AIBU to think it's time for the NHS to do itself a favour and make WL injections readily available.

[nextdoorconundrum]

I've posted about this before but following the news today from the chief scientific officer for the British Heart Foundation - Professor Brian Williams - that the health benefits of these drugs appears to be beneficial in the reduction of heart disease, high bp, stroke , arthritis and even Alzheimer's.. (interviews on R4 today programme and channel 4 news just now for anyone wanting to hear all he had to say ) .: Is it not time now for the NHS to actually save itself the fortune it spends in treating obesity related diseases - rather than obesity itself.

There is also something highly questionable about a drug that is readily available to people who can afford it - but is mostly not available to those who most need it . With extremely narrow parameters and some ridiculous hoops to jump through before being 'allowed it on the NHS.(Obesity affects 39% of women in the most deprived areas as opposed to 22% in the least )

www.nice.org.uk/guidance/cg189/documents/health-inequalities-briefing-2#:~:text=The%20greatest%20rates%20of%20adult,in%20the%20least%20deprived%20areas.

I say this as a financially comfortable mc woman who has lost 4 stone on WL injections. I no longer cost the NHS any money in BP drugs, Sleep Apnea machine, Corticosteroids for knees etc - in fact for the first time in 26 years I only take thyroxine which is not something that can be reversed. The only reason I have managed this is because I could afford to buy it. Surely this is not only wrong but immoral in a national health system ?

The argument of 'is it safe ?' doesn't hold water . It has been approved through extensive and thorough trials across both the United States and most of Europe. It is no more or less safe than any new drug.

The argument of 'some people get nausea and vomiting and other side effects ' yes this is true. As do some people on all kinds of drugs . I personally can't tolerate penicillin - doesn't mean it should not have been allowed to save the lives of millions for 70 years. !

Last but not least.. what happens when you get to a healthy weight and stop taking it ? Well I guess it's exactly the same as blood pressure medication. You take it when it creeps up again .. perhaps it just becomes one of those drugs that you take lifelong on and off to maintain good health ..

Far far cheaper than treating all the current diseases associated with obesity and morbid obesity..

YABU - we can't afford it
YANBU - it's a false economy not to make it readily available to people with obesity if they want to try it.

When I was a young theatre nurse back in the eighties people who were above 11/ 12 stone were rare . They were looked upon as very fat. Surgeons refused to operate on them until they lost weight . There is no explanation for the obesity crisis other than people eat a lot of rubbish and find excuses not to exercise these days. If people could exercise some self control and discipline they wouldn't be in the state they are in today. Less in and more out is key.
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That’s interesting.

Good that people are studying it, because apparently even adjusting for the same calorie intake, same exercise level, and roughly the same macros, People are still 10% heavier than they were in the 70s and 80s.

One of the theories is that it could be changes in the gut biome. Another that it could be prevalence of antidepressants.

But sure, self control is probably the problem.

There are some potential serious side effects and if you roll these drugs out to millions of people, that small percentage who experience those side effects will be a lot of patients. I guess that's one argument for keeping them off the NHS for now. However, drug companies are racing to produce newer, better versions and now the technology is here, I don't think it's going back in the bottle. There are clearly some potential benefits beyond weight loss - I've seen reports claiming they might help treat Alzheimers or Parkinsons, that they can slow ageing, that they reduce inflammation and cancer risk and all sorts of things. If any of those turn out to be the case, this could be a development similar to the discovery of antibiotics or vaccines - it might change healthcare completely, and certainly attitudes to weight. I imagine they'll be improved and refined, that there will be so much money up for grabs for the company which manages to produce safer and more efficient versions with fewer side effects and so a huge incentive for that to happen.

I don't know if that's a utopian or nightmare vision of the future honestly, but it seems far more likely to me than a society which goes back to pre-industrialised food production or one that adopts the Japanese model and starts taxing employers on their staff's waist measurements.

It's all pretty new and very hyped right now, but I do expect OP that the NHS will be prescribing these drugs (or rather the new versions) within a few years. I think it's much more likely than huge societal changes, and the reality is that only a tiny tiny fraction of obese people are able to lose weight and keep it off and so what are the options?

To be scrupulously fair, some people report that it improves their mental health as well.

For me personally though it was awful.

@BirdFeederFun

Well done that's a huge achievement.

And sod @mm81736
Who can only belittle you

A lot of them are young people, particularly young women and in the 15-20 stone range. When attending a hospital appointment, recently, I noticed a lot of the nurses ( one of which advised my husband as to the importance of losing weight pre op) were morbidly obese.

@SippedAway
surely the other health benefits attributed to these injections are directly related to not having an excessive amount of body fat?
Or are you saying that if the injections were given to slim people they would also have a reduced risk of Alzheimers, Parkinsons etc?

It's being reported that the medication could be used to treat these other conditions - how much of this is hype I don't know, but no it's not a consequence of weight loss. As these drugs were developed as diabetes drugs - and they are dosed differently for treatment of diabetes - and weight loss was discovered as an unintended side effect then a specific version of the drugs were developed as weight loss treatments, so a different version might be developed for these other conditions if indicated.

I think weight has been so irrevocably linked to disease and death that we automatically assume everything is treated by losing weight and that any positive health benefits are due to lower weight but that's not the case - slim people develop diabetes, Alzheimers, dementia, Parkinsons, cancer etc too. Semaglutide and tirzepatide are used to treat diabetics without inducing weight loss, but are prescribed in higher doses for weight loss.

So here is one article suggesting other benefits not linked to weight @blackshuck - all very speculative at the moment, but it explains it's to do with the mechanisms of the drug, not weight.

https://www.theguardian.com/science/article/2024/may/14/can-weight-loss-drug-such-as-ozempic-also-treat-addiction-and-dementia-semaglutide-cancer-diabetes

No - eat less, exercise more and spend more money researching cures for eg cancer

@Pussycat22 I find it interesting that being morbidly obese isn't considered as an eating disorder. Would you advise an anorexic simply eat more and move less?

I'd be interested to see if somebody posted a thread about the severe complications caused by deliberately depriving oneself of food would be met with similar comments made by some, here.

I had an ED in the eighties. Fortunately was managed by school and family, but I could do easily have ended up in hospital. Some of the 'food chatter' comments remind me of what my brain was doing in the opposite direction.

Why is there so little sympathy for those struggling with their weight at the obesity end?

This might be a lot of nonsense because (being honest!) science/biology is not my strong point, but is it not the case that people who over-eat expand their stomachs over time and then it takes more food to feel full? I've been on a diet for the last month and I feel like now my stomach is used to smaller portions and I feel full sooner, like my stomach has "shrunk"? So it's not quite as simple as slim people are lucky and they feel full sooner, slim people feel full sooner because they are slim and don't generally over-eat?

Hormones, as opposed to stomach capacity, play a major role in appetite, hunger and satiety. It's how these drugs work - they make the person feel more full by regulating insulin and blood sugar, not by shrinking the stomach, though they also slow the passage of food so it's also the case that the stomach is not empty. I always think of how powerful pregnancy hormones were in changing my tastes and hunger - the nausea, strong cravings and insane aversions to certain foods and drink. We are more at the mercy of our hormones than we realise!

It's true - I do IF and was starving for the first few days
Now I don't get hungry and get fuller more quickly.

There is a serious hatred and contempt for fat people on this site and the way people speak about them would appal everyone if it was directed at any other group. It's excused because they consider fat people as having brought it all on themselves and being a worthless drain on society but it's double-edged because if a fat person does something to address their weight, it brings about another slew of judgement and blame because any interventions eg injections are considered the wrong way to do it.

These drugs may well cut cancer rates, as being obese for a long time increases your risk of various cancers...

I say this on a lot of these threads, fat people are wrong for being fat, they're wrong for losing the fat in the wrong way.

Wrong!

Yes our food culture has been Americanised. Its a simple as that

Huge portions of mainly carbohydrate based foods, either fried or with fried things on top.

The more we have drifted from a European alignment (and we werent that aligned food wise), the worse it has got

We dont have any more ND or trauma, or medical conditions than other people around the world with lower obesity rates (and Europe is soon catching up with us because of their own Americanisation of food)

We snack, we eat on the move, we have massive portions, we dont exercise as a nation, we sit in front of the telly alone eating meals. We have an isolationist and individualistic society, self centred and self absorbed, this doesnt bode well for thinking about the impact of our actions on society.
We have special offers on massive portions of junk food but no lobbying or promotion of fruit and veg. Same in America.

We also dont smoke anymore which is a good thing but people move on to something else when they give up usually.

And we are animals, which we do share with the rest of the world, we are designed to eat and preserve calories, we are a cold country usually, our food heritage is of heavy meals because of the need to eat enough, our make up is designed for this.

All those things combined mean it is very difficult to lose weight and for those that do have conditions like depression, ADHD, trauma who use food it does add to the difficulties

Tools are helpful to help people lose weight, some people find SW or WW a great tool, some find medication or surgery a tool. No one should judge anyone else for how they do it or how they maintain their weight. Many horrible posts on this thread (as is usual here)

Agree with you op. Its about time these were available. I maybe think at £50 a month via nhs gp prescription. I do agree that if people paid vs free, they would take it more seriously and not as a lazy way out. Where are you getting it so cheap? Please tell me your secrets!

This. 100% this. Yes it’s true that some will put the weight on because they don’t change their habits and don’t retrain the way they eat and live. But that is true of any diet or weight loss method. The WL injections simply stop the food chatter in your head. You literally won’t feel like eating at all and struggle to get your calories in for the day. I think for those that have at least 4 plus stones to lose, that have tried everything but don’t want surgery, should have this available to try. For people today I did it through diet and exercise etc, good for you, I’m genuinely so happy for you. But everyone is different and has different stresses, pressure, responsibilities and above all health needs. To say everyone else you be judged by what I think is quite frankly ignorant. Whilst I do think it should be available, as many have said it’s mainly a supply issue. Because the NHS are able to prescribe some of these WL injections in certain areas, but very few do because they can’t get the supply. Above all else, I think unless you’ve been in the position of being overweight for many years and desperately trying again and again to lose weight and failing for whatever reasons, you can’t really relate to those that do struggle. The food is simply a crutch for other things that we aren’t dealing with. And until we can feel what an average person feels like about food, it’s honestly an absolute lightbulb moment.

A lot of people see being slim as some sort of virtue and being fat as a moral failing. They think that fat people are lazy, gorging themselves, and lack willpower. But I think the issue is that some people just have totally different biological responses to food and satiety. People who are naturally slim and have never had to diet and go on willpower probably don't have half the willpower some obese people have who have fought to lose weight for years and years, but having to have willpower every single day for the rest of your life is really hard v people who can eat a normal portion and just feel full. Some people just don't get full signals or their brain doesn't understand them and they always feel hungry.

A lot of people say MJ and the like turn off the 'food chatter', and I think a lot of naturally slim people just dont have that chatter in the first place. It's not moral superiority or willpower that stops a lot of people overeating, it's that they eat a normal portion and feel full and don't want any more. To some obese people, that's a marvel (and that's what the jabs allow them to feel). Nobody wants to be fat, and obese people certainly aren't necessarily lazy or even gorging on takeaways every night.

There seems to be this feeling that fat people have to suffer to become slim again and that's their own fault because they are fat, but if there's a solution to give obese people the same feelings around satiety and cravings as naturally slender people have, then why not?

As the price goes down in future, I hope it becomes available to more people. Being obese is not a character failing.

Great post @moppety ❤

I think as well @moppety there is something really pertinent about the role that restriction and shame plays in hunger. Obese people have often tried to restrict food, to fight their body's signals, to cut out food groups and diet over and over again, and the body reacts in a primal way with a hunger that is greater than before. You end up locked in a constant battle with your own body that you can never win and it becomes soul-destroying. The more you try to diet and restrict, the worse it gets - it's very well documented that diets lead to greater weight gain in almost everyone.

Absolutely. And it must be exhausting, to always be so aware of food, of having to fight against your body every day, dealing with the guilt and shame because a lot of people make judgements about you as a person. Many people will have spent a large portion of their lives losing and regaining weight, and that's both hard work mentally and physically. Fighting against yourself is just very hard to win and it gets to a point where you have lost that connection and trust with what your body is doing.

But there seems to be this need to further punish obese people, this belief they need to do things the 'right' way instead of there being an easier, more realistic way for them to lose weight. If these jabs can help people lose weight and enjoy life and be more healthy then surely that's exactly the kind of thing technology should be working towards. Many people won't need them or want them, but for those who do, it could totally redefine their life and relationship with food. It's a very exciting step I think, and I think once you sever that connection that is giving you constant appetite and food chatter, it becomes easier to make better decisions about type of food too and to make longer-term changes about eating well.