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!

It's the same with any diet.
except with most diets hunger novks most people off the wagon before they have lost much.

it can only be a poositive.

A considerable number of GPS and other staff onmy health centre are on GLPs.

What a nasty, nasty comment. What makes a person wake up and think you know what today I'm going to make comments on a forum that make me sound like a right cunt?!
Can you wait for side effects with other medications? Can't wait to see how many women get blood clots on the pill this year. Can't wait to see how many people die from taking neurofen this year.

There are so many interesting points on this thread so a big thank you to all who have shared.
i suppose Im also concerned about what happens when you come off them. I personally don’t want to be on them for life, theoretically I know how to eat well, protein, macros, don’t eat a lot of sugar, upfs etc (but would be lying if I said I never did!) and work out plenty with mix of cardio and also weight and strength training which I enjoy and never want to stop. BUT, will that be enough to keep it off? I guess no one can tell until they try.

If this was about the singer, Avery, she has blamed her osteoporosis on WLI when it is far, far, far more likely that her eating disorder caused it.

My DD is 32 has PCOS and has been on a weight loss injection for 3 months and has already lost 2 stone

This is obviously just my story, but I lost 3 stone with Mounjaro from May-Sep last year, taking my BMI to 22. I then tapered off, and took my last dose in November. My BMI is still 22.
I calorie counted while on MJ, then when I finished taking it I added on 500 cals for maintenance. It’s working for me.

You can’t wait for other people to experience harm? What a disturbing thing to say. What is your life experience that means you wish harm on people who haven’t harmed you?

@Oldgalgames how long were your two friends taking WLI for, and which medication were they taking? What were their starting weights and what were their final weights, before regaining it all? What period of time did it take for them to regain all the weight?

You might be eligible for the jabs under a private physician . Not a chance under the NHS unless diabetic. I have severe PCOS, with complications and insulin resistance and NHS can't give me the jabs. I'm 25 stone btw. It's a good question though ! I've often wondered what HCP are thinking about this issue

My BMI is over 40, I have T2 diabetes & high blood pressure. I know the NHS can’t afford it, so I haven’t asked my GP about WLI. If I cut back on some areas and did overtime, I could probably afford to pay got it myself, but it’s the idea of injecting myself that stops me. How do you guys manage to do it?

It’s a really small, fine needle. I didn’t even feel it.

I have a horrible feeling that in 20-30 years it will found to be a cause of some horrible illnesses and cancer spikes.

Of course it has its uses in helping some people who are morbidly obese which in itself is a life limiting condition but it shouldn't be available to anyone and everyone when more conventional calorie control and exercise would solve the issue in many cases.

I’m a dietitian and I know that GLP-1 RAs are clinically proven drugs which are life altering and in some cases, life saving. I believe they should only be used by those who meet the prescribing criteria (not those looking to shed a stone or two but are not clinically obese) and those who use them should have dietary support and mental health support to maintain long term health and weight management success.
Obesity is a chronic relapsing condition which should be managed with the sensitivity and expertise that any other medical condition is managed.

Not that my personal experience has any bearing on my professional understanding, but I can share that I have battled obesity all my adult life. I have had bariatric surgery and I have used GLP-1 RAs, and I am grateful every day that because of these obesity treatments, I am able to live a life free of obesity-related diseases and/or disability. My lifespan and quality of life has undoubtedly been increased by these treatments. Do not be afraid to get advice from your GP about these treatments, unfortunately prescribing on the NHS is limited for now, but for those who are fortunate enough to be able to access obesity treatments that are self-funded, I would say that it is worth discussing with your GP first.

They don't come into my clinical practice at all, so professionally I know very little about them.

I view obesity as a malnutrition problem. It's not a matter of willpower it's a question of the food environment having changed drastically in the space of a few decades of taking a minimally regulated profit-centered approach to food. Some people are far more vulnerable than others due to a multitude of factors, many of which are genetic.

I think it would be preferable to try to move society towards nutritious food which doesn't lead directly to obesity, nutrient deficiency and metabolic syndrome in a large %; and to achieve this primarily by properly regulating the food industry.

But, in the absence of that, it seems that these drugs are safe and do benefit the health of individuals taking them in a cost effective way. People deserve good treatment for obesity, which is a health condition first and foremost.

It's just, I don't know, a bit perverse that it's easier to medicate huge swathes of the population to only partially mitigate the consequences of our profoundly unhealthy food environment, than it is to regulate the food industry. And children are suffering the most.

It depends on the individual patient, and there is no one-size-fits-all medical advice.

My doctor advised me not to take it. He is not opposed to prescribing it in general.

@KidsDr I think the thing is that for individuals like me who are already obese and have been for a long time, we can’t wait until society has changed. That’s a huge long term project that no one really has the appetite to push through, it seems.

Google/ youtube the injection pens, as I think you'll find it reassuring. The needles are incredibly small, both in length and diameter.
It's worth talking to your diabetes nurse or your GP too, just to check if you could be eligible via the NHS.
When I first heard about the WLI I didn't think I'd be able to use them as I'm incredibly squeamish but I can inject myself now without thinking twice about it.

Two conflicting opinions

1. I think once you are in the obese category i.e. you excess fat storage is negatively effecting your ability to function and may shortern your lifespan, it is incredibly difficult to be able to have reasonable weight loss, and maintain it. Its good that there is some better understanding on how hormones effect this especially in women.
2. I am concerned that due to the profitability of these medications they will be used with inappropriate people leading to some yet unknown side effects. We saw what happened with the opioid use in the US, and even though there are better controls in place, I would predict our view will be differnt in 5 years time.

Essentially one of the main reasons that obesity is such a health problem is due to the lack of regulation on food. You can see this because the people with the lowest level of disposable income are often obese. This is not normal, if you have limited access to food you shoudl be underweight as in most of history and other cultures.

That's exactly right and I'm really glad to think that these medications can save and profoundly improve lives. I edited my post a little to make that clearer.

I just feel very indignant about what has been allowed to happen to food. I wouldn't be allowed to bring a pharmaceutical to market without extensive testing of its effects and safety profile, let alone continue to sell it despite overwhelming evidence of it being profoundly harmful to the majority of consumers. Yet it seems the standards of regulation in the food industry are comparatively non existent and this has been allowed to happen. Then there is the gaslighting by the food industry who have perpetuated the narrative that obesity is a matter of individual responsibility when virtually noone was obese before 1980 and now most people are, soon it will be most children.

Food is a much more absolute fundament of health than pharmaceuticals will ever be. Everybody eats. We're basically being experimented upon and there's an irony in people worrying about the long term safety profile of GLP-1 RAs when far more has been done to establish their safety as compared to the dodgy ingredients in nearly every type of pre prepared food that we eat every day, feed to our children, that we literally know cause obesity, cardiovascular disease, metabolic syndrome, cancer, tooth decay, constipation, etc etc and that's without even delving into emerging evidence re the unknown unknowns of the gut biome / pro inflammation etc etc

Like I said, I have no professional expertise in GLP-1 RAs & very willing to learn from those who know more. Are their beneficial effects simply the direct result of the people who use them eating smaller quantities of harmful foods, which would imply a global reduction in all the risks associated with those foods? Or do they interrupt some of the mechanisms by which the foods cause harm, in which case, other harms might not be addressed? That's an interesting question I don't know the answer to.

I wish you very well in your journey, you are not alone.

Weird - why?

You'd think with all that experience you'd realise that obese people aren't confused about whether salad or deep fried Mars bars are healthier, but they're battling hunger that is only satiated by calorie-dense foods. If it was as easy as learning to calorie count, nobody would be fat.

Just to correct/fact check myself that should be most people are overweight or obese.

Why? Why must there be a side effect “fallout”?

I think too there are a lot of women like myself in 50s and 60s who do actually eat very well and cook well and have gained weight at various points in life but not through eating shit - just eating too much on a far too regular basis and a biggie with many women too is the rise of a love for ‘wine and cocktails’ - I don’t know why but if I drink at all I simply don’t lose weight for next 3 or 4 days - that’s even just the odd glass - it’s easy to get the idea all of us who are a bit chunky live on a diet of chocolate and crisps and cake and are constantly grazing - that really isn’t true for all women with weight issues.