Doctors/Nurses/Dietitians/healthcare professionals, what are you real and honest beliefs about the whole weight loss injection moment we are having?

[Banrockmystation]

A genuine thread for me who is too afraid to ask in real life. For context I’m in my 40s with pcos, at least 2.5 stone overweight and despite exercising 4 times a week and calorie tracking etc for the last few years my weight issues continue.
I don’t have an opinion on other people being on the injections. My reason for asking is because despite probably being a candidate for them and knowing how hard I try to control weight, there’s something that stops me.
I worry that there is more to it than what is being shown by the media and that there isn’t enough research done on long term effects etc? Aibu? Is that just fear or an actual possible concern that others in the industry have too?
Despite my weight, I’m heart healthy and fitter than I’ve ever been.
Thanks!

Incorrect. They will prescribe a maintenance dose.

Can you source the claim re stomach paralysis and vision loss.

Thanks

The aim of big pharma is to hook you. I’m not a big pharma conspiracy theorist but I can’t help thinking that they are building a future repeat customer base and are rubbing their hands in glee.

Already the WLI are used in the USA as a weight maintenance drug by women and men who have not actually lost any weight.

I doubt that it will be licensed in this country as a maintenance drug for healthy weight patients. It’s too open to misuse by patients with eating disorders. As an ex bulimic who struggled for years to give up the practice of vomiting when I “over ate”, even when I was well within my calorie limit, the draw of these WLI is very strong. Like most eating disorder sufferers the urge to binge and purge is never far from the surface.

I recovered once I finished studying at uni, but have a lot of foods I need to avoid because of the ease I can still purge after eating them and it is over 35 yrs since I recovered.

I suffer with chronic reflux as a result of bulimia so GLI would appear to be perfect as a treatment but does not address the psychological cause of the condition. Fortunately I managed to control the habit but I wish that I had been able to access support when I started purging in my late teens.

Gastroparesis as a side effect does need further exploration, if people have diabetes which is poorly controlled, this can effect the nerves in the gut and cause it, using WLI could obviously exacerbate this ?
So someone who hasn't had their Hba1c checked, who doesn't realise they are diabetic, could go to a private provider and actually make an unknown condition worse ? I don't currently take WLI so not sure on the sort of history the private providers take ?

Already the WLI are used in the USA as a weight maintenance drug by women and men who have not actually lost any weight.

You have to have a BMI of over 30, or over 27 with a related comorbidity, to have them prescribed in the US.

Incorrect. They will prescribe a maintenance dose.

I think this is something that worries me about private provision, someone with an eating disorder could get several pens from different providers and dose themselves according to their perceived need ? do the various providers communicate amongst themselves to eradicate this risk ?

I know several with ED who take the jabs and as a result they are falling apart physically but they are addicted to the “easy” weight loss, they lied to get them. Hopefully it tightens up

Can you source that it’s being used as maintenance dose please for people who’ve not lost weight. That makes no sense.

I am currently prescribed a maintenance dose in the UK.

Most expect you to share information with GP.

But let’s be realistic about this, the eight loss is caused by eating less. Anorexics don’t need something to make them eat less. Affordability of multiple doses isn’t realistic. And the side effects would be unmanageable. This isn’t a risk. And is certainly not a reasonable argument against it being available to those who do need it.

It has tightened up. But if people lie, well I don’t believe that’s happening with the frequency people suggest.

Safe as houses.

Had a colonoscopy last year, seen private doctor for my eyes (suspect diabetic complication) and now a private gynaecologist. There is no fall out or anyone saying stop the injections.

HRT v’s weight loss injections to keep diabetes at bay - no contest which I chose.

Yes, I know they will. The same as when anti depressants stabilise a depressed person's mood they don't just stop taking them 'because they are happy now'. But they won't prescribe a maintenance dose if your BMI drops too low. The aim is to help people get to and stay at a healthy weight, not to drop to an unhealthily low weight.

Oh definitely shouldn’t stop it being available to overweight people, there are always those who abuse meds.. just hope they require more proof so they can’t lie. Because it is happening, the people I know with anorexia get the food noise and guilt so they like not having to fight themselves anymore. They have both had severe kidney pain but one of them is still carrying on with it as she loves how in control she is.

Not sure how the quote you posted relates to your question, but GLP drugs effectively work by causing the slowing of stomach emptying, hence the feeling of fullness lasting...

Gastroparesis or stomach paralysis is a known adverse side effect. People are left with permanent or ongoing nausea, vomiting, gut pain, and often malnutrition. Some go on to develop bowel obstructions.

Visions loss has been studied more recently, as opticians notice cases occurring. For example: "A recent study published in JAMA Ophthalmology found a striking association between semaglutide use and nonarteritic anterior ischemic optic neuropathy (NAION), a leading cause of sudden vision loss. The study, which analyzed 16,827 patients, revealed that individuals prescribed semaglutide faced a significantly higher risk of developing NAION compared to those on other diabetes or weight-loss medications. Among patients with type 2 diabetes, the risk of NAION was increased by 4.28 times, while in those using the drug for weight management, the risk surged by 7.64 times. Over a 36-month period, the incidence of NAION in semaglutide users was 8.9%, compared to just 1.8% in the non-GLP-1 RA cohort."

These are not common side effects, but the massive uptake means more cases are coming to light. I personally would not want to risk either. YMMV.

Here's an article that explains some of the adverse effects, or you can just google them:

Patients Are Suing Over Alleged Side Effects of Weight-Loss Drugs | TIME

I personally would not want to risk either

That’s fine, because no one is asking you to.

Yes, it is a discussion on a discussion forum.

I'm not sure what your snide little comment is meant to achieve here.

Although I do understand one must never, ever criticise in any way or point out any potential downside to these drugs. That is the law.

It wasn’t ‘snide’, how ridiculous. My point was just that other people are able to decide what risks they are willing to take.

And just because they’ve decided that a risk is worth it, doesn’t mean that they think there is no risk.
I knew exactly what the risks were when I decided to take MJ. They were worth it to me. And 6 months after coming off it, having maintained my new lower weight, I still think they were worth it.

For the love of Jesus, you just will not quit with your obsessive reprimanding of me, based on a slew of assumptions, and clearly affected by a severe case of lastworditis.

I certainly hope you don't treat your patients in this manner - refusing to believe their stated experience, running roughshod over their reality, lecturing, imposing, rapping their knuckles, shaming, blaiming, hectoring, etc etc etc.

PS: How kind of you to consider the feelings of my patients. I do not have any patients as I am not a doctor. HTH.

Yes. As I wrote, YMMV.

Ah sorry, I’m not up on my acronyms.

I think it's about time. Many of us have felt that there was an issue with appetite control that simply wasn't due to will power! This proves it for me. If we could give erections on demand then it was about time.

It might have helped the OP to be clear that you don't have patients and aren't a medical professional, and aren't answering in that capacity, given the OP was specifically seeking the views and beliefs of healthcare professionals about the injections. Hopefully they can now be reassured that your views are from a different perspective.

The majority of analyses of the safety profiles of these medications are favourable, when the medications are being used in line with their clinical indications. No medications are without risks, so everyone considering WLIs should consider their own risks and benefits, and make a decision about what's right for them. Most healthcare professionals I know wouldn't judge someone for taking a prescribed medication for a clinical need, and hopefully these medications can help on a population level as well as an individual level to improve everyone's overall health.