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.

Yes - it’s because it acts on the hormones and whatever other physiology that causes disordered eaters like me to eat as we do.

I now feel I eat more like a normal person- the person I was before the events that triggered my comfort eating to commence. Do I get hungry and am I ready for my meals - yes. Do I now feel when I get hungry - pain, distress and like my body is hollow and that my brain will literally scream at me to keep until the hollow is filled - no

so yes once you stop the meds which change how you react to hunger I guess old behaviour can just come back

I agree but I think it does need to happen alongside lifesfyle changes, which are hard to achieve. I am 6 stone overweight. In January I began crossfit classes and running.

I have kept up 3 classes a week consistently since then. In June I started WL injections. I have remained on the lowest dose but have lost 2 stone in that time. It is coming off quickly but I think the fact that regular exercise is ingrained now will help keep it off if I have to stop. I have also changed what I eat and the hope is feeling fuller on healthier foods will also remain.

I do feel it is unfair that I am able to achieve this because I can afford to pay for it. I think once you get to tier 2 wl management on the nhs it should be offered.

No, the best way to lose weight, and keep it off, is to change your eating habits/lifestyle.

All drugs can have base side effects, and the NHS shouldn’t be funding it on demand anyway.

Aldo - other than the costs at the moment I wouldn’t be too fussed at remaining on it long term. If you frame it as a drug to treat a health problem then why not. I have recently been diagnosed with a couple of conditions that require lifelong medication. I would rather that than suffer unnecessarily

Absolutely it is. WL injections support people to do that.

The problem is, food companies want us to be addicted to food so will keep finding ingredients which makes it hard to quit. Pharmaceutical companies want us to be ill - lifetime chronic illness (so we’re unwell but not dead) is what is driving their profits. And these food and pharmaceutical companies have so much influence over our university research centres (paying for “studies”), our media and our politicians that society doesn’t ever really stand a chance of becoming healthy.

I don’t know how that loop is broken, unless the government really to want to change things and bring in much stricter regulation of these industries.

Going to preface this by acknowledging that if I read what I'm about to say at my heaviest I would have been full of excuses and "it's easy for you to say that.." but it's important to note they were definitely excuses. I say this as someone with a disability and an exhausted parent of ASN children (those were my excuses at the time!):

I'm someone who stayed morbidly obese for a long time. At my heaviest my BMI was 44 and I weighed 244lbs which given I'm short really wasn't good. I had a health scare myself last year and rather than wait for the NHS to give me injections etc I gave myself the kick up the arse I clearly needed. I stopped with the excuses and sorted out my diet. I'm 300 days into my weight loss and down by 81lbs and I'm still going. Another 28lbs to go but it's doable. I feel a massive sense of accomplishment that I wouldn't feel with an appetite suppressant. I feel less of a drain on the NHS than I would if I'd had to use an appetite suppressant. Ultimately the biggest appetite suppressant should be the reality of risk we are putting on our own lives by remaining obese, if that doesn't suppress your appetite then as others have said it's time to look at the actual root cause rather than sticking a proverbial plaster over the problem.

No they don’t. They just enable people to carry on eating the same crap( just less) alongside getting zero exercise.

"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?"

If you're genuinely interested in trying to answer this rather than in rhetoric, then the analysis based on current evidence and current drug pricing suggests that if she already has a weight related comorbidity (and taking into account other factors such as BMI and ethnicity) then it is more cost effective, but if she doesn't then it's not. Which is why NICE have recommended reimbursement for these drugs in patients who satisfy certain criteria, where it is predicted to be cost effective, but have not recommended it for a broader population.

I think the NHS knows more about the pros and cons on this than I do. Although I also agree it is very poor at preventative medicine (but then obesity rates are in fact proof of that, and this medication will not treat people at risk of becoming obese, it will treat people who are already obese, so more proof of failure on the prevention front…). In all honesty, given rates of obesity, which have gone up massively in the last century, you do really seem to be asking for the NHS to deal with a problem that should not have arisen in the first place, rather than dealing with the fact that something is causing burgeoning rates of obesity (often accompanied by malnutrition in poorer sectors of society). It’s not just overeating that is causing an obesity epidemic, so imvho, it’s not just drugs that will cure all associated health problems caused by an obesogenic environment and it is dangerous to give the impression that a drug will make everyone slimmer, fitter, healthier and live longer. Too often, people look for medicine as a cure, not an aid. I can very much see the NHS letting lots of people stay on medicines for a long time without helping them to make the other necessary changes to their lives and thus not fixing the real problem, just medicating lots of people.

Just to add that of course no-one should be calling anyone a fat lazy bitch - this should go without saying but as this is MN I expect to be jumped on unless I say so explicitly. But it's a straw man argument to suggest that the only options are 'fat lazy bitch' or weight loss drugs.

if someone wants to just eat crap and do no exercise on these drugs they will not work. They do not burn fat. They remove all the food noise, hunger, and the hit from food which makes it easier to eat healthy food and maintain a calorie deficit

I don't have personal experience but the posters on the MN injectables board often say that they find it easier to eat healthier: they're not just less hungry, they're less vulnerable to the specific call of terrible food: cronuts, dirty fries, Frappuccino's with whipped cream or whatever.

More able to say "I'm finally hungry today, I need food, I'll eat actual food."

No, non-overweight people absolutely should not have access to this.

These injections are not for people who have a little trouble keeping away from the biscuits. They are for people who are unable to do what you find a bit difficult. If you are able to keep your weight in check with a bit of effort, you don't have a problem you can't manage without drugs.

If you were given a drug that is designed for people who are obese, not just carrying a bit extra, what do you think would happen?

From what I understand, the injections work as appetite suppressants. That's fine when your appetite is constant. But suppressing a 'normal' appetite, which is what you actually have, even if you don't think you do, will result in dangerous under-eating.

This attitude to it is what frightens me about the prevalence of this drug on the internet. It's not a 'cheat', it's a medical intervention for a serious health problem. It needs to be prescription only, shouldn't be obtainable by filling in an online questionnaire alone.

This is where getting it on the NHS would be good. It's a drug. Like all drugs, its availability should be based on 'need', not 'want'. The NHS is less likely than a private company to hand over a drug you want, but do not need.

I am very concerned to keep this out of the hands of people who want it but don't need it. The potential effects of such a drug on people who just don't want to have a menopause belly could be catastrophic.

How does it make it easier to eat healthier food if somebody eats shit to the extent it is killing them. Those eating high processed diet, high fat, high sugar diet aren’t going to suddenly switch to a diet high in veg and low in sugar and fat. Nibbling on 2 chicken selects as opposed to 10 isn’t going to reduce your cholesterol.Your % of bad fat will be the same. Your risk of cancer isn’t going to change if you eat the same processed food but just less.

I’m at the high end of a healthy weight and my cholesterol is just in undesirable. I’ve had to cut out full fat milk in my coffee and butter on my toast. Not being obese doesn’t make it any less desirable.

The cancer inducing food companies must be rubbing their hands in glee. They’ll be pedalling the same cancer inducing crap in smaller packaging but charging the same. They’ll actually make money from these jabs.

The majority of people are not overweight due to food trauma or neurodiversity.

So it’s a choice then? People are perfectly capable of cooking real food but they choose not to. I thought it was an addiction?

If it’s a choice they should be doing it themselves and not just have the NHS drained to do it for them whilst the MH services that could treat the origins of it have nothing.

Just no for so many reasons.

I don't want to offend anyone. But it offends me that there are so many hungry people in the world, and people with no access to clean water, sanitation, vaccines. People can't get treatment for serious lifelong illnesses, cancer or childbirth complications. Children die of entirety preventable disease every day.

And here we sit, unable to control our compulsive eating, greed and bad choices, expecting precious healthcare resources to be spent this way when we have so much already.

I'm aware, been through surgery last year. Vitality has now changed their restrictions to a 3 year wait which will unfortunately push more people to go abroad.

Your logic maybe, but not mine. It's called ACCIDENT and Emergency for a reason.

It offends me and the carbon footprint too of the plastics, manufacturing process, being flown from China….. no no no

Better MH services, access to fitness and food education please.

You have done incredibly well. That is absolutely brilliant!

I would say that, as human beings, we are all different. Let's pretend there are no physiological factors at play in the development of obesity. Say it's ALL about psychology - about motivation and will power. Why is it a failing if someone doesn't have the requisite motivation and will power to lose weight? We aren't clones and we all have our unique genetic makeup and life history. Am I a failure if I can't overcome anxiety/depression without medication?

If every GP surgery was like that then there may be less problems overall. You are INCREDIBLY lucky. You do realise that the vast majority of GP surgeries are not like that?

At mine it’s a 5-6 week wait to be seen by a nurse practitioner who then tells you there is nothing wrong with you.

Well it makes it easier for me, with disordered eating!… I can’t explain it any better than I did above. I no longer get a “hit” from eating food. I did before, I got a “rush” from eating something like chocolate or crisps etc and the rush would make it harder to resist eating more of it.

now I don’t get the hit I don’t crave the sugary or fatty stuff. I don’t eat to make myself feel better but just for fuel and because I know I need to eat still a certain amount of calories. Because I no longer get a hit I can more easily choose the apple over the doughnut or the grilled chicken salad over a creamy pasta. Yes I could have chosen those before but when you have your hormones and the other physiological forces at work it’s extremely difficult to overcome. Same as an alcohol abuser (I was one of those too, now long term sober) still makes the choice on some level to buy and drink alcohol when they could choose not to. The addiction/compulsion takes over. Does that make any sense? I think if someone comes at it from the perspective of a “normal” eater who does sometimes eat unhealthy things or occasionally overeats it’s not the same as for a compulsive eater. Same as someone who can have a glass of wine and then leave it doesn’t come at it from the perspective of an alcoholic.

Again though, some attitudes on this thread just demonstrate that in some people’s eyes, whatever fat people do is wrong.