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.

No, because the jury is NOT out as to whether they ‘cause’ pancreatitis. The evidence that clinicians follow are that in the absence of contraindications, such as gall stones, there is no significant increased risk. Certainly, the prof of Endocrinology with whom I discussed this specifically before agreeing that he could prescribe it for my 16yo was pretty adamant that tirzepatide/mounjaro is totally safe. He cited the following, to which I attach more value than journalistic articles produced by the ABC.

I don’t expect you to agree, in fact I exhort you not to reply to me in anyway. I am simply attaching it for anyone becoming uneasy by your unfounded claims.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10613702/

I am absolutely convinced that people think using WLI is cheating (and try to undermine and make us feel bad) because they are afraid of their pretty/slim privilege having to be shared with more people and therefore losing some of its value. I cannot wait to be slim!!! Health benefits + plus a better chance at a speedy recover from the hip replacement I will be having next year..... but also to test my theory that I have been held back all my life for being fat, particularly in the workplace.

Sorry: she looks unhealthy/sick like her coactor in Wicked. They both descended on a weightloss journey during the making of the film. I used to look like a bag of bones when younger due to an eating disorder. I didn't see it then ofcourse. When you're in it you're delusional. It's a horrible disease.

When it's prescribed by a GP it's obviously a good thing. It can work miracles for people having struggled all their lives and it's also a gain for society as a whole with less obese-related illnesses taking up the NHS. And then we got the likes of Sharon Osbourne giving Ozempic a bad name.

So, because some random actress is gaunt and emaciated - for whatever reason and likely completely unrelated to WLI because even in the US prescribing them for a non obese patients is illegal - we should be concerned about young people obtaining medications that support the clinically obese in losing weight and managing/improving their health?

So much to unpick there. But essentially the inference is that obese people should continue struggling because a tiny number of young people might develop EDs because they are obsessed with anorexic celebrities?

Some one up thread posted that after a year people that stopped using it regained 15% of what they had lost. I went and looked this up and sadly it is actually 15% of their total body weight that they will regain or 2/3 of what they had lost. Only about 10% will be able to maintain without continuing.

I thought for a long time about whether I wanted to carry on after reading this. But I have been fat for ten years since the birth of my third child so I think this is my only chance. I have regained the weight from the one successful diet I have been on about four years ago (though I never made it to a healthy weight) and now I can't even lose.

People saying eat less and move more. Well that used to be me in my 20s and 30s. I have the photos to prove it! Now if I go on a diet (even quite a moderate one) I will be woken at 4am by severe hunger pangs and only be able to get a few hours sleep. This is even happening to me on mounjaro now the first few days have passed.

but that’s fabulous; it means a ten stone woman will regain 1,5 stone max. Likely less as it is up to 14 percent.

where as on every other diet they regain 100 +percent of what they lost.

no one is on the drugs unless they are obese, so most people will be losing up to five stone, many more, many less. So regaining a stone or so is a fabulous result.

@NonVedoIlMare not sure what research you looked at but recent research indicates much longer weight loss maintenance (attached)

Key Findings

• One in four patients who started a glucagon-like peptide-receptor agonist (GLP-1) medication at a BMI of 40 or higher doubled their weight loss one year after discontinuing semaglutide or liraglutide.
• Two in three patients who lost at least 40 pounds on semaglutide or liraglutide maintained or continued their weight loss one year after discontinuing the medication.
• More than half of patients who were prescribed semaglutide or liraglutide for at least 90 days were able to maintain or continue their weight loss one year after treatment.

Study looks at over 60k users and shows that if obese patients (BMI 30-35) who lost over 40lbs 56% kept it off for over a year and when the obesity level increased to level II and III (BMI 35-39.9; or 40+ respectively) this rose to 55% and 62% keeping it off (and, in a number of cases, continuing to lose). There is a bigger study looking at 440k WLJ that shows the same 56% average across all obesity scales.

This compares to just 5-20% of traditional dieters maintaining all/nearly all their weight loss (depending on which research you look at.)

https://www.epicresearch.org/articles/patients-with-higher-initial-bmis-and-greater-weight-loss-while-on-glp-1s-most-likely-to-maintain-or-continue-weight-loss-after-stopping-glp-1s

I suspect in all these averages, there are some people who do keep it off or carry on losing, and some who put it back on. I'm finding it relatively straightforward to maintain my weight after stopping, I would struggle to lose anything, but maintenance seems more doable, and also they know they can return onto the medication at least within the year if their provider allows for it, mine would allow me to restart without going through the whole process again.

For some, maintenance doses of the drug will work, for some maintenance calorie control will work, and for some it won't work, but I don't see the rationale for continuing being obese unless it knackers in your metabolism more by losing and gaining, for which there's no evidence at this time point.

Someone said- I'd want 50 years of evidence to know the long-term effects. That's most of an adult lifetime and almost nothing you are currently using would meet that criteria! I mean staying obese for 50 years to wait for the data will surely be more risky!

not really sure that its fair to make upf more expensive just because some people lack control?

yeh but they weren't all always doing that were they or they wouldn't have got themselves to a point where they need medication to help them lose weight

if the input is less than the output how exactly are they not losing weight?

Yes, I gained weight going to the gym 4 times a week and eating 1500 calories a day. Menopause had changed my metabolism- I only use up 1300 calories a day these days.

My horrific, greedy overeating that caused weight gain was what many people would eat to lose weight.

We are all different.

I haven't heard anyone say it cheating. I have heard people say they worry about long term use and if the weight will go back on if you stop.

FFS - YES they were doing all those things, which is why they are frustrated that they gained weight. Because the point is they were not making enough of their own GLP1 naturally so no matter how little they ate they did not lose weight because ‘calories in +calories expended’ is now fully understood to be a simplistic and inaccurate scientific paradigm because it takes no account of: ethnicity, age, build, sex, hormones, underlying genetics/general health issues.

This has been stated over and over again on this and other threads. It has been evidenced by research, with links attached. It has been reported as having been explained thus by clinicians, such as my own Prof of Endocrinology. And still people like you refuse to accept their expertise or respect the informed choices others have made.

I can only repeat. If you don’t want to take them, don’t. But, otherwise, it really is none of your concern. Leave the rest of us to exert our autonomy and make our own informed decisions. Your opinion is of no interest to us.

Thanks will have a read. This was the article I found.

https://www.bbc.com/future/article/20240521-what-happens-when-you-stop-taking-ozempic

Though it is about ozempic rather than mounjaro.

Then I found the article below which was much more optimistic. Interestingly in that study participants stuck to the lowest possible dose which allowed them to maintain their diet rather than moving up. And this is what so many women on mumsnet are also doing.

https://easo.org/is-coming-off-semaglutide-slowly-the-key-to-preventing-weight-regain/

I dont think they were all doing all those things tho were they

I've actually just been to see my GP this morning, not on a weight issue but an ongoing osteoarthritis in my knees issue. I'm on the injection and have been since September after trying for the past two years to get the timber off that I had gained since menopause and I did all that I could to lose it but struggled due to the above knee issues.

Has it made a difference? Massively, it's helped me become more mobile again and my quality of life has shot through the roof. My knees are very thankful!
I have always kept my practice surgery aware of the injections and I had a good chat today with my GP. He was genuinely happy for me to continue on it, he was happy with my food/calorie intake, my active lifestyle and my bloods. The only thing he asked me to be aware of was to make sure I buy from a pharmacy with registered NHS connections (which I do) but apart from that he was more than happy for me to continue and he was also happy that it was making such a difference to my health.

The question of is it cheating? The effort I put into spending my hard earned money on these is one thing but I personally am literally working my arse off alongside the drug so as to get the best results from it. It isn't a sit and eat all you want drug and still lose weight, you absolutely have to meet it way more than half way so as to get the best from it, changes made are essential and need to be ongoing.
Luckily any side effects are far and few with me as possibly because I I drink lots of water, eat clean, take good quality supplements and I walk over 25k steps a day in my very physical job and have found this keeps the nasties away.
At the end of the day it's a life choice and down to that individual surely, I'd never judge anyone on any medication, be it for health or alterations to physical looks and I'd like the same thought about the many of us who have chosen the route we have and not to be thought of negatively in any way.
Each to their own...

Thank you for sharing and I do appreciate where you are coming from when looking at general news items.

So, the BBC article came out before the study I mentioned - ie, it is based on already out-of-date data. It is also written by a journalist, albeit one who specialising in science, but it is in no way comparable to a large scale research study written by actual clinicians. David Cox is a freelance writer who writes about fitness and nutrition, and not even a medically qualified expert. I am a bit sad and google every author of news reports to check their credentials because I’m a bit anal (and a PhD student, so it’s a bit of a habit - it also means I have access to the actual studies and research that informs a lot of these articles via my uni and can see when writers cherry pick from them).

I think part of the problem is that people see these articles and then don’t weight them against more recent research (which is coming thick and fast as more longitudinal studies are completing and being published) or check the credentials of the person writing them. It doesn’t invalidate what’s been written, I just prefer to interrogate the source research.

Re the second article: I agree that it presents a much more optimistic outlook for users when they come off medication. The slow titrating off meds has always been part of the protocol with my clinic, but I am gathering it may not have been previously for many providers, with people stopping suddenly (due to reaching target or cashflow issues - which is why it should be offered on the NHS and the pay monthly model is concerning).

As I’ve referenced up-thread, the slow titration is about allowing your body to adapt to lower doses of synthetic GLP1 agonists and to enable their bodies own naturally GLP1 synthesis to take over. For most people, no longer being obese, a higher protein/lower carb diet, and increased exercise levels SHOULD mean that the 20% decreased synthesis experienced during obesity has been corrected. Titrating down allows the patient/clinic the chance to calibrate dosage and the body to adapt. Other research above does seem to confirm that taking GLP1 agonists long term appears to be safe (based on these being prescribed in various forms since 2005 and nearly 20 years of use showing no significant issues thus far), so I am open to remaining on a maintenance dose if needed.

This is especially so as I have a personal fear of developing Parkinsons and Alzheimer's. I have older teens, both with AuDHD, and want to be here for them as long as possible and not be a burden on them, esp one which they may not have the capacity to carry, so the recent research (very, very early stages) hinting that these may have a beneficial/preventative impact on the development of both those later life diseases is exciting. These meds certainly help with my ADHD, so I am optimistic about this too, but only time will tell on whether broader applications will come to fruition as, obviously, they’ve not been testing/monitoring for these until now.

Jeez, am so sorry that was a long rambling answer - was actually discussing this with my clinic at a review this morning so am a bit tuned in to it just now!

That’s right, we’re all liars.

I’m torn between are people really as ignorant as they are making out or so bitter and envious they feel able to post shite anonymously online.

Like are they totally and utterly ignorant of any facts surrounding obesity and the drugs, and genuinely think there was limited trial, no research, no nothing, and global health authorities all went, fuck it, let’s just break protocol. Take a chance shall we. why the hell not.

And that obese people haven’t tried everything to lose weight. We all just sat there, on our sofas, eating junk, not giving a shit, until the drugs were launched and we all rushed to get them. Thinkjng that’s great, and now the fat just melts away?

As that’s what they are posting.

or are they all so utterly consumed by their own envy and resentment due to their own weight issues . They just can’t stop themselves posting shite to have a go, as they are anonymous on line.

Combination of all the above, as evidenced by their admission that they are trolling at 13:18, which I believe is reportable under MN guidelines?

Ah yes so they are sigh.

As I said it would be highly unpopular. But targeting obesity before it starts is the best option.

Also upf are highly highly addictive, would you tell an addict to just use some self control and only have 1 pint?

Addiction rates to upf is the same as other legal addictive drugs ( alcohol and tobacco) in the adult population what is scary is they are almost double in youth. We limit the exposure of our kids to alcohol and tobacco ( rightly so) but we expose our children to upf on a daily basis. Would you gibe your 5 year old a glass of wine a day? If not why not?

https://pmc.ncbi.nlm.nih.gov/articles/PMC11150183/#:~:text=The%20rate%20of%20UPF%20addiction,unprecedented%20%5B25%E2%80%A2%E2%80%A2%5D.

I am an addict.

junk food is not the same.