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.

They fund things like cancer treatments acquired by smoking, or liver transplant for alcoholics etc.

By your logic, we shouldn't do those either?

From the BBC article:

Tom Quinn from the eating disorder charity Beat said: "Wegovy or other weight-loss medications should only be sold under the strictest possible conditions, with stringent physical and mental health checks to ensure patients are well enough.

"These medications can be very attractive to people with eating disorders as they seemingly offer a 'quick fix' solution, however there is a very high risk of making those affected even more unwell and can further entrench eating disorder thoughts and behaviours. It is vital that people are aware of the dangers of abusing medication in order to lose weight and there should be more education on their effects."

It also cites a large-scale follow-up study which concluded:

One year after withdrawal of once-weekly subcutaneous semaglutide 2.4 mg and lifestyle intervention, participants regained two-thirds of their prior weight loss, with similar changes in cardiometabolic variables. Findings confirm the chronicity of obesity.

... On balance, they do sound like miracle drugs. But miracle drugs have a tendency to show a dark side after long-term use, and it does look like most users would need to stay on the meds or at least keep going back on them. The potential for abuse is obvious, and so is the risk of malnutrition in users whose food choices aren't the best.

Even after the supply issues are resolved, I think there's good reason for cautious prescribing.

Did you actually read the article?

Thank you.

Yes, did you?

I'd love to be prescribed Mounjaro, I'm T2 diabetic on Insulin and Metformin and have a BMI of 32, I eat low carb and am slowly losing weight but I don't qualify for Ozempic, Saxender or Mounjaro on NHs because to be eligible you need to have shown no/little improvement in sugar levels with 3 other medications (insulin, metformin etc) first.

Despite the fact that Mounjaro is specifically designed to reduce blood sugar levels in diabetics and would help me to lose weight which in itself would help my body to produce more insulin. It would most likely reduce me from 2 injections and 4 tablets a day to one injection a week.

I think that these drugs do need to be made more widely available on the NHS but that while there are still shortages and cost challenges, they should be prioritised to people with diagnosed health conditions.

I would buy it myself but I'm currently buying my own Continuous Glucose Monitors which is just over £100 a month, as I'm not eligible on NHS, so that I have constant visibility of my glucose levels to find the trends and eliminate the foods that are causing highs (working really well for me). I'm also concerned about the lack of continuity of care if I start taking a medication prescribed privately while simultaneously being prescribed insulin and metformin by the Diabetes clinic which I may need to reduce or I would risk Hypos.

To be fair that article does just tack on a sentence at the end saying several studies had found independent benefits. Presumably that means some didn't.

That's not true OP. I'm not wealthy and yet I have no issue providing myself and my ds with healthy home cooked food for about £25 a week each. Lots of fruit &veg.

Eating healthily is NOT more expensive.

Eating healthily is about education on nutrition and how to cook simple meals quickly. And about ignoring the food advertising industry.

Mass provision of WL drugs doesn't address the underlying issue of people eating over processed rubbish.

I suppose because we are not all overweight through greed? Although, even that shouldn't prevent treatment tbh, we treat lung cancer in smokers.

I'm overweight because of trauma. Part of my complex PTSD diagnosis relates to food - neglect specifically, when you have been hungry, and I mean really hungry, as a child it's not too hard to understand why food can take over your whole life when you become an adult with unlimited choice.

No. There has not been enough research into side effects. Plus the NHS wasn't set up for this kind of life long mass treatment for an avoidable illness. It'll bankrupt us. To be used in exceptional circumstances when all other methods have been exhausted - ok. As the first go to option - no!

Yes, this happens when you lose weight:

“Is it a fountain of youth… I would say if you’re improving someone’s cardiometabolic health substantially, then you are putting them in a position to live longer and better,” he said.

I know it goes on to speak of reducing inflammation (yet fails to link any of the 'many' studies, there's also language such as theories the author subscribes to, sounds really robust.

Lots of people have a lot of financial interest in these, I'm not saying they don't work but there is nothing to suggest they're a sort of miracle- even if they are, we still don't know the long term effects of non diabetics using it for sustained periods. It works in part by slowing down food passing through the digestive system; we know from decades of lots of research that the longer food is passing through, the higher the risks of certain things. Lots of people also just eat processed crap just in smaller quantities.

Exactly this. We need to eat on a budget- veggie chilli, Dals, pasta, curries with chicken thighs and veg, in season fruit, porridge, soups etc can all be cooked very healthily and cheaply.

Wouldn't it be better to invest in better support and treatments for these underlying elements though? For trauma, for PCOS, for thyroid issues, hormone imbalances, chronic illnesses etc?

It’s only now at 43 that I’m starting to understand how difficult it is to lose weight for some people. Because if I gained a bit at Christmas or on holiday I could always take it off quite easily. Now I’m peri and I’m hovering at a BMI that’s only just within the acceptable range by eating less than 1200 calories a day, walking 12000 steps a day and going to the gym 3 times a week. I cannot take another lb off. This is what I’m doing to sustain a bmi of 24.5. It’s absolutely soul destroying and unsustainable.

OP, I don't think you have answered the question about what happens when people stop taking the drug.
I cannot tell you how tempted I am to go down this route, I can afford it, it would be amazing to finally shift the three stone I cannot get rid of on my own. My relationship with food has been a problem my whole life, I am 50 now and it saddens me that this has dominated my thoughts since the age of 12 when my well meaning mother first out me on a diet.
I know I would feel so free and confident to not be thinking about food all the time.
But... I know that once I lost the weight, and stopped taking the drug, my old habits would return. I have battled them all my life and they are not just going to disappear by themselves. I know how to eat healthily, but it's never that simple is it. So what happens when all the weight piles back on, and probably more? I have in the past lost 5 stone through sheer willpower, guess what eventually happened? It's soul destroying.
I don't know what the answer is but this is not a magic long term cure, sorry.

Yes, you can feed your family on ingredients quite cheaply!

Veggies are cheap!
Reduce the meat portions/use chicken thighs not breasts etc nobody needs an entire breast for example, or 3 sausages or whatever.

Problem is , a huge amount of people just don't know how to cook and they think there's a entire food group of "kids food" that only kids should eat, do will think that they need to feed their kids turkey dinosaurs, paw patrol canned pasta and potato smiles... It starts from weaning with "baby food" like "baby" crisps/puffs, biscuits, cereal bars, Juice... and just utter junk all sold as though a baby can't drink water, eat a carrot and not eat crisps at all...

My child has complex PTSD but no access to treatment. I want NHS money to be spent on the car wreck that is MH treatment and the frequent cause/ continuation of disordered eating. I’m sick of sticking plasters on crisis which is what these jabs are. They enable users to continue to eat crap( just less of it) and don’t sort the root cause. Meanwhile there is zero money to treat EDs such as Anorexia, non inpatient beds to be had anywheres and people are dying…There is no money for MH full stop with many really ill people being given nothing.

All the same junk they’ll continue to eat with the jabs but just less of it.

The money would be far better spent on education, support and MH treatment.

There were 11 or 12 new studies released last week. That's why the newspapers went a bit crazy with the anti-aging angle, etc. Weight loss undoubtedly brings benefits but the drugs themselves have a dramatic impact even without weight loss.

This study suggest some of the drugs could even increase metabolism: https://www.newsweek.com/ozempic-works-differently-thought-1943422.

It's going to be a fascinating area of research for years and years to come.

@Flexibubble

Wouldn't it be better to invest in better support and treatments for these underlying elements though? For trauma, for PCOS, for thyroid issues, hormone imbalances, chronic illnesses etc?

Oh absolutely. I'm not saying the availability of the drugs should be the only thing considered, in fact I'm not even convinced that is the right course of action atm. I guess I just hate the 'greedy' aspect people talk about. If I could have had help for the trauma, and I have tried over the years, perhaps I would be in a much better all round position

I had horrific ones! I wasn’t sure if I was unlucky as everyone on Mumsnet seems to talk about it as some kind of miracle and nobody really mentions any problems. But then my husband tried it and had the same, and my friend is currently debating stopping it as hers are getting worse

I had the most painful acid reflux and bloating I’ve ever experienced, sulphur burps, constant nausea and diarrhea for about 6 weeks straight until it got so bad and I was so uncomfortable that I felt like I would rather be fat than carry on feeling that way!

I think people with no side effects have been very lucky

And then when I stopped my hunger came back with a vengeance, worse than it had been before I’d started taking it. Food was all I could think about and that was only after taking it for 6 weeks

Thank you for being understanding. It's fucking hard loosing weight. And when you have a lot to lose it feels impossible. Or perhaps doable for a month, but then it's exhausting and depressing to feel hungry all the time. WL injections are revolutionary and are going to change the lives of so many people for the better. The only problem is the judgement from some people who don't or won't get it. They just see overweight people as lazy gluttons who deserve to be unhealthy.

Op are you saying literally everyone who wants the drug should get it on the nhs regardless of their weight? Or just those who are overweight according to their bmi? If the latter then I’m not sure how it can work because as soon as their bmi hits a healthy level then they won’t be prescribed it anymore and the weight will go back on.

I have 3 adult kids who would forget to eat, but dd1 and myself would be craving food all the time.She works out all the time to keep fat away and has become bulky with muscles which makes her miserable.She just wants to be slim like her siblings.
For most human beings for most of history, the drive to eat food when available and lay down fat stores us what enabled survival.
People are different genetically and hormonally.It is not down to greediness you are battling your very survival instincts!

It's not only that, food companies have spent hundreds of millions to create food products that override our natural satiety signals. They are designed to be overeaten. It's no wonder so many struggle.