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/

The government are influenced by big business in their policy making; I was reading on Reddit about the influence of the gambling industry on the Labour party and it can be seen that they haven't done anything to tackle it. It's not a stretch to imagine that there may be financial interests in not harming the food industry and everyone who stands to lose something if obesity is treated on a wider scale.

You're right. I don't like hearing from someone who knows nothing about me or my body that apparently I'm just a lazy bint who won't walk to the shop, where I'm buying all the cakes. And I'm guessing you don't like to hear that I think judgemental pricks who think like that have relied for too long of feeling some sort of moral superiority over the gross fatties and they're bummed that they'll need to find something else to judge people for.
Much easier for me to stop being a lazy fatty than for judgey pricks to stop being judgey pricks though.

Can you please explain why it is then that every time I have started walking more I have lost weight, despite eating the same amount, and type, of food.

Yeah I have to say this is absolutely true for me. I run about 25-30km a week and struggle to put on weight. Without exercise I'd be able to eat about 1600 calories a day without putting on weight. With the exercise that I do it's about 2200 calories a day and I wouldn't say I'm that crazy on the exercise. That's running, walking the dogs and yoga. I'm not a big person either. If you weigh a lot to begin with you will burn a lot more calories exercising than I do.

Thank you for speaking sense.

No you can’t. Running for half an hour burns about 300 calories - so let’s say 1000 calories a week if you run 3 times a week. This is less than 3 muffins from eg Starbucks. if you are eating significantly too much - which you have to be to be significantly overweight - exercising three times a week is not going to fix it - you cannot outrun your fork.

Exercise is good for you generally and a lifestyle overall including exercise really helps people maintain weightloss, but weight loss itself comes primarily from diet adjustment.

@NattyTurtle59

see above. exercise is helpful in the mix, but if you are consuming way too many calories - which anyone who is very overweight is, then exercise cannot have anywhere near the same impact as adjusting your diet.

You absolutely can!
My food/calorie intake is roughly the same every day, however when I increase my exercise for a month (3 runs a week as an example) I loose weight, without amending my diet.

A decade or so ago fluoxetine (the first of the SSRIs) was hailed as a miracle cure.
Before that ranitidine was the best thing for stomach problems with no side effects.
Both of these medicines became widely available faster than normal (ranitidine even became OTC): both have since been withdrawn because of potential life altering side effects.
The development of these metabolism altering drugs was originally for diabetes, so the initial risk/benefit analyses and subsequent regulatory submissions were done based on these treatments for a disease which killed, not based on cost to the health service.

The use of these treatments to assist weight loss is a different proposition: there are ways to lose weight without the risks. We really don't understand the full effects of such significant metabolic adjustment in someone without diabetes. There are going to be side effects which we won't see for a decade or even longer.

I would much rather that NICE wait to make a full post-phase III analysis before they start 'rolling them out' too freely. The NHS can't afford the lawsuits that the American medics will face in due course.
These can be life-improving medicines, but the side effects (apart from the thyroid tumours which are well known now) aren't fully understood yet and they should be a last resort.
I bought one of the earlier GLP1 meds myself: I'm certainly not against the use of these meds in principle, but I think that the NHS are right to be cautious.

@amoreoamicizia

It isn’t an untrue statement

Are you obese and eating far more than your body needs?

Absolutely agree that I struggle to keep weight on when running regularly. I eat what I like and more all because I exercise. It's not the answer to the obesity crisis for various reasons e.g. many are unable to exercise and exercising at a larger size is very hard, nevertheless, to say a calorie deficit "only comes through reducing what you eat" isn't true.

Also, you have actually proved my point with your example. Run three times a week = eat your Starbucks muffins. Run four or five times, eat the same diet otherwise and you'll lose weight.

If you are significantly overweight you are going to burn more than 300 calories running 5km.

It's been proven too that people who exercise regularly make healthier food choices and have less desire for calorie dense fatty food.

In my experience exercise is really helpful for losing and maintaining weight. When I see people posting on here that they can't eat more than 1200 cals without gaining weight I think why wouldn't you just exercise and change that?

For those asking about the cost to NHS
2.5mg £140 per 4 pre-filled syringes
10mg £196 per 4 pre-filled syringes

It doesn’t state whether the syringes are single dose or multiple but I presume one 2.5mg syringe will last four weeks until the dose increases.

So currently it is a very expensive drug for the NHS. In comparison a months course of Anastrazole is 96p. So you could treat 36.5 breast cancer patients fo a month for the same price as one obese patient on starting dose. Or 51 patients on 10mg dose.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10714284/
This study showed that when participants were given a placebo after 36 weeks ( it was double blind so they didn’t know) they had a weight gain average of 14% having had an average weight loss of 20% of their body weight in the first 36 weeks of the trial. The trial last 88 weeks in total.

The dose during this study was 15mg so cost wise £66.50 per dose. About £5878 for the whole study at NHS cost price.

Look it isn’t that hard:

People who are very overweight are eating way too much. Exercising three times a week or whatever cannot create enough of a deficit to move the dial if you are eating way too much - you have to reduce what you eat.

No one is saying exercise doesn’t create a calorie deficit in those who aren’t eating much too much - but those people - which includes you - are not obese.

Do you understand the point now?

@theduchessofspork

I'm not obese but I love food and eating more than 1200 calories so if I didn't exercise I would be overweight.

Have you never heard of eating disorders,these can cause people to be too fat as well as too thin!!!!

Whenever these threads pop out, I’m amazed at how invested some people are in health conditions that don’t concern them - and specifically obesity.

The success of Mounjaro is demonstrating what endocrine experts are saying - that obesity is mostly due to genetics and to a flaw in metabolism. When you take the drug, that fixes the flaw, you eat less and you lose weight. It is phenomenally effective, hence why it is also being studied in relation to other conditions and addictions.

For a lot of people, that drug will need to be a permanent treatment, same as statins, anti hypertensors, insulin, etc. So what? Lots of treatments are for chronic conditions. I don’t see people on here bleating against antidepressants, eczema treatment, HRT, antihistamines and asthma drugs.

The benefits of countering obesity, on an individual and society level, are huge - physically, economically and emotionally.

If you don’t have that condition - good for you! Count your blessings, consider yourself very lucky, keep your judgement of others to yourself. If you have no skin in that game, what can you possibly gain from expressing your uninformed views about the lived experiences of people who suffer from that condition, other than a (false) sense of your own superiority? And if you need that to feel superior, isn’t there something for you to explore about where you could find self worth, other than in belittling others?

The average person expends 328 calories running 5k - so if you’ve got 50lbs to lose it would take 4 and half years at 3 runs a week. So yes you’re right…but also no you’re not really. Because most people don’t want to wait 4 and half years for that kind of weight loss. Much easier and quicker to do both ie 500 cals a day from food reduction and 200 from exercise.

1. Don't patronise me, I understand perfectly well and I don't go about making scientifically untrue statements.

Exercising three times a week or whatever cannot create enough of a deficit to move the dial if you are eating way too much.

This differs from your original claim.

You said: "weight loss itself comes primarily from diet adjustment", which is untrue. Weight loss comes from creating a calorie deficit. Exercise burns calories. If you create a calorie deficit by exercising, and as a result lose weight, then you have lost weight through exercise. Understand?

Ok, thank you for answering that - your situation is different to that of an obese person:

People who are very overweight are eating way too much. Exercising three times a week or whatever cannot create enough of a deficit to move the dial if you are eating way too much - you have to reduce what you eat.
No one is saying exercise doesn’t create a calorie deficit in those who aren’t eating much too much - but those people eg you - are not obese.

Do you understand the point now?

Thank you for acknowledging that I am right. The point about what people want to do is a separate one.

I think unless you are overweight or have been overweight you will never truly understand what it is like or how to manage it. Being fat is seen as a moral failing, it’s a visible failure of being able to control yourself adequately.

Believe me, with a BMI of 40 I feel more disgusted with myself when I look in the mirror than any one of you judgy fuckers who think I just need to go to the gym more could possibly do. With any addiction the answer is to work towards abstinence, you have to surrender to the fact that you can’t do it in moderation, whether it’s alcohol addiction, gambling, drugs etc. That is not an option with food. My brain does not appear to work in the same way as someone who is naturally slim does. By taking mounjaro I switch off that part of my brain that compels me to eat beyond hunger. It makes my brain work in the same way that someone who finds it easy to have a small slice of cake on a special occasion or one biscuit out of the packet or no biscuits at all. It is changing my life and I will not apologise for that and if I need to take it for the rest of my life then I will.

You don’t become overweight by eating 1800 cals per day and running 15k per week. Those people who maintain their weight by doing that and upping their exercise to lose a few pounds are not the people who mounjaro is intended for.

If I need to eat 2000 cals per day to maintain my current weight and I’m actually eating on average 2500, going to the gym 3 days a week and burning 500 cals a time is NOT going to put me in a calorie deficit without addressing my eating habits. It will just mean I put weight on at a slower rate. You cannot outrun a bad diet.

I acknowledged you are technically right ….but it’s also technically right that I can cut my lawn with scissors. It’s doable but really not the most optimal method and actually a bit stupid

Funnily enough, I did cut someone's lawn with shears this summer when they were in hospital and I couldn't access their tools. Small house, didn't take long.