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.

''These injections are for those with diabetes, they were never intended to be used for people to lose weight."

Pharmaceutical companies have been desperate to come up with safe and effective weight loss drugs for a long time - it's the holy grail and will be making billions in profit. It's not like greedy, lazy fat people are clawing drugs out of diabetics' hands - the companies realised the weight loss benefits, got the injections approved for weight loss prescriptions and started selling them. Eli Lilly et al didn't begin with pure altruistic intentions to benefit diabetics, they created medication that can treat diabetes and obesity and they're selling it for both. And if obese people use them to lose weight, that reduces the number of future diabetics and all the associated expensive health problems that come along with that disease.

I haven’t put any weight on 6+ months post the jabs. Everyone in my group has maintained or lost further bar one person who put 4lb back on but now maintains.

I will tell you. I was forced fed the food as a kid. By the time I was a teenager I was overweight and have spent the last 30 years trying to lose it. I was stuck in addiction - the jabs have been the only thing to break that. I eat more now than I have done for about 12 years. But it enabled me to lower my weight point so I could become healthier rather than just reducing calorie intake.

@SofieM0 5 months ago you were posting on a Wegovy thread that you were about to start 4 weeks on an increased dose.

but now you’re saying your 6+ months post finishing

🤨

I do agree that there should be MH support @MarvellousMonsters

What you are missing are the other factors involved
Poverty
Availability
Life stressor
ND
Time
UPFs

Imagine you are poor, in an abusive relationship with ND or ND children
You work long shifts
You are exhausted, have limited funds, anxiety and don't drive
Your children will only eat a limited diet
You have very little time to shop or cook
You cannot afford to waste food that they might refuse , UPFs are all around you

Now tell me its easy

Instead of looking at the NHS for short term solutions, we should be looking at why people are obese in the first place and tackling those issues.
Processed/upf foods are massively addictive, they contain large amounts of ingredients that we wouldn't recognise as food to keep costs low, then shaped and flavoured, high levels of sugar and salt added. Huge marketing campaigns aimed to keep us eating them. The long term effects on our children are still unknown.

The government should be taking a more proactive role in reducing the amount of poor food that swamps our supermarket shelves.

Addiction… that’s what you need to tackle!!! The jabs might help you lose the weight but there’s no point taking them if you still are addicted to food 🙄

Agree but it was the jabs that helped with this. Plain and simple. I couldn’t eat sugar & that helped me break the cycle. That’s been the biggest turning point for me.

She's stated in the post you've quoted that the jabs broke her addiction and enabled her to tackle it.

why are you fibbing on this thread @SofieM0 ?

@cauliflowercheeseplease

Not sure you get what I'm trying to say.

You seem really against a medication that is now available to people as a weight loss drug alone, yet you seem really bothered by this as it was only intended for use for type 2 diabetics, which in most cases has been caused by obesity and lack of exercise. Why are they not being chastised for not losing weight/eating better/exercising and getting themselves into that state?

Maybe the lifestyle caused type 2 diabetes patients should be paying RRP for this medication and not be prescribed it on the NHS as they put themselves in that situation and can't/don't want to make dietary changes off their own back either.
These injections are not a magic cure but they are a catalyst for being able to makes changes.

I'm not a user of these medications, but if it is helping people to lose weight in the way it is, then I just don't see the problem that in the future it may be available more easily on the NHS as a stand alone treatment against obesity.

Every one of the people choosing to buy the medication is doing so off their own back will have made their own risk assessment from the knowledge available to them. I just don't see the issue really.

I mean, where do you draw the line of what the NHS should and shouldn't spend money on?

Weight loss injections - yes, we can lose weight by eating less, I certainly have managed to quite easily just by being in calorie deficit as I had no medical reasons for being overweight, just ate too much. Not everyone can achieve it without help.

IVF - very unfortunate situation for a lot of couples being unable to conceive, but the NHS can fund this in certain areas instead of saying 'tough, it's not meant to be'

Menopause - HRT to improve the symptoms caused is prescribed by the NHS, but as it is a natural bodily function, do we just say 'no HRT on NHS prescriptions as you should just ride the natural aging process out'? No!

I could go on but think you will get the drift...

So how do you propose to deal with leptin resistance? Damage to the hypothalamus? Insulin resistance?

Obesity can cause all of these and they in turn mean that the body’s weight control mechanisms no longer work properly. Look at the weight regain graphs for people who go on programmes like The Greatest Loser and it shows that even supervised diet and exercise are not enough.

Obesity prevention may be achieved via diet and exercise but obesity management less so. Hence the comment about alcoholism preventing alcoholism is arguably much easier than treating it once the psychological and physiological changes have set in.

Two call outs in 2 minutes by you. Chill out!

I have recently moved into the 6+ month group we have for maintenance as my last order was Jan. But you’re right, I doubled checked my last dose which was actually taken in Feb. Supply issues + other things made me decide not to continue (piling weight back on being the biggest concern). And so I went cold turkey with my private healthcare as support and moved onto IF. So I’ve been off 5 months and 2 weeks and haven’t regained. Maybe I these next 2 weeks I will regain to satisfy you!

so the post 5 month ago where you say you’re literally just about to go up a strength because current strength hasn’t been doing much…. you then stopped despite never having had real success with it?

i mean it’s fairly contradictory to you saying that you have been fine since 6plus months of post jab

doesn’t look like you’d barely started taking it 5 months ago 🤷

so you stopped 5 months ago despite it not having worked for you? ok

you gaining weight won’t “satisfy me”! i couldn’t give a hoot either way

You not lying on this thread is probs a good thing though

You clearly have no understanding of how they work. To get up to 1.7mg you have to pass through all the other strengths. You can’t just start on 1.7mg. And each strength is a minimum of 4 weeks. Yes the last 3 weeks of my second 1.7mg was having no effect. But I’d lost a lot by then.

Because these quick fix medications only work long term with lifestyle changes. The tier 3 services are a complete programme to ensure that where these expensive medications are prescribed on the public's pocket they are long term effective.

Better than these meds are long term lifestyle changes including diet, exercise and often psychological help to reduce dependence on food

I agree. But, if you look at any of the numerous threads about UPF from people trying to cut down, people trying to understand what it means and any thread where people are questioning how to eat more healthily and the posters who advise, who recommend podcasts, who help are at least matched in number by those mocking and pouring scorn on them for even thinking about it claiming that UPF is just the latest fad or there's nothing wrong with it or it's no different to/tastes better than (?!) home cooked food.

That's not poverty speaking or shifts speaking or marketing speaking or any of the other reasons given. That's sheer willful ignorance and belligerence. Traits which some appear to regard as positive qualities.

I've said before that some people don't want to make positive changes or to understand or to educate themselves. Some people want to be exonerated of that responsibility.

so it had done “nothing for you” at that post was planning on moving up

but… that day you decided to jack it all in

and now here you are on this thread waxing lyrical about it and how ”6 plus months” is actually 5 months…. and you haven’t gained anything

i’ll leave you to it @SofieM0

I'm diabetic, type 2 (supposedly the type caused by being fat). It runs in my family, in some cases one parent and all the grown children have it, in a lot of cases obesity did not factor (we are talking size 10-12 adults). I was personally overweight but not obese, but then put on a lot of weight after I became diabetic.

I use Ozempic, its the only drug that I've tried that controls my blood sugars. Using Ozempic I've lost 40%+ of my body weight, I'm now a size 12. I'm still diabetic though, the fairytale of "lose the weight and your diabetes will go into remission" is by no means guaranteed. If its genetic, tough.

I need that Ozempic, without it my expected life span is reduced by over 10 years, I could lose my sight, toes, feet, legs, suffer incurable neuropathy (nerve pain), be at much higher risk of heart attacks, strokes, DVT, as well as dying from diabetic ketoacidosis (diabetic coma).

I appreciate that obesity on its own has its own comorbidities, but gastric surgery, diet, prescribed pills, are available, if not as easy on the patient's willpower. And in an ideal world there would be enough of these drugs for everyone. Until there is, please excuse me for unashamedly putting myself to the front of the queue.

Absolutely I’m waxing lyrical about it! I’m super fucking happy - I’ve even lost weight naturally now I’m not addicted!

you can have your 5 months 2 weeks vs my 6+ months. I’m so super excited that I made that group that I didn’t meticulously check my dates but luckily you’re there for that.

Feel free to share my Oz journey, my MJ trial trial results and all my Wegovy losses that are searchable too. And yes, I spent about 3 weeks ummm and arrring on my next steps. I would have continued and gone to the final does of Wegovy 2.4 to try and shift more but could not get it due to supply and by then I was caught up in the ‘get off it before you can’t’ scaremongering and I had lost a lot of weight. All those decisions, fears, elations and conversations are searchable too!

I’m classed as obese. Yes I’m overweight and I can only wish for Iv spent years trying to get help with it. But the problem I have is that I have no appetite I eat next to nothing. No matter what I do I can not lose weight. The docs have allegedly checked my bloods and everything else. Cant find a reason. Got sent to weight management who sent me to a dietitian who then sent me to mental health who sent me back to my gp. Not one answer, not one bit of help. I’d love to be able to get these injections