiences. We will learn more about obesity as science progresses.

Simplifying a complex issue like obesity to "eat less" showcases the ignorance, and unwillingness to stray from society's traditional disgust of obese people and putting them in a lazy, fat, ignorant box when you know nothing about them. You don't need to feel disgusted about me, I feel disgusted enough about myself and the state I am in already.

For the first time there is a readily available medication (for those that can afford it anyway!) that works and I can tell you the ignorance from some people on this thread thinking this drug, that has some unpleasant side effects for many, is hurting others, who are just trying to make their lives better, reading it tonight.

The NHS will do an analysis on whether the drug is safe, and if it cost effect for the NHS to provide and there will likely be strict criteria who have access it.

But you aren’t going to die imminently and potentially not at all. Those struggling with Anorexia will do. There are next to no resources. Some Anorexia patients are now just being transferred to palliative care and are expected to take responsibility for that. Those struggling with obesity need to take responsibility too. We as a country don’t have the resources to just shell out ££££ for whoever asks for the injections.

But if the underlying reason is medication you have to take it's better to gain the health benefits of losing weight even if it will creep back.

Not in the same way.

If an 18yo gets cancer, has the cancer drug and is cured, but they know that the treatment will mean they likely can't have kids, they'll hit 40 and still be thinking thank God that cancer drug existed because I wouldn't be here now.

If the same 18yo was obese through overeating, took the weight loss drugs, hits 40 and has been ttc for years and we've found out 20 years down the line that the drug permanently affects fertility - will they think thank God I've been taking this drug for the past 20 years, or will they wish they hadn't and gone down the more traditional diet and exercise and education route and have been able to have a family?

But you aren’t going to die imminently and potentially not at all.

Did you seriously just says that!

You have no idea how seriously my obesity impacts my life and health. You have no idea what led me to the place I am in today.

According to this doctor, who has done research in it, a study he did showed many regain the weight within a couple of years. He thinks it’s a lifelong medication and supports it.

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

Obesity is a disease.

Nadjaofantipaxtos sorry that wasn't t intention. I genuinely don't know

Pressed send! I don't know much about the drug hence asking

And? That doesn’t mean it isn’t caused by factors within a persons control.

Because it would be too damn easy for people who think they are entitled to them.
Pretty degrading stuff going on, apparently, when used.
And dangerous.

When did being wilfully dense become so prevalent?

This nonsense is the only thing I keep being offered! My GP has just referred to a separate service - 3 options:

1. 3 months of slimming world/weight watchers - not my thing at all - not the kind of food I eat and 3 months won't touch the sides of the weight I need to lose
2. Half price gym membership - I already go to the gym
3. Phone calls for 12 weeks for 'motivation'!

Probably be the same as the health coach programme I've done twice talking about all those things. Bur I already know what calories are and recommended portion sizes. Other things are not relevant to me. The one thing that never gets mentioned is when you are gaining weight due to medication! Do you cover that? Do you have strategies for that? The rest of it I just find patronising. I already go to the gym 4 times a week but to be honest you won't lose weight with exercise alone.

He did try and refer me to an NHS programme but the referral was declined as my BP wasn't high enough. Even though it is very high compared to my baseline. He has suggested the injections once he can refer again. But I need to do this course first. And probably more afterwards. I don't mind doing anything if it will help. The only way I can lose is on 800kcals but it's hard. So motivational support is great but if only 12 weeks are offered it won't make a dent in the weight I need to lose!

They are expensive, in short supply, don't necessarily treat the root cause of the obesity in the first place, are more open to abuse and the long term effects are unknown.

And what? I was responding to a poster who claimed it wasn't.

I have no control over the medication I need to take.

What do you mean by 'pretty degrading stuff.'

Well, not everyone can afford it can they?

Underthecedartree

• 3 months of slimming world/weight watchers - not my thing at all - not the kind of food I eat

But the food you are eating is causing you to be overweight. So regardless of injections you will still need to change the food you eat

Apparently vomiting, uncontrollable diarrhea, nausea, impossible to eat - that's what I heard from people using/buying these jabs.
After the weight loss, most people look ill.
I would be 💩 scared to use this stuff if needed.

But if you’re going to be eating less you’ll be saving money from that.

I eat the same as I did when I was slim. My medication doesn't make me over eat. I just find it difficult to only eat 800kcals as it's the only way to lose weight.

I ate a dietician planned diet for a year and gained weight! I hate it!

I am in a FB group for Mounjaro users. Can honestly say I haven’t seen what you describe?

"These drugs" are not dangerous. Mounjaro and Wegovy are available in the UK legally for private prescription. They are approved for weight loss and have been studied and there is clinical research articles available for those who want to read them.

What is dangerous is private prescribers not doing enough due diligence to ensure that people are actually suitable for these medications. If you're not having an in person consultation then you need solid evidence of current weight to make sure you're not prescribing to people who are not obese or with associated health issues.

If the NHS began prescribing these medications it would be for those with a BMI over 30 with comorbidities, not for people who are a little overweight and want it for a lifestyle choice.

I can't see it being enough to compensate. How much less does it make you eat, I wonder?

When I am doing 800kcals a day I can't say I saw a lot of difference in my food shop. Still got to feed everyone else, after all.