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!

I asked my doctor this week if I should go for them, seeing as I was there for blood pressure review ( failed it and have increased my dosage) and have a BMI of 34......she just said no and I was too surprised I didn't ask why!

Dr was also very overweight so can't believe she hasn't done some research on them.

So, sticking with personal trainer, same price per month as mounjaro and actually calorie counting for once and the weight is coming off but my God, it's so slow!

@gingercat02 yes indeed- my friend lost large amounts of weight whilst to me eating huge amounts of not always that healthy stuff when she started running big style - half marathons etc , - not feasible for most and to be fair she was probably only about 12 stone max at start and 5 ft 10

What are you going on about? That's nothing to do with what I posted.

@ArtTheClownIsNotAMime you did indeed say its not about calorie counting and I should know better which I do. People generally have very little idea of what effect their food choices have on their health.
People who use and follow these types of threads are often more knowledgeable than the general population.

No, I didn't say that. Try reading again.

She said if it was as easy as calorie counting then people wouldn't be overweight. I agree. Research is telling us that it is much more complex than CICO.

My medical history.

You need to re read because you’re missing the point. No one who’s obese is oblivious to what you’re saying. The point is they aren’t able to stick to healthy choices / calorie counting. Knowing it and doing it are two very different things.

What about it was the issue?

The one unfortunate thing is that the leading person in the states who's been researching the effect of upf's for years has just resigned. Due to the repressive nature of Trumps government on proper research. They wanted him to squash a recent finding as it didnt suit their narrative.

I am obese as a result of medications for two conditions. My blood sugar could become dangerously low on Ozempic.

Seems unlikely.

Mel Robbins has just done a great podcast on this with an expert in endocrinology and obesity, and there’s some really interesting stuff from the medical perspective.

https://www.melrobbins.com/episode/episode-281/

There’s a transcript too. I found this bit quite refreshing:

‘I want to say that I'm sorry In behalf of the healthcare providers, we didn't know better and we failed you. And I've learned this. I've been humbled by my patients. I've learned and hear their stories, and we got it wrong. We got it all wrong. But there is help. We are learning more, we science advances, like everything medicine is an evolving science and we are aware and we will do everything we can to fix it.’

Also obesity is multi factorial: lifestyle is one part, but there’s also genetics, hormone changes, ageing, environmental factors. So someone might be able to control the lifestyle part easily because they aren’t fighting the other factors. But control of the lifestyle part is much more difficult if you have some of the other factors: genetic predisposition towards weight gain; hormonal factors that promote weight gain such as PCOS or being (peri)menopausal, etc.

Because it’s multifactorial, that’s why plenty of people who have no real education on what makes good nutrition are thin and plenty of people who do eat generally healthily are obese; the cofactors that contribute are important.

We do need to know what's causing this massive rise in obesity. Especially in children. I've seen so many fat little kids with normally slim parents recently. What's the cause? Is it something in the environment/diet? Or lack of exercise & processed foods? Just going back to the 1980's child obesity was very rare.

I do agree with this, I'm on MJ and I'm slowly changing my habits, learning what portion control looks like, finding healthy foods exciting but more so I'm recognising why I ate like I did - dopamine seeking behaviour, I'm therefore addressing that too .

I know personally someone who likely has ADHD and had gastric surgery but has gone back to the same size as she was before surgery because she hasn't changed anything she was doing. The jabs aren't an easy way out, yes it suppresses appetite but you still have to calorie count, choose healthy food etc. but it allows you to think differently and be mindful about eating if you want that. If you don't, you'll likely be on it forever (which is a valid option) or come off and put weight back on which is a risk of all dieting.

All of which is true of the previous, less successful methods we had of trying to manage increasing obesity rates. And we know most of the population don't adhere to those for life. Whereas with MJ people might actually be able to.

Humans haven't evolved for environments of abundance, so it isn't a shock that the majority of us cope badly with them. The ability to show willpower in the face of high calorie food would've been at best useless for most humans who have ever lived. This drug hasn't come a moment too soon.

These medications could save the NHS money.I have seen the problems involved in accessing extra large beds and chairs for larger patients. Obviously the health impacts of obesity are significant too. But from a financial perspective, these drugs can only be a good thing for the NHS in my view, provided they are used appropriately and safely.

I have seen challenges arise when trying to transport or organise investigations for larger patients. We had one large pregnant woman and there was a discussion of where to find an MRI machine that would fit her, and a genuine suggestion was made of using one from the veterinary hospital. Another woman had to be transferred from her local hospital 200 miles away to give birth at our specialised unit because she had a BMI of 52 and had some complications. Hopefully with women being a lower weight pre-pregnancy, these kinds of situations can be avoided.

my feeling is that we should really reserve these injections for people who are significantly obese and their health and lifestyle are seriously being affected.

The other thing with obesity, I think we need to look at why there is greater obesity in areas of deprivation. My social circle is generally educated middle class, and I can think of one or two people who are a bit overweight as we are now in our 50s. However, not a single person is obese. These are all privileged middle-class people. I do think we need to look into the socioeconomic factors that lead to obesity more, and in an ideal world we would tackle these as well as prescribing weight loss injections.

One thing I will say is that to lose you are having to adhere to to a fairly strict calorie control diet even on the jabs- and yes it’s kind of self restricting because it’s far easier to feel full - but hopefully in many cases it will re educate as to what levels will maintain weight — itsall got to be far healthier though than people who lost vast amounts using things like lighter life and simply didn’t eat - and then very often put a lot back back when they did start eating again — I never thought that was a very healthy way of dieting at all as didn’t retrain ingrained habits, moving more or portion size in any way

@Bigfatsunandclouds yes - I think people associate certain foods with ‘treats’ or ‘cheering yourself up’ - and as you get older in particular , you meet a friend and they suggest coffee and cakes, you get relatives round and the biscuit packet comes out or hot cross buns or scones etc, you take the kids on a playground trip and ends with ice cream etc - I think it’s partly a societal thing - we associate treatish and not usually very good food for you as part of hospitality/caring - it’s rare you would pop round to your grans or even a friends and they would bring out a fruit plate or some hummus and pitta etc, etc - I’ve mentally had to train myself to think I can go for a coffee or a tea and ‘not’ have something with it . Something in all honesty I am not bothered about either it’s just ‘there’ and seems polite . I think it starts with toddlers and maybe re-educating on snacks - offer grapes or a few yoghurt covered raisins or even a crumpet or a banana mashed on a slice of whole grain toast - it’s not always about many either- I see plenty of clearly not well off people using mac y ds and Greggs like an ‘in between meals’ snack bar - not even as proper meals

I think it is retaining
Getting used to eating much smaller portions and not using food as a crutch. Even without drugs on a regular diet you do get used to eating less quickly.
Smoking is the most dangerous thing you can legally consume with no positives for the body. Even with lifetime serious habit more than a third of people survive unscathed.
Even with possible side effects the payoffs of WLI must surely outweigh them?

Why?!

The benefits far outweigh the side effects for the majority of people.

What side effects do you mean?

My thoughts these are valuable drugs to combat obesity which is an obvious threat to jealth. However we have to be cautious about these drugs being used as part of a culture of normal weight women wanting a size/shape that matches an ideal. I would worry about perfectly healthy women using prescribed drugs as part of effectively a beauty regime.

I also have reservations about obesity being stigmatized as those that are overweight may be criticised by not using freely available medication. Being fat will be associated with being too lazy or apathetic to not self administer an injection...I would have concerns with this.

Ironically the stigmatising is working the other way - us lazy fatties are proving how lazy we are by 'cheating' using WLI, rather than just gritted teeth and will power.
Lazy if we stay obese, lazy if we use the WLI and now the fear of being lazy if we don't!

What seems unlikely?