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.

Some of this comes back to education - for years people have been told to eat salad or cabbage soup to lose weight but it’s not sustainable and not particularly effective.

I’m on about 1600 calories a day which should average 1lb per week weight loss. Today I’ve eaten porridge with pecans and chia seeds, a protein shake (protein powder and water), a portion of leftover sausage jambalaya, Greek yoghurt with blackberries, pumpkin seeds and a bit of honey and then lamb Tagine with couscous and roast veg.

Yes it means weight loss takes time, but I don’t feel like I’m restricting myself, I’m rarely hungry and I know I can stick with it.

I know there is a bias that greater weight = lower IQ points but actually there are plenty of obese people who are really well educated about nutrition, to whom there is little anyone can suggest that they aren't aware of or haven't tried.

Unlike other addictions or behaviours we’d rather hide from others, obesity is very visible and seemingly many (on MN) think they can start commenting on other people. Unusually with little prior knowledge of the individual.

You can smoke, drink, take prescription and illegal drugs, gamble etc without anyone knowing. Become overweight - god help you.

As to why some ppl get obese...
My esp. large friends who struggle with their weight, admit that they binge & comfort eat. It's not that they don't have full signals, it's that they have conditioned themselves to ignore the full feelings. Which habit comes down to emotional crap in their lives, some of it very historical.

I perceive that if there was an effective treatment that dealt with those emotional legacies, that would be a route to them being happier overall, not just smaller.

As long as the injections are cost-effective then I don't care if they are offered by NHS. But giving injections reminds me of giving someone infographics to make decisions because they can't read.... if they can learn to read, teaching them to read would be so much better for them. It could be argued as unethical to not try very hard with obese people to encourage them onto a better pathway to recovery than medication for life. Same as trying to get T2 diabetics, people with CKD or asthmatics to avoid chronic medication.

Er how do we encourage asthamatics to avoid medication?? (asthmatic since childhood and parent to an asthmatic - only ever heard how important it was to keep up the preventer. What "lifestyle" leads to asthma??)

t giving injections reminds me of giving someone infographics to make decisions because they can't read.... if they can learn to read, teaching them to read would be so much better for them. It could be argued as unethical to not try very hard with obese people to encourage them onto a better pathway to recovery than medication for life

I think this analogy is really flawed. Firstly, what does teaching people to reverse obesity look like? We don't have a successful strategy - there is no Phonics for Fat People here. There is weight management education on the NHS already and it's not working. Nothing is working - any diet, any change of lifestyle or programme, anything currently available - no one has come up with something that works long term to keep formerly obese people at a lower weight. The statistics are overwhelmingly dispiriting. If 95% of kids in school never learned to read, we wouldn't keep bashing phonics into them would we? But that immense failure rate for long term weight loss doesn't discourage people from insisting that we need to educate fat people slimmer - because that assumption is so baked in that fat people are stupid and they just haven't tried hard enough. I think that's what they used to tell kids with dyslexia years ago, and it didn't help them learn to read any better than it's helping obese people lose weight and keep it off.

Then, the analogy is also based on something we just don't know, which is the long term success or failure of these injections. At the moment, there is a theory that people may be on them for life. It's also possible that someone might take them for say two years and manage in that time to resolve some of the issues around binge eating. Maybe weight set point theory will turn out to be true and people could use the injections to reset their body weight, making it more likely that they can maintain over time. Maybe the injections will be like every other means we have right now of achieving weight loss and people will gain it all back and more - and we will be in the same position as we are today.

But there is no point saying 'we shouldn't use WL injections because other means of weight loss are better or more successful' because that's just not the case. Once someone is obese, it is very unlikely they will successfully reverse that long-term because of physical changes in the body that make it near enough impossible. The percentage of people who do that is absolutely tiny. So it's not a helpful solution when so many people are obese and the numbers are rising. We do need something better if we actually want to change that. That might be the injections, it might not - but it definitely isn't a case of teaching people not to be obese anymore because that is not working.

People are skinny in Japan partly because it's a very socially conservative society where no one wants to stand out. There are all sorts of fattening foods available but people don't gorge on them as that's not socially acceptable.

School dinners have soup, veg and pickles, breakfast is soup and fish, dinner will be rice pickles etc. there's a lot of veg.

There is a lot of evidence it causes long term issues. Did you not want to read that bit?

Please cite someuseful source for this…. 🤣

Interesting
I wonder if Ozempic can be used along side other therapies, in the same way anti-depressants are used along side CBT for example.
So, the ozempic tells you that you are full and don’t need to eat
You lose tons of weight, all while exploring the triggers of emotional eating and how to listen to your body when it tells you you feel full
You get to a healthy weight, come off it and then as your stomach is smaller you will feel full after less food than you did before you had the WL injections and you’ve hopefully developed new habits and behaviours around your eating (as well as getting therapy) that makes it a long term solution??

Ive never been overweight so maybe I shouldn’t have an opinion, but I would imagine that the double burden of trying to lose tons of weight as well as dealing with the emotional issues of why you eat would feel insurmountable

Kind of like with depression - if even brushing your teeth feels like a mammoth task how are you supposed to find the will and energy to get better? That’s where medication comes in. Gives you just enough of a boost to help yourself get better.

I might be talking shite here though!

@Errors I think you've got a good grasp of it! That's my hope and intention, to use Mounjaro in my case, to get to a healthy weight and use the time and mental freedom to work on not putting it back on.

What's not useful about her source?