To think that they could roll out mounjaro in less than 12 years?

[caffelattetogo]

I thought this was 12 months when I read it first - is it me or does 12 years seem like a long time to prescribe for all eligible patients? Particularly as we are told so many expensive medical problems are caused by obesity.

www.lancashiretelegraph.co.uk/news/national/uk-today/24823250.nhs-mounjaro---will-eligible/

Studies in the USA have found that it is not a quick fix for the morbidly obese for whom this service will be easier to access. Longterm patients regain the weight, and more so it may be a drug that needs to be taken for life.
interestingly I’ve noticed a number of posts on social media where people taking it have had a planned break so that they can “ enjoy Christmas” this suggests that they are not addressing their eating habits.
The cost of the drug is not really the issue, but the cost of support services.

Anyone prescribing the drug is legally responsible for the health of their patient, as such unregulated/unmonitored prescribing could end up with litigation if a patient suffers a serious side effect. If there are significant cases then indemnity companies may make it a specialist service that not all GPs will sign up for. Also if they don’t receive payment for the service they may opt out.

Also anyone thinking they can see their GP in order to lose a few pounds pre wedding or post partum is likely to be disappointed. It will still be only prescribed if you have a BMI over 30 and unlike online prescribing there is no cheating the system.

It’s been a few days since we last did one of these… who’s ready for bingo?

NHS weight loss services are (in my experience) pointless. As a fat person I am fully aware of calories, and fat, and what foods are “bad” etc.

I’m paying for Mounjaro .. 2 stone in 2 months … quite happy to carry on paying, if it stops me from a terrible appointment with a NHS weightloss person.

That said, it’s not cheap .. and people who can really benefit can’t get the drug, which is a shame.

Reducing obesity will save the NHS millions, and weight loss jabs should be treated like any other preventable Health treatment.

I’m not jealous of smokers getting NHS medical help to stop smoking, no idea why people are so bothered about fat people getting jabs.

There isn’t enough known about the long term effects and this “miracle cure” for obesity seems to be everywhere at the moment. People can lose a lot of weight on it which is great but how do they sustain the weightloss once they come off the injections? I also don’t agree with companies prescribing these injections to anyone over the internet, Med Express etc. Anyone could lie on those questionnaires to get it and they just keep prescribing every month. I totally understand that people are paying for it but there does need to be tighter regulations on it.

I feel really strongly and against the NHS prescribing this for obesity unless the recipient is closely monitored throughout the duration with face to face medical checks. I’m not sure how I’d feel if the NHS prescribed this medication for months and once off it the person returned to their old eating habits. So many people had bariatric surgery on the NHS and never managed to change which was a waste of money.

Well you started the charmless dash idiot offensive, so you gotta take it if you’re handing it out.

Anyway OP - I don’t imagine it will take 12 years in the end, but as the drugs available will change rapidly, it’s hard to know what the landscape will be like in a decade.

The NHS is in a fix right now, so vital though solving the obesity crisis is, it has to be balanced against all the other things the NHS has to do, compounded by the fact there’s no system associated with this as yet - eg you’d think this would be the sort of thing physician associates could look after, but they are under review at the moment.

Anyway, I think the patents loose exclusivity in a couple of years, by which time we’ll know more about how to manage weight loss maintenance - so I’d imagine this general of drugs will be rolled out in 5 or 6 years.

I’m guessing maintenance doses will be figured out over the next few years.

What appears to make these drugs different to anything that’s gone before is they appear to switch off addictive behaviour (what some people call food noise) - realistically I think some people may always need some degree of treatment to keep their weight down.

You make some good points, but the risks of the slight free for all going on at the moment, have to be weighed up against the individual health risks and risks to the NHS of obesity - when you consider this I imagine it can be justified.

I actually think people over estimate how much these drugs cost and think almost everyone can afford to pay for them privately. This is what I would do. The cost can to be offset by reduced spending on food. I'm sure they won't cancel each other out but spending less on food will make a significant dent into the cost of the drugs.
I remember when nicotine patches were first marketed and there was huge demand for them and talk of NHS collapse. Apparently nicotine patches were priced to cost the same as cigarettes so in truth no smoker could claim they couldn't afford them.

I’ve been through all of the NHS weightloss services right to being offered surgery which I don’t want and didn’t lose a pound. They still sit you in a room full of people and tell you fruit and margerine is good for you and butter is bad like something from the 1980s.

I had a trainee doctor accidentally prescribe me Ozempic and then a hurried phonecall from my normal doctor telling me not to take it as it could only be prescribed by the Level 4 weightloss service which is over a year’s wait and no drugs available at the moment.

of course I took it!! Nearly 3 stone down in 3 months. I’m now going to self pay so I never have to visit the crappy weightloss service ever again!

With regard other NHS weight loss treatments (apart from surgery). I agree with PP, really, what are they going to tell you that you don't already know? I'd be interested to see how successful these interventions are. I suspect not very.

I am happily 'taking it' as you so eloquently put it. Both happy and entitled to post my view, as are others here. It's aibu, so opinions will differ, but apparently overweight people on MN are never at fault...
But what is a 'charmless dash idiot' offensive?

I think the issue is the weight gain when the injections stop, and the loose skin, will tummy tucks be funded?

Not as much as it costs in the short term and the NHS has to work to an annual budget like any business.

I think it doesn't solve the problem of how/why people are obese in first place. Surely more proactive methods would be beneficial and mental health support for people who have binge eating disorders.

What happens when people come of it in terms of their psychological overpowering drive to eat.
Does that return as the drug wears off.
If so does that mean it has to be taken permanently

Technically the nhs is here to save lives. With that in mind are tummy tucks saving a life ? I suppose that depends how the nhs view it as a mental health issue. There are lots of drugs they won’t fund that could save lives ( I’m thinking some cancer drugs ) so I believe it would be unethical to deal with tummy tucks etc and not deal with people with cancer.

Weight loss drugs could help save lives in the long term although I think if we’re all more realistic it’s to save the nhs money. It’s their quick fix as nothing else seems to be working

Keeping diabetic or patients at risk of diabetes on these drugs for life will be worth it and cheaper than treating the diabetes and all it's complications. The patents on these drugs are not that long, mounjaro is 2036. Remember the NHS won't be paying the same as a private prescription. Diabetes is an expensive and usually progressive condition so these drugs could potentially be revolutionary. Giving them to obese patients especially before they have developed diabetes will hopefully get people healthier for the long term.

@SavingTheBestTillLast yes you're right.

I find the whole concept difficult to get my head around and a sad place the country is in. Watched Grease yesterday, no obesity, no fillers etc. so much has changed in 40 years

im diabetic with a very bad binge eating disorder, my gp realised i needed help i got it in june still on low dose lost 3 stone 1 stone to go. my blood pressure is now normal. i have not eaten 1 bite of chocolate since day 1 i was binging daily on that, its life changing, i am in a group on line for support some very heavy drinkers now no longer drink at all, it really is life changing, it could save the nhs a lot of money in the long run, very few people get it off gp etc , most are buying it them selfes but saving a lot in takeaway and naughty food choices,

Great to here it works for you. How do you intend to maintain it when you stop injecting?

It also has positive effects on cardiovascular health, lowers high blood pressure, reduces inflammation and seems to supress addictive behaviours other than just eating .

Yes and yes. The food noise comes back when you stop taking it. To maintain the weight loss you’ll need to remain on a maintenance dose. This is fine though - many people are on lifelong medication for chronic conditions.

Watched Grease too……you are quite right.
I recall Mr Mosley looking at eating habits pre 70s
Not that long ago breakfast was bacon, eggs, porridge
Lunch and dinner were lots of veg a small amount of meat
Snacks rare and pre prepared food and crisps non existent.

I think it’s more about what’s on our shelves for people to buy ( not that you can’t buy the veg too of course )
Along with the fact more people own cars.
I remember one car on my street of terraced houses in the 70s. We walked everywhere including to buy food which we got home with a trolley so we were exercising just as part of daily life.

The problem is now is not then and for many they have grown up very differently to those of the pre 70s.

What will you do when you come off the Ozempic though? Let’s face it and be real here, most people who are overweight and turn to drugs like Ozempic or Mourjano have deeper rooted issues around food. These drugs work while you’re on them, surely the hunger and food noise return when you come off them? If the hunger was there before the injections it’s going to return isn’t it? Of these injections switch off the “food noise” how will people cope after coming off them?

Someone posted earlier a weightloss drug bingo earlier on the thread but let’s face facts, the drugs work while you take them but you can’t stay on them forever.

So many people got bariatric surgery who either paid for it privately or had it on the NHS and that never worked for lots of people.

I’m sure the PP will have her own answer to this, but my guess is in a couple of years it will be standard for people who have a really addictive relationship with food to go onto a low long term dose to help them with maintenance. Mounjaro appears to help with addictive behaviour in general, not just food.

It would be lovely if mental health initiatives were a viable alternative but to be effective they are simply too expensive.

Can you link to the studies please of the maintenance dose?