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.

It's socially acceptable to fat shame in Japan. That, combined with an almost enforced active lifestyle (driving is extremely expensive and fraught with complications, so most people have to walk at least some to get to public transport), traditionally healthy food (though that is changing) and a cultural belief in never eating until you are completely stuffed leaves lots of people very conscious of their weight.

As for the injections, I can see it happening as a last resort, but the staffing for the supervision needed isn't there.

Absolutely not, the injections are far to expensive for the NHS to be able to aford this at the moment. Not saying it may not change as prices come down. But it's not just the cost of the drug you need weight management clinics as its been shown that 2/3 of people just put the weight back on when they stop the drug. So unless you put resources into helping people change lifestyle at the same time it won't help long-term.

There is a good possibility they may become like blood pressure medication in the long run. Ie we will have a lot off people taking them long term for their health. But that's years away not anytime soon.

The government needs to be spending money on addressing issues with the cost of healthy food and easy access to high processed low cost food in the mean time.

Where on earth are you finding that price? Did I miss something?

Massively different cultural norms - very reliable public transport, travelling long distance by car is extremely expensive due to tolls, using public transport for short distances is not cost-effective so there is a big cycling culture, lack of land results in it being extremely expensive to keep farm animals or export meat from abroad, food is outrageously expensive anyway. Tofu costs pennies though. Portions are tiny. No dairy in the diet.
Japan is not immune, though, and it is becoming more common to see an overweght person.

Is people loosing tonnes of weight with drugs going to make their kids less obese in the future? Like will it save one age range but they'll still be a new generation of overweight kids growing up?

Well they pay for people to have bariatric surgery so why not

Have there been studies that show if people who use weight loss injections keep the weight off long term OP? If not then regretfully I think YABU.

I say that as someone who has struggled with morbid obesity in the past (at my heaviest I had a BMI of 48). I lost 9 stone through diet and have mostly kept it off for the past 7 or 8 years (by mostly I mean I have yo-yo’d putting on a stone or two and then losing it again). Anyone and any diet can lose the weight - it’s keeping it off that is the issue. I am still in the overweight category and would love what sounds like an easy fix - I found/am finding dieting very hard.

My concern with the injections is that they don’t address the reasons for the weight gain in the first place - imo usually poor mental health that causes people to crave heavily processed fatty and sugary foods that give the brain a temporary serotonin boost. So I’m guessing if the reasons behind the poor food choices/overeating aren’t addressed, just like any diet once you stop the injections people will eventually go back to eating how they did before.

With a limited NHS budget I think it would be more practical to see extra funding spent on mental health services like counselling and mindfulness courses designed for people struggling with their weight rather than injections (that they might have to be on for life, if they can’t change their habits once they stop).

Though I do wish there was a magic money pot that would fund both long term extra mental health services AND a limited number of initial injections (so people could get a helping “boost” to help them start their new long term lifestyle change if they wanted it).

Absolutely agree op. 👍

There will be more of these types of drugs available with different drugs companies having their own versions.

The drugs will also be improved and work better.

They are also looking at using them to prevent excess weight gain in the first place.

People say "you'll have take them for life" since I correctly take blood pressure pills and thyroid replacement pills indefinitely why is that a problem? People are very shortsighted. And many are if the mindset that overweight people should be in some way punished and weight loss should be hard. And preferably not long term successful.

I think the NHS would be mad not to make them more widely available when the price is reduced.

But if the nhs pays for bariatric surgery which also doesn't address the cause I don't see the logic in your concern @IamnotwhouthinkIam

I'm morbidly obese and terrified. Dieting has a 95% failure rate and so there is little hope for me.

I would love access to these drugs.
Or to be honest access to adhd meds which similarly calm the chatter in the brain so I believe.
I think my next step is surgery but I really would like to avoid that and surely drugs would be better.

@IamnotwhouthinkIam wow 9 stone. I am failing drastically. And yes I think I get so far and want the seratonin/dopamine hit from food. I'd love to hear more how you did it. You could be in the 5%

Oh well they best stay fat then .......

By making you actively not hungry. To the point that the thought of eating is unpleasant.

This is not to say you never experience hunger, you will feel peckish at mealtimes or after a few hours without food. But you will eat a small portion and feel full to the point that the thought of eating anything further is grim.

That's how it works and I imagine would work on emotional eaters.

What’s that got to do with it? All drugs have side effects. It’s about assessing the balance of risk.

i agree OP these meds and similar future ones are and will be game changers and revolutionise the treatment of obesity. Unfortunately there are too many people who just see obesity as a moral failing and that the undeserving, greedy and lazy fatties shouldn’t get anything that might help them; the NHS and wider society, whilst also bemoaning the drain they are on the NHS

I’m lucky to afford it privately and am happy to keep it away from the NHS but it’s a shame for people who can’t afford it

Yes they do x I can only describe it that I no longer get a hit from eating and I don’t have the desire to eat to make myself feel better. I have now what I imagine is the level of interest a “normal” person has in food. Work to do on myself for when I am off it, I appreciate

The NHS needs to spend more money running A&E departments if my family member's experience on Friday evening is anything to go by. Well I say Friday evening. They sat waiting in A&E all night and were still there at 8am Saturday morning.

Sorry to be blunt, but obese people can take matters into their own hands and improve their own health.

You can't stitch up your own head injury though, can you?

@Babycatsmummy I've been on Mounjaro for a month. I have lost over a stone. I've done dozens (hundreds?) of diets and this is the easiest one ever, almost effortless. It's been the best thing I've ever done.

It works by shutting down the hunger messages...I rarely feel hungry now. But also by shutting off the cravings and obsessions about food. It is incredible.

I have ADHD, anxiety and depression and all three of these have significantly improved as well. My brain is now not constantly whirring.

The needle is so thin I literally cannot feel it enter the skin. I've had some constipation but now successfully avoiding that by taking a psyllium husk tablet per day.

I am with MedExpress and have a £40 off voucher you can use (plus anyone else who wants it). I a, not allowed to share it but pls PM me for it.

Actually, this is not the case. The NHS’s collective bargaining power means it gets drugs far more cheaply than private providers

There is something fundamentally wrong with lifelong drugs being the 'answer' to obesity and many other health issues. Our desire to medicalise our way out of things that our society and our way of life have mostly created, rather than addressing the root problems, is lazy, flawed and self-defeating.

But hey, that's humans for you.

By that logic, half of the head injuries, just like obesity could have been avoided. There would be more money and more staff availability, if they were treating less people who have the conditions that obesity brings.
The research shows that Ozempic resets a person's metabolic rate. Experts in the field of obesity etc are calling for injectibles to be more available. I think that they will be looked at as statins etc are. We are dishing out a lot of drugs that a massive change in lifestyle would do the same job.

Exercise has a great dopamine hit.

We need to relearn relationships with food and Exercise not resort ri medication.

It's a terrible idea. Obesity is a condition that cab be entirely self managed. I would rather see the drug money go towards education and programs.

It shouldn't save the nhs money, as the NHS should not cover preventable.illnesses.i.e if you have 12 months of attempting to quit smoking/ lose weight and make no progress then you are no longer able to access free treatment for related diseases.

But it can't. Or rather self management had a 5% success rate. There are other factors once a body has got to that size.

Even Chris Van Tullekan and the why we eat too much guy say these once you get to a certain weight. There's so many other factors. The boyd wants to hold onto the weight through homeostasis etc.

Yes Education can prevent it in the first place but once you're there it feels like an early death sentence.

Id love help.id genuinely love these drugs or ideally adhd med which would make applying all the "education" possible.

And exercise is incredibly difficult if you put on weight due to a fatigue condition and are now morbidly obese. If going for a walk is no longer comfortable and you can't stand for long...

Id live to be more. Mobile genuinely. I think weight loss would mean I could be.

Being conservative about very new treatments, that could have long term outcomes that are unknown, is part of protecting patients.

That also involves a long term cost analysis.

Sometimes it means it takes some time before a treatment that proves itself, or will be cost effective, gets implemented, but rushing into things can have really serious consequences. There are liability issues to consider too.

Ithink a lot comes down to food culture. They have a strong food culture that includes a healthy approach to food as well as healthy foods.

We have a lot of unhealthy foods, and very bad cultural practices like constant snacking, right from childhood.

SO much comes down to habit. If you grown up with good food habits it serves you well, but if you don't, it is hugely hard to change your habits in adulthood, even when you know you should.

And even harder if everyone around you is living the same way, who wants to tell their kids no, you can't have a snack at playgroup because it's between meals?

Say the NHS did prescribe it and someone started it at 18….would it then be funded for that person for life

afaik, it's not as yet established that the drugs are appropriate during pregnancy. As a precautionary measure, even when shedding weight ahead of TTC it might be sensible to use contraception and have a washout period before actively TTC.