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.

But why not, if it works? A significant reduction in obesity rates would be hugely positive for the NHS. Is there any evidence of therapy reducing obesity? And why is it better to spend money on therapists than medications?

My husband lost the weight by willpower, saving to the NHS 100%

The NHS should NOT be picking up the tab for lazy self indulgent lifestyle choices!!!!

@stickingatit yeah, your sister sounds much more moral and worthy than those other dreadful fat people who don't work hard and don't deserve any sympathy. Well done to her.

Again, well done to her.

Have you seen the long term side effects????? Are people mad buying these injections from random online retailers and taking them with NO monitorimg

@SofieM0, thanks for sharing your encouraging story. When you say the injections changed your weight point, is ‘weight point’ the same as ‘set point’ that I see doctors in obesity research refer to? I ask because in the Zoe podcast I linked to where they interview a doctor, Dr Robert Kushner, who prescribes and researches the jabs (the STEP trials) the doctor says his study of a group of patients after being off the jab for 1 year showed participants regained two-thirds of their prior weight loss, The study concluded, ‘findings confirm the chronicity of obesity and suggest ongoing treatment is required to maintain improvements in weight and health.’

He says science has discovered the body establishes a biological set point that the brain has of where your weight ought to be, namely at the higher weight. He says after dieting or coming off the fat loss injections your body will be fighting to get back to its set point at the previous higher weight through increasing hunger hormones and suppressing satiating hormones. For this reason he believes obesity is a chronic relapsing condition and people need to stay on the injections which he supports. Of course your story so far is different and you have not regained which is encouraging. Also are you saying even off the jabs you cannot overeat anymore?

When you say you cannot eat as much as you used to without dire consequences and side effects, is this also off the jabs? I am wondering what the mechanism is. I read the jabs slow gastric emptying which could mean fatty foods would fill you up quickly as fat also slows gastric emptying, but I don’t understand why there would be dire consequences and side effects of eating more than small portions once off the jabs?

Also am I right you pay for the private healthcare not to buy the jabs but for ongoing support maintaining your weight loss? And finally the jabs took away your sugar cravings? Many thanks, sorry so many questions.

Yes. It's the sort of thing a decade down the line we find out it caused cancer etc. I would be very hesitant to be part of this trial period.
Also I think all that Botox / implants etc will end badly too.
And vaping.
Signing out.
Norma Negative.

But GLP1 meds have been being used for more than a decade!?

I didn't know that. I thought it was just another new thing 😜

The dispensing of ozempic and wegovy to name a couple has resulted in a shortage for patients with diabetes II. But they and similar drugs are still widely being prescribed privately.

I tried one product - it did really work suppressing appetite for a few days but the side effects of fainting and being really sick was awful. I had to stop.

But I'm still eating the normal healthy diet I ate before I had to take medication.

And therapy wouldn't help those of us already making good food choices.

Sounds like you're not really bothering to read @UndertheCedartree's posts @stickingatit

So much ignorance and hate in this post

People quoting how one person has reacted to eating food and extrapolating that information to apply to others is ridiculous.

So you weren't overweight? Or you're still eating what made you overweight? Or you mean you ate and became overweight, but then decided to change and eat more healthily but couldn't actually reduce by enough to lose the weight?

If dieting doesn't work long term you're basically saying that everyone who takes this medication will need to take it for the rest of their lives?

If you're obese then you're not making good food choices. If you are obese, good food choices involve eating less than maintenance in order to lose weight. If you already know this, and you're not doing so, then taking medication is a cop out.

This, of course, doesn't apply to those with actual medical conditions that retain weight and fluid.

@usernamealreadytaken, obesity is an actual medical condition itself.

Sharing your personal views about who is 'justified' in being obese helps nobody, except presumably it makes you feel a bit better yourself.

"If you already know this, and you're not doing so, then taking medication is a cop out."

Every single obese person already knows this, for goodness sake. If it were that simple then there would be no obesity epidemic. Taking medication is not a cop out. You would presumably prefer that obese people just stay obese?