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.

Thanks @SofieM0. I had assumed private healthcare wouldn't cover anything pre-existing. That's really interesting.

I'm still baffled that they are using BMI as a standard. Why not fat % which is such a better standard to as retain risk.

I am straight in the middle of the healthy BMI. I am however in the overweight scale when considering fat levels for my age. My cholesterol is also high. I am very little boned so 9 stone for me is not good, but BMI wise, I am perfect.

Ridiculous!

I

Dieting is cheaper than both! :)

it is all about mindset

The latest science is showing that this simply isn't true. It's about hormones - hunger and satiety hormones. I would recommend reading Why We Eat Too Much, written by a bariatric surgeon. It's an accessible and fascinating read.

If you've struggled with weight your whole life it's probably worth understanding at least the basics of these drugs. I found this summary helpful (it's a year old so some of the questions about side effects have been clarified by now).

www.science.org/content/blog-post/ozempic-and-other-glp-1-drugs-more-people-realize

I think the nhs generally wastes a massive amount of time in many areas on low quality education.
When my dd was diagnosed with asd I had to go for weeks getting gems like ‘try turning the tv off’ or ‘look at her when you talk to her’ before the next step.
I was a senco, and two teachers and an Ed psych were also on this course. Common sense and a quick conversation could have saved a fair bit of cash, and opened up spaces.
My mum is 9stone and type 2 diabetic. Never been near overweight. She is forced into listening to diet advice that basically involves eating a lot worse than she does. I had gestational diabetes. I had to get weighed and lectured regularly, despite being in a healthy weight range giving birth. They’d look straight through me and talk about weight loss to reach a normal weight.
Oh and accessing physio here when you are pregnant. You automatically have to wait for and attend really basic group classes on basic advice. Even my friend with arthritis of the hip

When I say struggled I don't mean to a massive degree, I'm just unfortunate enough that my Dad's family have the 'fat gene' and I take after them. I have typically been about 2 st overweight IF I haven't exercised 3/4 times per week and watched my calorie intake. I can and do manage to keep my weight under control but it has always required significant effort.

Tbh I'm not interested in taking meds for something that I can work off.

i can see the headlines in a decade or so

Compensation claims for the tens upon tens of thousands of users who now suffer horrific long term consequences due to use between 2022-2026

Agree

What do you think the horrific long term consequences will be, and is that for every type of weight loss injection, or just for a subset of them?

i don’t know! 😆

Nor does anyone
otherwise it would be pulled off the market…. now

but i’d put a lot of money on this being a very sad situation dominating the headlines in a decade or so

Well, I'll come back and let you know in a few years time if I'm suffering horrifically.

All the long term studies on these drugs to date have shown no serious long term issues. Yes, of course they aren't 20 year studies or longer because they are too new, but these drugs seem to encourage some people to expect some kind of medical tragedy in the future as if obese people somehow deserve it. Don't forget it would also affect all those who are prescribed these drugs for more socially acceptable reasons too.

a decade or so i said

We shall see

i hope not because it seems half of mumsnet is on it

I would NEVER wish ill health on anyone. Most if these drugs have been used for diabetics to help with their control. There will be side effects, as insulin or metformin have side effects if taken incorrectly.

My main concern is the lack of research available to make an informed choice.

I work in advising on life insurance/other personal Insurances and the underwriting on this is a bit sketchy currently which suggests to me that medical underwriters are also concerned about long-term use of such a drug.

Ah, so you're not "lazy" like the other fatties, @Toooldtoworry. Got it.

I wasn't remotely suggesting you consider taking it, but it is worth informing yourself of the basics before giving your tuppence-worth.

If you're familiar with the medical underwriting of these drugs, how on earth can you still think this?

huh

i have reread that posts three times and i can’t see where on earth you’re getting that impression from

No one is suggesting that these drugs should be used incorrectly. Of course nearly all drugs have adverse effects if you overdose or use incorrectly. Over the counter medicines can kill you if not used correctly.

Prescribed for people with the appropriate clinical criteria, these drugs are not dangerous or especially likely to result in a medical scandal.

anti nausea drugs positively encouraged during pregnancy? i doubt anyone saw a medical scandal on the horizon

who knows

but my belief is… trouble is on the horizon

Another thalidomide reference? Really? That was from an era when new drugs were not properly tested at all. Not even slightly. It was being given out for all kinds of complaints, with no controls over who or how much. Nothing like that could happen today.

Ozempic is a fully approved and licensed medicine in the UK. However, it's only been approved as a treatment for type 2 diabetes and isn't currently licensed as a weight-loss treatment.

I know it is being used for other purposes, but it is ONLY licensed for T2 Diabetes in the UK.

I literally joined a thread about weight loss WITHOUT injectables and you are hijacking it.

@Toooldtoworry This thread is about injectables and whether they should be prescribed by the NHS. It's not about losing weight without using injectables.

@Ponoka7 I've found doctor perscribed slimming tablets to work as the injection is supposed to.

what pills are those? I’d love something to help me

Then I apologise because I clicked on the wrong thread, and I'll leave you to your day.

ok

my bad

doesn’t change my view that this has future shit show stamped all over it