People who think weight loss injections are cheating

[AuntieDote]

I've seen this viewpoint over multiple threads recently, and I'm just really curious to understand it a bit more because it makes no sense to me whatsoever.

What do you think people using the injections are cheating at?

As in - what's the competition and who are they gaining an unfair advantage over? What do you think the rules of being allowed to lose weight are/ should be?

Is it more important to you that overweight people/ those struggling with obesity lose the weight, become healthier, reduce the burden on the NHS, stop taking up more than their allocated amount of space in the world, or just stop doing whatever it is that upsets people so much about the existence of fat people -- or is it more important that they struggle and suffer whilst doing so?

Or would you secretly prefer them to remain fat so you can feel superior?

Is it that you feel you've worked really hard to either lose weight, keep it off or never put it on in the first place, so nobody else should be allowed to achieve this without the same amount of struggle?

What do you think the weight loss injections actually do, and do you not recognise that those on them are also doing all the usual things people who are trying to lose weight e.g. modify their eating, exercise etc? Does it not count that they're doing these things because it's made easier in some ways by the drug?

What types of weight loss support or tools are not 'cheating'? e.g. I used hypnosis once and it worked for a bit, to the point that I felt pretty much the same way I do with the injections i.e. reduction in food noise and compulsion to snack etc. It didn't last anything like as long, but it worked for a time - was that cheating?

Would it still be cheating if they weren't as effective as they are?

FWIW, I really couldn't care less if people think I'm cheating - who cares? Who does it impact only me and my bank balance? If someone said here, press this button and you'll be a healthy BMI overnight and stay there forever I'd press it with both hands and not give a shit about how anyone felt about it.

But it's just the logic of it that baffles me - I've never seen it as a competition and have never felt like getting to or being a healthy weight only counts if it's done in a certain way - I suppose I'm not much interested in what size anyone else is or what they do to get that way, so I can't imagine for a second ever thinking another person was 'cheating' - only ever being happy for them if they're happy and hopefully healthy too.

I think the opposite... it is kind of a mental health drug because it's stopping the mental "food noise"
Yes it works biologically but so do all mental health drugs! For example drugs that combat depression by boosting serotonin. Mental health and physical health aren't totally separate things. To me the effectiveness of this drugs shows the mental health issues around obesity because this drug doesn't magically melt away fat ... the person has to do all the work you would have to anyway.. it's just much easier to do because the craving to binge eat isn't there. Which shows you there is a psychological aspect to it.. it wasn't just a case of choosing not to do the work.. it was a case of psychologically being unable to do it and this drug has got rid of that issue.

That's like saying anti-depressants are cheating and people should just cheer up.

You still have to count calories.. in some way. Even if you aren't literally counting them you still have to have basic awareness
Some foods will fill you up more than others.. so you can have a high volume of low calorie foods but you can also have less filling foods that are higher in calories. So you still won't loose weight if you eat high calorie foods that aren't filling. Because you'll still be consuming more calories than you need!
It's just a tool to make it easier to stick within your calories.
But it won't work if you literally only sit there eating cream and haribo all day long. You won't be able to eat as much if it as you used to but you could still easily go over your calories if you don't at least keep a vague eye on it.
So no you cant just eat whatever you want on these drugs. You can in moderation. But yes there are ways in which they might not work because you aren't keeping enough of an eye on your calorie intake.

I’m taking mounjaro and I’m strictly calorie counting. The drug has made this possible. I would have given up by now without it (and had done just that many times in the past). It’s not easy but the drug has made dieting easier and possible.

I see what you mean and but nonetheless I think it’s seriously weird to argue that mounjaro is a mental health drug - and I’m not sure any doctor / medical professional/ scientist would classify it as such?
eating because you are hungry is not a psychological illness or mental health problem (and it’s not an addiction or sensory/ comfort seeking as you claimed in your previous post) it’s a normal behavioural response to a physiological stimulus- like scratching an itch.
If someone scratches themself because they have chicken pox, do you call that a psychological issue? And if there are creams that relieve itching do you call that a mental health drug??

No scientist will agree with you. It manages insulin, blood sugars, is a hormone which we have anyone, which signals fullness and also slows digestion. It isn’t a mental health drug in any way. No more than paracetamol or nurofen is, or a blood pressure medication.

Right

Actually scientists do agree with this:

Conclusion: In the SURMOUNT-3 trial, adults with obesity or overweight treated with tirzepatide experienced significant improvement in multiple domains of general mental health and weight-related psychosocial function vs PBO after intensive lifestyle intervention.

https://diabetesjournals.org/diabetes/article/73/Supplement_1/1676-P/155807/1676-P-Tirzepatide-Improved-Mental-and

I don’t think that means that it’s a mental health drug.

Rubbish - if the drug is shown to impact mh positively and is then prescribed for it, it will be considered a mh drug (what ever that is!).

My GP prescribes a medication to my son for migraine management. One of its observed benefits is that it also improves anxiety, so it is often prescribed where anxiety is comorbid with migraine (as is the case for my son). You’d probably say its not an anxiety medication (or ‘mental health’ drug), but clearly my GP would disagree with you.

I entirely disagree with you . What is your basis for claiming that mounjaro is prescribed for mental health problems?

A study showing that taking mounjaro can have a positive impact on mental health does not make it a mental health drug. Of course if mounjaro helps people to lose weight it is likely to have positive mental health outcomes.

Hormone replacement therapies have positive mental health outcomes - do you therefore consider HRTs mental health drugs that are prescribed for mental health problems?

I'm on saxensa and have lost 1.5 stone in 3 months, I'm eating roughly 1300 cal, thing I can't figure out is I also did 1300 calories forn2 mths prior to getting saxenda and lost 2lb, yet saxenda only suppresses your appetite, as far as I know there's nothing else in it that will help you lose weight, yet I'm losing weight and I couldn't before I took the injections, can never get a straight answer about it Anyone know?

Also note having an eating disorder is a contra- indicator for being eligible for weight loss injections.

Look, there is no such thing as a ‘mental health drug’. There are drugs which treat the body and have beneficial impact upon mood regulation etc. They do not treat ‘mental health’. So you are talking rubbish.

There are drugs which treat the symptoms of depression, anxiety, OCD, etc by rebalancing hormones and neuro-transmitters by stimulating or inhibiting them. I.e. they are working on biological and chemical dysfunction which can manifest as low mood or anxiety or other behaviours that the lay person may call ‘mental health’ [ironic as they/you mean mental ILL-health]. Many of these drugs were initially formulated for other ailments but the longitudinal studies revealed additional benefits to mood regulation, etc. Consequently the majority of these drugs were not initially licensed for prescribing for MH conditions, though it is perfectly legal for consultants to prescribe them off-label for this purpose (eg migraine meds that treat anxiety, as previously mentioned). They often later come to be licensed for this purpose.

It is very likely that in time these medications will come to be prescribed specifically to help patients with low mood, etc where it co-exists with weight problems. At the moment the extensive evidence is that many individuals taking these medications experience improved mood, reduced anxiety, improved ADHD management in addition to/in correlation to weight loss/management. There will absolutely be clinicians who, being aware of these benefits, will be choosing to prescribe them to patients specifically over other weight management medications because of the additional benefits. I know this because the prof of endocrinology who treats myself and my DS specifically selected this treatment route for my AuDHD/clinically anxious DS on this basis and liaises with Ely Lilly directly as part of the protocol.

But feel free to continue to disagree.

As far as I understand and I’m no medic, if you were insulin resistant before it would have been really hard for you to lose weight. The saxenda helps with the insulin resistance which allows your body to process food better.

So you are talking rubbish
But feel free to continue to disagree.

there is really no need to be rude- your tone is unecessarily superior.

I do disagree. In some sense you may be right that quibbling about what is a “mental health drug” is a somewhat semantic issue.
But I think it’s seriously problematic to conclude that just because studies show that a medication can be associated with positive mental health outcomes, that therefore means that the underlying pathology it is treating is a psychological one (which is the claim that was made by a pp that I was disputing- which resulted in this exchange). All kinds of medical interventions may be associated with positive mental health outcomes with both direct and indirect causes. That does not mean they are necessarily treating an underlying pathology with a psychological cause.

Furthermore, the impact of mounjaro on a range of mental health outcomes is by no means conclusive - the evidence is limited and also mixed, and as it stands having psychological issues with food / disordered eating is a contra indicator for prescribing the drug.

(Also I consider this to be an extraordinarily bold claim- “It is very likely that in time these medications will come to be prescribed specifically to help patients with low mood”)!

fairycakes

It's because Mounjaro (and I'm going to assume Saxenda which you're on) are NOT weight loss drugs

Weight loss is a side effect of all these drugs

Instead they're HORMONE REGULATING DRUGS and that's why your body is losing weight on the same 1300 calories

This is why threads like this drive me nuts all these twats going on about cheating and 'eat less', exercise, people eat too much, they're lazy etc etc

Nope, it's my hormones and my peri menopause, and my height- not because I'm troughing chocolate all day you fuckers

Should have added :
“All kinds of medical interventions may be associated with positive mental health outcomes with both direct and indirect causes. That does not mean they are necessarily treating an underlying pathology with a psychological cause.” - or that they will be prescribed for that purpose in the future !

This is a great post.
Feeling hunger and responded to it by eating is not a 'psychological issue'
It is not treated by therapy

Tirzepatide treats it.
Obesity is a medical condition, now with an effective treatment.

And that's all there is to it. Whatever some posters think!

But some people think that too, more or less. Unfortunately.

Obesity is a medical condition, now with an effective treatment

Right. This medication demonstrates that obesity is very typically a physiological condition related to the physical and chemical processes of the body , and can be reversed with a drug that addresses these physiological issues.

Why are you?

I lost 7 stone the 'hard' way. No drugs or surgery. I make no judgement about people who use drugs or surgery. The important thing is that you become healthy. Whatever way. The only thing that bothers me is if you go down that route you are perhaps less likely to address the issues as to why you are overweight. And you really need to do that if you want to avoid putting it back on again. Drugs, surgery, exercise however yo have done it.

I say this as someone who is on these drugs and completly pro their use but I disagree that these aren't metal health drugs ( I'm taking that term to mean something that targets mental health disordersor aspects of the brain involved in them)

I think trying to say eating and mental health are not interlinked is wrong. The rise in our understanding of the gut brain axis is huge. We now know that gut hormones regulate a huge range of behaviours outside of just feeding.

In general the brain uses something called the blood brain barrier to keep a variety of things out of the brain. So when we are looking at developing a drug to treat something in the brain the first 2 things we look at are

1. Can it cross the blood brain barrier? Both the endogenous GLP1 and the drugs designed to mimic it ( maunjaro) can cross the blood brain barrier.

1. The second thing we look at is where the receptors are expressed so what part of the brain has the ability to recognise and react to these drugs. GLP1 is expressed in our feeding circuits but also those that underlie memory and fear processing. These memory and fear processing centres are highly highly implicated in depression and anxiety.

I disagree with the concept that you should have the will power to overcome this. GLP 1 is truncated in obesity so actually our body doesn't make enough of it. This impacts on mental health and stress eating is a commonly seen issue in obesity which is alleviated partly by modulating blood sugar but also by affecting the neurotransmitters that affect mood.
In short these drugs are being investigated for use in mental health disorders alongside neurodegenerative diseases like alzheimers and parkinsons disease ( where depression and anxiety are sometimes one of the earliest symptoms). They do act in the brain and have a profound effect.

SSRIs are the most commonly used "mental health drug". Did you know they were not developed for the treatment of depression but actually as a treatment for TB. They were administered to patients and whilen the drug had no effect on the disease the patients were happier. Hence the emergence of modern neuropharmacology. Off target effects of drugs are so common place that their is a specific pathway that drugs ready on the market go through for a repurposing of a drug. So it being a mental health drug is probably no different to us considering SSRIs as mental health drugs.