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.

The NHS is top notch in an emergency, but it has shaky foundations.

Someone needs the courage to lay out the initial cost, it will benefit everyone.

However the Tory's have run the NHS into the ground...

I do believe a more preventative approach to health, rather than only treating the illness would make the UK a much healthier place. Which includes helping to prevent obesity....

YANBU

Thing is, you are saying you knew everything they told you in the classes. So if you knew it all, surely you could have lost at least some weight on your own in the 17 months?

People dont need these pens to lose weight (or surgery etc) they want them as a quick/easy fix. But it comes at a cost. And the NHS is underfunded and stretched as it is.

I also think but i could be wrong, that some of the injections have caused a shortage for diabetics?

Is this just for the people using them for weight loss or for the diabetics using them control their blood sugar?

Never seen anyone debating drugs for any other condition but when it's weight loss everyone likes to come out with gems like these!

What makes these types of drugs any different to any of the other drugs on the market that would have gone through the same research / trials before being given to patients?

Why can't doctors just tell people to exercise more and eat less instead of prescribing expensive fat jabs that don't solve the root cause of obesity?

Perhaps check your facts (and which thread you’re on) before throwing caps around.

Tirzepatide was licensed for obesity in November 2023. If you’re not aware of that then there’s not much point in trying to discuss the pros and cons.

They've been doing that for decades, Oona. How would you say it's been working out?

Weight loss jabs are like putting a plaster on a broken leg. For most, losing weight is too much like hard work - and you get stuck in a cycle of your body craving high sugar high salt and high fat foods. If people can't address this and why they are overeating in the first place, there's little hope of long term change.

These drugs are meant for diabetics and in 10/15 years there will be an epidemic of pancreatic cancer/kidney damage and honestly, I'm not going to have much sympathy. I'm sick of reading threads on here about how wonderful it is and people using them without medical supervision.

What do "fatties" who want these injections rather than sticking to a healthy diet think about the treatment of "druggies" with NHS funded treatments like free methadone prescriptions?

Come on, it can't be that hard to process.

That doesn't work. It hasn't been working for decades. Obesity is growing and growing. Contrary to what some people think, most obese people aren't thick and know full well that eating less and moving more will produce weight loss. Yet that knowledge doesn't result in a reduction in obesity. Presumably you think that's because we're all lazy feckless weak willed fools.

The jabs help you sustain for much longer so you can break out of that addiction cycle coupled with the fact you can’t eat those foods. I’ve never broken the sugar addiction before. That’s been the biggest & most transformational win.

I support that - it helps people to combat the addiction. Drugs alcohol sugar gambling - I support all medication and therapy to help people.

I have Diabetes, (auto immune) and was prescribed Ozempic by my GP. I'm overweight but not massively so. It was ghastly for me, I felt like I had the worst morning sickness 24 hours a day. Unable to eat almost anything, and my diabetic control was unstable. Low carb is a better way, but it’s expensive. Maybe making fresh foods and protein cheaper should help more.

I have been on mounjaro for 2 months. I’m getting it via the GP due to my T2 diabetes. I have had a normal blood sugar for the first time in years! I’ve lost 7.5kg. I get that people think fat people should eat less and move more and the weight will come off, but if it was actually that easy, no one would be obese right? These GLP1 medications change how you think about food, it turns off the food noise - I genuinely don’t think about food most of the day. I imagine that after a time on this my relationship with food would have changed and my stomach would have shrunk. I feel like I can just live my life without compulsively overeating. I can go out for dinner but just have a main. I only eat one serving at dinner. I don’t want a Mars bar before bed. I feel normal.

Those who can’t afford it and can’t get it on the NHS are being terribly disadvantaged. I reckon I’ve saved at least £150 per month in takeaways and lunch at work though, so maybe it would pay for itself.

A pork pie has calories in it? No shit, I thought they were the super healthy option, can't believe a salad would be a healthier. Mind blown 🤯😉

Why should the NHS have to pay for those who choose to over indulge? Lose weight the practical way.. healthy eating and exercise.

The NHS wants a large proportion of patients to remain fat so that they can't be referred for surgeries hence the waiting lists look better.
My experience of the NHS regarding help for weight loss has been zero so I've helped myself by cutting out carbs and lost 9 kilos. Sod them.

Apologies if I'm repeating, I haven't looked at all 18 pages of posts!

I see that there appears to be a positive use of this type of medication in reducing certain menopause symptoms, but has anyone found benefits related to hormonal-based weight gain?

I already have a low calorie intake and don't want to reduce appetite any further as that would take my calorie intake too low- does this type of medication support with hormonal fluctuations that cause weight gain or prevent weight loss? Has anyone come across this as a benefit of this or any other medication?

Gosh if only all the obese people in the world had been given that advice for decades we wouldn’t be in the situation we are now.

The fact that being obese damages your body’s intrinsic weight control mechanisms is utterly irrelevant so why do all those silly experts keep bringing it up.

Now if alcoholics would just stop drinking…

Haven't finished catching up, but just saw a post about serious side effects which only affect 1% people 🙄 and thought I'd leave these here....a drug that all of us have taken many, many times...

•	Bloody or black, tarry stools
•	bloody or cloudy urine
•	fever with or without chills (not present before treatment and not caused by the condition being treated)
•	pain in the lower back and/or side (severe and/or sharp)
•	pinpoint red spots on the skin
•	skin rash, hives, or itching
•	sore throat (not present before treatment and not caused by the condition being treated)
•	sores, ulcers, or white spots on the lips or in the mouth
•	sudden decrease in the amount of urine
•	unusual bleeding or bruising
•	unusual tiredness or weakness
•	yellow eyes or skin

Paracetamol. No drug is without side effects.

Not talking about alcoholism I’m talking about over eating so don’t digress! Really annoying when people do this 🙄

These injections are for those with diabetes, they were never intended to be used for people to lose weight. It’s much cheaper to have a controlled diet and take regular exercise. If you can afford all the sugary drinks and snacks etc then you can afford to join a gym.

Before anyone says 'it's not that easy' it kinda is.

Weight control is 80% what goes in your mouth. What goes in your mouth is a choice. Overeating is as much an eating disorder as undereating, but people think anorexia is the only one.

We would be better off giving seriously overweight people the psychiatric help they need to fix their relationship with food, educating about proper healthy eating and basic cooking skills, so that they can break the cycle and control their weight properly.

Injections and gastric surgery are not the answer, proper self care and healthy lifestyles are.

Sadly our mental health services are as stretched as every other part of the NHS, and people are willing to pay for the 'quick fix' of surgery and medication, but aren't willing to genuinely take responsibility for their health and make real, long term lifestyle changes.

I see patients everyday who are eating/drinking themselves into the grave, but all they ask about is 'treatment'. And there's often a bottle of red Coke sticking out of their bag.

I'm not skinny, far from it, but I don't eat everything I want, I resist the cake, the crisps the pizza and the chicken nuggets, because I know that if I eat that stuff regularly I'll balloon and end up seriously obese. You only have to look at the contents of the average shopping trolley to know why so many people are overweight.

@MarvellousMonsters I hope those patients don't pick up your contempt for them, nor that it affects how you interact with them.

@cauliflowercheeseplease

''These injections are for those with diabetes, they were never intended to be used for people to lose weight. It’s much cheaper to have a controlled diet and take regular exercise. If you can afford all the sugary drinks and snacks etc then you can afford to join a gym''

The vast majority of people with type 2 diabetes have put themselves in that position by obesity/poor diet/lack of exercise.

Any reason why they couldn't have controlled their diet and used the gym before getting themselves an illness that requires an injection??

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Why are the NHS making access to 'fat jabs' almost impossible.
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skyeisthelimit · Yesterday 11:38
My GP wanted to prescribe them to me for T2 diabetes, but there is a huge shortage of them due to "rich people buying them to lose weight" to quote her.

So they can't put anyone new onto them, only the people already on them can have them.

So YABU unless enough stock is produced and they are given first to the people who need them for diabetes and other medical reasons, not just weight loss.

YANBU to think that if they work and have huge benefits, then they should be available to all, alongside education on how to keep the weight off once you come off the jabs.

I'm really confused by this. There's a shortage of the drugs. So you think rich people shouldn't be able to buy them? What's the solution? Only giving it to certain people in the NHS for free? How about those with a BMI of 35? Making them available for absolutely everyone over a BMI of 25 on the NHS isn't going to be feasible, because of cost and availability. The bigger issue is that these drugs haven't yet shown a benefit in reducing strokes, heart disease etc. It's only now that we are beginning to see that the weight piles back on when people stop them. Then what, people take them for the rest of their lives? Is that cost effective? Is that good for your health?

thats something you need to ask those that are obese and demanding injections.

nobody forced food down them!