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.

Particularly if they are eating the same crap but just less.

The sad fact is many don’t want to stop eating the foods they like or to exercise more hence wanting a drug which will enable them to eat the same foods( just less) and not exercise.

Tell her she will be thankful for having good muscle tone which will see her into her old age really well. I'm currently working on building up my muscle after my chiropractor told me a few home truths and having muscle in old age is beneficial compared to those who are slim but very little muscle.

My GP surgery does a pretty good job of encouraging healthy living - they have a free walking group run by volunteers that meets multiple times every week, they have health care assistants you can check in with regularly to weigh you and give lifestyle advice, they have an exercise referral service to access gyms at reduced cost, they have tons of information in the waiting room about healthy lifestyles, they have Parkrun posters. They have social prescribers you can speak to about all sorts of lifestyle issues. "Preventative healthcare" is our responsibility.

The NHS is there to treat the most serious diseases / disorders. How we live our life before we reach that point is on us. And I say this as someone who suffers with a metabolic disorder. I know that managing my lifestyle is the key for keeping it under control, so I prioritise that. I weight train. I eat healthily. I spend my weekends in ways that benefit my health - I don't drink, I socialise with my friends doing outdoor activities, I go to bed early. We are in control of the choices we make every day, that's not the NHS's job.

I'm not saying I disagree particularly but I haven't done any research on the issue of whether you need to stop or stay on it long term, which is the crux of it for me.

I think my real worry is that we could find ourselves in a situation where we have a huge proportion of our population relying on a drug to fix an issue without any emphasis on root causes. It just doesn't sit comfortably with me. I'll fully admit I'm incredibly ill-informed on it but I feel like there could be people who use it to allow themselves to eat nothing but UPFs and that just feels very unhealthy and unnatural. If people stay on it forever then there's no incentive to change eating habits and there is more to this than just weight. And if they have to come off it without addressing root causes then if they gain again the whole thing becomes an expensive waste of time. And yes...I know the cause for some people is about more than over-eating, but how can a GP possibly make that distinction.

I know it's more complex than this, but it's a bit like having a drug that protects your liver and still allows you to drink 10 pints a day.

Not sure it was set up for that really although it makes sense now. Education re diet as opposed to expensive care for bariatric patients.

I think the HCP that posted earlier is right - give it out for free and people will take it for granted. If you pay yourself much more incentive to stick to it!

The NHS is being asked to go above and beyond it’s original purpose, and there just isn’t the resources for everything.

What concerns me, as someone who, as a teen, was bulimic, is that I have already heard of people lying about their weight to get injections online. I'm not going to lie, at 50, having gained following menopause and got a little tummy, I have thought about it, even with a BMI of 22.5. Just because I don't like having a bit of a belly.

It's true to say the thinking of someone with disordered eating never totally goes away, but I know it's fleeting thoughts and I wouldn't take this drug. But I wonder how many people still battling the much louder anorexia/bulimia voice I once had will be looking to find ways to get this.

I'd like this to be something that those battling with weight at the other end of the scale have access to with a proper consultation with someone whose primary goal isn't to sell you something. Availability on the NHS would help with this.

I tried mounjaro. It gave me horrific panic attacks and a racing heart, and insomnia. I looked online and can see this is not especially rare. It might have got me slim but it would have destroyed my mental health.

It's not a magic bullet for everyone. My worry is that women who find it ramps up their anxiety will be dismissed, when for me it was so awful that I had to discontinue the meds. I would rather be fat than lying in bed awake with waves of fear rippling through me and my heart pounding like I am running a 5k.

There is so much that needs to be done to change the way things are here in regards to food, and how it is viewed. It has been normalised to feed a weaning child jar foods, and foods in pouches, instead of having home cooked food. This pattern of feeding continues, with children going on to being fed highly processed foods, such as nuggets, sausages, frozen chips, fish fingers etc. The pattern continues, cooking skills are minimal, nutritional knowledge even less. It is just shoring up problems for the future.

https://www.researchsquare.com/article/rs-3419258/v1

Nine suicides thought to be related to these meds increasing psychiatric events for some people.

I take one of these for diabetes.

really. I think we ought to make sure the evidence is more solid before embarking on large scale use like that.

On an individual basis I can see the appeal and it must be amazing for people to lose weight when they have tried everything,

The whole thing makes me a bit sick though about how society has developed in this world. In parts of the world people have no food and are starving to death. Whilst in other countries, rich Westerners are injecting themselves to get rid of excess body fat from eating too much. A depressing state of affairs.

I think if people actually engage the healthy living type courses are great and effective. I have a relative who has reversed being diabetic over a 9 month course. She's now very low carb and doesn't miss anything, says she's not hungry but has lost quite a bit of weight and taken up more exercise than she's ever done. On the other hand another relative (also pre diabetic, miracle they're not fully T2) has said they'd engage in an online course but they have absolutely no intention of changing their ways. A friend has been told they're pre diabetic only in their 40s and really not that over weight and don't seem to have any intention of doing a thing about it! This is the problem.

• most private health insurance policies do not cover bariatric surgery

• all diets basically have very high regain stats sadly

Indeed
But I think that many people in the west are obese and simultaneously malnourished due to their poor food choices. And I firmly believe it's upf that is driving obesity in most cases.

These threads are always depressingly full of people who don't have a fucking clue that other people's lives are not exactly like their own.

There's a difference between say Jenny who is naturally slim but put on half a stone in perimenopause and Jemima who comes from a family where:

• one side of the family is slim and birdlike and the other have large builds and store fat just by looking at it.

• food trauma started young because it was embedded in poverty and hunger.

• neurodiversity and poor impulse control around food and substances are a thing (dopamine driven)

• the family are living in a time when food is literally engineered to be addictive as fuck and Jemima has yoyo-ed up and down with her weight for the last 30 years

• throw into the mix that Jemima is a working mum with a physical disability and three young kids to care for.

Now tell me: is it going to be easier for Jenny or Jemima to lose weight? Answers on a postcard. I'm quite sure the occasional Jemima manages to shed those stone and OF COURSE she is justifiably proud BUT those Jemimas are the exception NOT the rule.

So is it more cost-effective to support Jemima in losing weight through these drugs alongside a programme of dietary advice and exercise? Or will we just tell her she's a fat, lazy bitch and then spend the next thirty years treating her diabetes, knee replacement, cardiovascular drugs, cancer, blindness and ultimately dementia?

How do you know what level of interest a “normal” person has in food? I am a healthy bmi and always have been but that’s not because I have less interest in food than over weight people. I also get a hit from eating. Pretty much every mammal alive on the planet does. It’s not that slim people don’t like food as much as overweight people, it’s that slim people deprive themselves of too much food or unhealthy food to stay slim. I would love to be prescribed something to make that easier (i.e suppress my appetite) and if overweight people are prescribed it on the nhs then so should non-overweight people if they want it.

What about sports injuries? My dd broke her foot doing gymnastics?presumably thay shouldn't be funded either

Very well put and I couldn't agree more.

I shouldn't open these threads because the attitude of some people makes me despair.

I can’t get it even though I’m overweight and type 2 diabetic too.

Yes. Since hitting the menopause I have had to be so strict with my diet. It is definitely less fun restricting yourself. I tend to be v v careful in the week and have a more relaxed weekend. It’s not easy but I don’t want to be overweight and increase my cancer risk etc. I am in no way ‘naturally’ slim sadly!

I don’t want injections though…

I think that's how slim people normally view food, along with restraint like @Grumpy12345 suggests.
I don't actually think about food between meals but after about 5/6 hours without eating I an hungry and enjoy a meal, just stop when full.

So it sounds like the drug mimics normal appetite and yet there must be more to it if people go back to old eating patterns when they stop taking it.

I was so big for so long that I was actually offered bariatric surgery on the NHS (or rather they suggested putting me on the waiting list for it, but they said I shouldn’t have to wait that long) but I refused it as I was determined to get there by myself. It’s definitely been tough - I have lots of loose skin, am still medically a couple of stone overweight and still crave sugary and fatty foods everyday - but its helped that I had a good reason for wanting to loose the weight ( I wanted to have children).

I couldn’t do it with exercise - I have back problems that make that very difficult, so had to rely on diet alone. I have PCOS and I think sugar is the major culprit for my weight gain ( including “hidden” sugar in carbs) - so I have focused on limiting my carbs like potatoes/bread/pasta etc to one meal a day and also limited my treats like crisps, choc, ice cream etc to again only once a day (or twice if I’m having a bad day). I won’t lie and say it’s not tough- there is still the odd time I can’t stick to it ( feeling especially unwell and need the boost or on holiday and temptation too much etc) but I try to think of them as a day or even a week long blip and then get back on track. You’d think after nearly 8 years of keeping the weight off it would get easier but I’ve had to accept it’s a lifelong struggle for me.

I hope you manage to find something that works long term for you, that you can stick to as well 🤞

How does Mounjaro work?
This medication works by activating two receptors called GLP-1 and GIP to increase the level of incretins – hormones - in the body.
It works by helping your body to produce more insulin when needed. It also reduces the amount of glucose, or sugar, produced by the liver, and slows down how quickly food is digested. This all helps to lower blood sugar levels and HbA1cc*.

The online sites have really tightened up their procedures recently. They’re asking for photos plus proof of ID and have software in place to identify photoshopped pictures and ensures the ID matches the full body shot. They also now insist on letting your GP know. Of course there are ways around it but it’s much harder now than just lying about your weight