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.

This- still I do worry about long term side effects. Will power is safer and cheaper.

No it's not. After a diet the vast majority of obese individuals regain with interest. As others taking it have pointed out its not as easy as move more eat less. This doesn't work in 95% of cases long term as you are in a perpetual argument with your own hormones.

The regain then increases their risk of a huge range of conditions associated with obesity. If your concern is truly about safety theses drugs have been on the market for decades and have a good safety profile. This is the joy of them being a repurposed drug.

I would worry about long term side effects of any drug taken over long periods including SSRIs mentioned above. As a treatment for obesity I think they are great- as a long term strategy to remain at a desired BMI as I said will power or self- control if you prefer is cheaper and safer.

But it's an endocrine condition where your body never goes back to making sufficient GLP1. Do you also think people on thyroid medication shouldn't be on a replacement therapy for life? What about people who don't make enough insulin?

The problem is obesity os a disease which society perceives as a failing of willpower but actually its a endocrine disease characterised by a lack pr production of certain hormones. These need to be replaced.

Not comparable at all. I don’t need money to get antidepressants (other than the prescription fee).

OP, you might be interested in Magic Pill, by Johann Hari, where he takes the medication and explores his own ambivalence. It's less about thinking the individual is cheating and more about thinking we're failing to tackle the factors that make society so obesogenic. I think it is a decent point, and he's clear that it's not blaming the individual who has to make the best decisions they can in the society they live in.

I worried more about the long-term effects of obesity, which are well known and undisputed.

”Will power is safer and cheaper” is a facile comment.

I think for obese people it's a game changer and hopefully can solve a lot of problems. I can understand people though who think it's unfair that people who are slightly overweight but have plenty of money can access it. The rich can use an injection a be thin the rest of us have to work really hard at it and still not be thin. Also the celebrities, Influencers and woman who claimed to love their bodies and are so proud to be curvy etc are now on it and have conformed to the 'you must be stick thin to look good and be happy '. So many of the celebrities look skeletal and have aged terribly. So yes it has it's place but this notion of celebrating all different body types could be a thing of the past.

Cheating isn't a word I'd use but I don't know what word would use.

I say this for my weight loss and my weight loss only. It wouldn't work for me. It would be a plaster. It wouldn't help me change what I need to change. The minute I stopped it I'd regain because my issue is portion control and the minute I could fit more in I would and I'd pile it back on.

Lots of my friends are using it and they are losing weight quicker than I am because they can feel full eating less. I am secretly jealous at times that I'm not losing as much but I'm not losing as much because I'm eating more calories so the only person I can be cross with is me.

This is an interesting post, and it sounds like you know more about how these drugs work chemically than I do.

However, again , (it is my understanding - correct me if I’m wrong- that) these drugs work by regulating blood sugar and digestion , such that a person feels full quicker when eating and stays full longer . This means the person is not as hungry and does not feel the urge to eat.

This is how the drugs work to support weight loss - they do not work to support weight loss by changing mental health / mood (eg stress, anxiety and depression ) and therefore moderating eating through mental health regulation . (This is regardless of whether they also act on chemicals in the brain).

These drugs also treat diabetes through GPL1 / blood sugar control , but we do not say that diabetes is a mental health disorder , requiring mental health treatment - regardless of the fact that GLP1 receptors are also found in the brain.

Speaking as someone with an anxiety disorder and clinical depression, SSRIs are extremely effective for me in improving my mood, by regulating release of serotonin in brain. They have changed my life and transformed my mental health. however, they do not impact my eating behaviours .(furthermore, SSRIs have been associated with weight gain).

Meanwhile, mounjaro does not help my anxiety and depression- if anything I have been questioning whether it has been affecting it negatively (I know this is just my personal experience, but there is plenty of evidence for this as well). I think it’s massively premature to suggest that there’s strong evidence that these drugs are going to be found effective as a treatment for mood disorders . i think some people are getting massively ahead of themselves there . But I may be wrong of course!

Nobody is saying that “eating and mental health are not linked” - mental health is linked to almost everything . however, we really do need to get away from this narrative that obesity is usually/ primarily a psychological/ mood disorder (addiction, stress, sensory seeking, comfort eating). These drugs very much demonstrate otherwise; they have shown us that obesity for many (/most?) is caused by hunger/ appetite which is a function of blood sugar and digestion, not mood .

Eating in response to hunger is not psychologically disordered, but a normal behavioural response to a physiological stimulus.

I've read a lot of this thread, not all but a lot and the conclusion I've come to is that I don't care if you think I'm cheating.

This morning I stood on the scales and my weight started with a 12. I have not been in the 12 stone range since before I became a teenager. I'm 41 years old, I've been obese since primary school and today I'm overweight and only about a stone off of the Healthy BMi range. I've tried every diet and weight loss group known to man and none of them have worked till Mounjaro.

So judge me for being a lazy cheat if it helps you make you feel better. I'm feeling just fine about myself and my choices.

If you alleviate or cure any signficant medical issue, be it obesity, or bad toothache, the patients mood is enhanced by default. Obesity is not something anyone loves, let’s face it, it makes us unhappy at our core. When we start to get slim, don’t feel the awful hunger, we feel happier.

that doesn’t meanthese drugs are mental health drugs , or that all fat people are mentally ill. The fact they are diabetes medicine and shortly to be approved for cardio vascular and kidney disease should give the rather Ill informed poster pause for thought. in her odd rhetoric. I’m not even sure why we’re all dignifying something so daft with a response.

That's interesting, thanks. WHO agree but like a lot of people here caveat it's multifaceted so include the causes as environmental influences such as the availability of unhealthy foods and limited opportunities for physical activity, as well as psychosocial factors like stress or emotional eating.
WHO agrees genetics also play a role, as do some medications, diseases and a lack of early intervention.
Armed with this knowledge, I would say I agree with jabs (I never didn't, actually), but as part of a package which starts with good nutrition in childhood.
I'm not one for fighting btw, I view this more of a debate. Malnutrition does a much damage so I think it's important to do what WHO says regarding eating from both ends of the spectrum.

Why do you think that? Why are you so bitter about someone using medication to turn their life around?

There are some utter bitches on this thread. I honestly fail to understand how some people can't just be happy for others without the "you shouldn't take it as you will put the weight back on one day" or "I (faux) worry for your long term effects", or the whole "I suffer so everyone else should too".

Why? Why are you so bothered about other people leading a better life than they were? What is wrong with someone like me using a medication that makes my life better.

I don't need money to get mounjaro, other than prescription fee (well, pre paid cert). Along with my anti depressants and blood thinners.

But what about the antibiotics I got from a private GP last month and thus paid for outside of prescription charges? Do they not count as I had to pay for them?

Next argument.

Most GP’s aren’t handing it out for free. Blood thinners and medication are not comparable to people buying weight loss injections when they do not medically need to. Are you deliberately being obtuse? Next argument 😂

No, I'm not.

I'm asking if a private prescription means a drug shouldn't be given? The fact that it is hard to get on the NHS is much more down to the fact they don't have the man power to deal with so many requests / follow ups than it is that they don't want people getting it.

Very few people using it are lying to get it - yes, some are, but the majority do medically need it.

I think you need to spend some time thinking about why people taking a drug that helps them upsets you so much. Why are you so angry about someone like me taking a drug that has been truly life changing? A drug that seems to be allowing me to actually function 'normally'? Why are you so bitter that I am also losing weight? Why so jealous of other people losing weight?

You are absolutely correct regarding the mechanism of action of these drugs I am not debating that.

The point I was making is that behaviour in general including feeding behaviour and mental health disorders are not exclusive. Classic neuroscince considereted the brain to be a bunch of different regions each with a single function. However this overly simistic model is not widely accepted any more and while we may talk about a memory centre for example I do so out of simplicity because it is actually for more complex. The brain is a large circuit all interconnected. So your feeding centres don't receive input just from the periphery they also receive input from your fear circuits, memory circuits, circadian rhythm circuit ( internal body clock). Feeding behaviour is not as simplistic as modulating insulin and glucose levels.

In the brain this drug dampens dopamine. Dopamine in the reward centre of your brain is the part of your brain that makes you happy. It gets raised in response to food more so high sugar fat food. It is also the part of your brain that mediates addiction. This drug stops those highs. This reward centre indirectly targets the feeding centre via a relay circuit. My point is it is not as simple as saying obesity and mental health are distinct, every aspect of behaviour is interlinked.

I also don't think obesity is caused by depression or vice versa. I actually think all behaviour is endocrine ( but I am an neuroendocinrologist so I would say that). Hormone receptors are expressed throughout the brain and mediate pretty much every aspect of behaviour. Let's take SSRIs as the example. The mechanism of action of these drugs is still up for debate but a recent paper showed if you sever the nerve that goes from the gut up to the brain you eradicate the effect of the drug. Essentially saying the effect of SSRIs is mediated exclusively in the gut. In fact the widespread effect of these drugs without a definitive clear mechanism of action ( if it was a simple as they increase serotonin the drugs would work instantly rather then taking days to weeks to be effective). 90% of serotonin is made in the gut where there are widespread receptors that mediate a whole range of effects. The vegus nerve and the gut in general mediates alot of its effect via hormones.

I will confess my knowledge on the gut brain axis is limited however the emergence of the gut brain axis as a field of research and the role of the endocrine system in this highlights more so that in medicine we need to stop looking at things in isolation and look at the whole system to understand what is going on.

Are you actually worried though? I don't think so!

Are you also worried about long term effects of, Viagra for example? Or when the revolutionary AIDS drugs were developed did you worry about them too?

Willpower to you and willpower to someone else are completely different things. Just like some people have easy childbirth and some people end up in intensive care . Our bodies are different, our minds are different.

I have said on this thread already that the only way I lose weight at my age is by eating 1000 calories a day. I did that for a year and without Ozempic I really wouldn't have been able to do that. I tried to lose my menopause weight for 8 years, exercising like a demon, dieting, denying myself absolutely everything but nothing worked because I can eat so little now.

Cheating means to act unfairly or dishonestly to get an advantage.

so clearly as long as no one is lying to get the drugs, then they are not behaving unfairly or dishonestly.

however those of us on them, do have an advantage over all the apparent self declared miserable as fuck struggling slim people taking issue on here. We can take the drugs, be slim, not feel deprived, and they need to keep struggling and being miserable as sin.

so sure, do we have an advantage over them, arguably yes, especially if we go for maintenance as many are and staying on a low dose for life. Have we unfairly or been dishonest to get that advantage no.medical science has given us it.

so the tables have turned. That’s the issue. These not naturally slim folks who struggle and are miserable,will need to continue to be, miserable and struggling, and they will no longer even able to be smug or feel superior to the fatties, where as us fatties, will now be slim, not feel deprived, not have to struggle like them and can look at them with their struggles, and feel sad for them.

I’ve literally said people who don’t medically need it! People paying any old online pharmacy that charge a hundred quid per month without any medical exam. I’m not talking about people who have been prescribed it 😂 you really are being obtuse.

I am asking whether you consider ALL private prescriptions the same? Are you suggesting that everyone getting it prescribed remotely don't medically need it? Or are you just upset that a tiny fraction of people lie to get? Just looking for clarification here.

I think it's similar to the kind of mindset that "I didn't have any help having children so why should I give up my time" and "these gen z crying about housing - we had interest rates of 15 million percent".....

People are just bitter about someone getting things "easier" than they did.

I can't get my head around actively wanting someone else to have a shit experience if you know what it feels like yourself - why?!

And all this fake "I just worry about side effects" BS - why do you, they're not happening to you. Just be honest and admit you're jealous/bitter/other relevant horrible thing

Ffs can you read? People. Who. Don’t. Medically. Need. It.
people who choose to get it just because they want to easily lose weight. Not for medical reasons. Jesus. I can’t make it any more obvious.

how are you not getting that?

The medicines and healthcare products regulatory agency ( MRHA) is the bristish equivalent if the FDA. This the goverment agency that asses clinical trials and detemrine is a drug is safe and beneficial within a population for treatment of a disease. The MRHA have set the prescription criteria for maunjaro to be a BMI of over 30 or a BMI of over 27 with a weight related condition. In this population the risks of side effects from the drug drastically outweigh the risk of continuing the be obese or in the case if these clinical trials recieving dietary and exercise advice. This is the criteria that private pharmacy's are using to privately prescribe a regulated drug.

NICE is the body that sits behind the guidelines for the determining what treatments the NHS can prescribe. One of their key calculations will be cost benifit. Currently they have decided that a BMI of over 35 with a health condition is where the cost benifit lies. This has nothing to do with the risk of side effects it is purely money based. Ie how much the NHS are willing to spend on this disease. This has nothing to do with side effect or risk.

As these drugs get cheeper they will be far more widely prescribed but the current role out is expected to take 12 years. I don't really want to wait 12 years for my health to worsen for me to qualify based on a health condition ( my BMI was 34 so only needed to gain another stone and develop a health condition which woukd be probable in 10 years). So I paid for a private prescription which still needs to meet the MRHA criteria and needs to be assesed by a doctor.

Are there some people getting these drugs outside of this criteria? mabey, but the vast majority are within the criteria and taking a life saving drug now rather then waiting 12 years for the NHS to have the manpower to roll it out.