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.

There are people who are born with jaw issues that cause them to grind their teeth down to nubs and have sleep apnea, people with deviated septums that means they can't breathe properly, and adults with crooked teeth that causes painful mouth ulcers and worsening dental health that also have to wait years and years if they're even considered bad enough to warrant the surgery on the NHS and you're upset that they won't fork out for obesity injections for people who can't stop eating and say it's making fat people jump through hoops? Spend some of the money used on getting obese and pay for it privately.

The jabs don’t cure the root cause though - you are much better off actually addressing the reasons why you over eat and changing your eating habits than relying on these jabs.

Its the same as any weight loss diet program- so you will lose weight whilst you follow the diet but as soon as you come off you put the weight back on, we need to be teaching people about adjusting their approach so they can maintain healthy eating for life.

Yes it would be better if the NHS prioritised prevention. Weight loss injections are not available in Northern Ireland on NHS at all, there are no weight loss services to provide it.

Diabetic. Have not had the injection now for a long long time. Shame as I am sure it was helping my diabetes and noticeably altered my appetite.

My GP told me their is a shortage of the medication right now so can't refer anyone. I've already had 2 lots of health coach sessions and a dietician. Still struggling with my weight (caused by medication.) He referred me for an NHS online programme but I got turned down because my BP wasn't high enough. It's actually really high for me as my baseline is 90/60. So he's referred me to a service that does 12 weeks of phone calls - sounds just like the health coach!! They actually said I need a higher level service but I told them I'd been turned down so they signed me up for the phone calls!

The root cause for me is medication which I can't stop taking. It's so frustrating!

Because it's it an area,of healthcare that the public seems interested in, despite the volume of overweight people. Because the mentality of est less, move more, still prevailed, despite there being research into why that's an over simplistic view. That some people can't turn off the hunger cue, but that's just seen as being lazy with excuses. Because weight loss is a multibillion pound industry and those desperate enough will fine the money. Because obesity is one of the few preventable and treatable conditions, which has a whole raft of other diseases which isn't recognised as a chronic disease. If people weren't overweight, there would be a huge reduction in strokes, heart attacks, diabetes type 2, and mobility issues......and yet no. You're fat, you're lazy, and did you know that your portion of protein should be no bigger than your hand.......

If you still haven't learned to eat like a thin person, you rebound and put the weight back on

If you've suffered side effects - screaming nightmares, disturbed sleep patterns, altered taste and smell, diarrhoea, nausea and fatigue, then these might settle down

You can get it from a GP, I just been put on mounjaro by the diabetic nurse at the gp's, I'm in Kent so maybe not the same everywhere

Because they know many will pay for it privately

Probably be viewed as a bit harsh, but instead of complaining about it, why not just pay for it like the rest of us have to?

Same for me. I have high cholesterol and BP so take meds for that. Also HRT and one anxiety medication (that has helped greatly). Borderline type 2 diabetes. I'm 5' 3" and weighed 85 kg at last but one checkup and began changing my diet afterwards. Small portions, no more cake/desserts etc. Went back for checkup 2 months later and weight was the same. Cut back food intake further and today weigh 84 kg. So my reasoning is it is all down to the combo of meds I have to take 😡

This happens in EVERY NHS department. Whether it’s neurology, cardiac, respiratory, whatever. Layers and layers of appointments to get to one conclusion. With the aim of saving money, but no thought given to the knock-on costs across the board.

It’s so frustrating. Sorry you’ve had to go through this.

It's a postcode lottery, I think

Did you get those side effects by taking the injections?

Did you lose weight? Gain after stopping?

Because the nhs probably can't afford it.

Because it's not a quick fix and if underlying issues aren't dealt with people will just put the weight back on when they stop.

Because no one should be encouraged to look for a quick fix for weight loss and health, they need to commit to changing their diet and exercise first. Free and much healthier, does anyone know the long term effects of these jabs?

IIRC they can't prescribe the meds diabetic people also use as there's already a shortage in that particular medication

Imo it should be reserved for those who really struggle and require specialist support. Otherwise half the population would probably be on them.

Rude and ignorant.

I’m going to disagree with you slightly on this point - they do work in a different way, addressing to a protein deficiency that makes you feel full.

i haven’t had a jab for 3 weeks, yet I still feel full with a lot less food in me.

Admittedly, I do think it put me in hospital with kidney issues, but that’s another story and one of the risks of taking drugs with side effects.

This is such an embarrassing 'daily mail' attitude. The jab would cost so much less than the cost of treatment for the myriad other health problems. It would save tax payers money.

There could then be a strategy to taper off the injections alongside healthy eating and exercise. The enhanced health benefits alone would help people maintain the weight loss.

I love that everyone says “you should address the underlying issues” as though there’s any help available to do that…

(Fwiw, yes I would absolutely support prescribing therapy alongside jabs)

The cost will come down as patents expire and drug companies keep developing the treatment. I think the jabs will end up being much more widely prescribed and it will overall be more cost-effective for the NHS. I think the jabs need to go along with good diet advice and lifestyle changes, and some patients might take them for life.

Firstly, it’s the NHS, so the service is going to be a bit shit. There are people who have to jump through hoops to get treatment they need when there is no alternative whatsoever to solve the problem, this isn’t a problem that is confined to obesity. It’s ridiculous that people have to travel so far away from home to access health care as you had to do, but it is completely fair to expect people to address the causes of their obesity and lose weight normally before we go down the path of GPs handing out weight loss medication.

It’s similar to the debate about how GPs treat mental health conditions and there have been complaints that they hand out anti depressants like sweeties without considering other healthier, more cost effective things that would help first. Weight loss drugs could easily fall into the same category.

The huge amounts of money saved on treating health issues for obesity could help pay for all these other conditions. It's not rocket science fgs.

I went to Turkey for a gastric sleeve as the NHS path was so degrading and pointless.

I also think some people regard therapy as a cure, but it doesn't actually fix everyone. Lots of people need medication along with therapy for various conditions - eg therapy alone might not cure someone's depression but taking antidepressants and also using talking therapy to develop coping strategies or come to terms with past trauma might help someone live a much better life. I think it's the same with these injections. I don't think therapy is the sole answer for everyone obese and it might not work on its own. But these threads are always full of people very dismissively asserting that fat people 'need to address the root cause' with no understanding that this is complex and not a guarantee of success either.