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!

This substantial muscle loss can be largely attributed to the magnitude of weight loss, rather than by an independent effect of GLP-1 receptor agonists,

@pirateshirt it was this bit that made me think that it was about the actual amount of weight lost ?

On this thread, there has been confusion re and/or posters unaware of the potential to lose substantial amounts of muscle mass and bone.

On other threads, I have seen posters who claim to "know all the side-effects" positively shrieking when some of the well-known major adverse affects (eg gastroparesis) listed on the packaging inserts are stated...

Etc.

I would prefer to get it via my GP, and would happily pay to do so, but even with a BMI of 49, I don't qualify. I am not diabetic ( according to last Hba1c ) or have any other diagnosed health conditions ( blood pressure is fine ), take no medication, other than the very occasional paracetamol, I don't have any digestion issues, no reflux, no IBS etc, rarely if ever ill, maybe get a cold once every 18-24 months if that, needed antibiotics twice in the last 20 years, for surgery related phlebitis and insect bite cellulitis. I am menopausal and know that I need to act now, before my weight causes me serious issues. I have tried unsuccessfully in the past to lose the weight, I am not an emotional eater, I enjoy healthy food, am a good cook, I just don't feel 'full' very often and certainly not for long ! I think that this medication could help me achieve a substantial sustained weight loss, along side a healthy diet and exercise.

It will absolutely change your life . I went from 122kg to 64 in 9 months. Unlike you I was already in the grip of comorbidities. I was pre diabetic, have horrendous IBS, High BP, fatty liver.. having injections for knee pain and that was just the physical stuff. Add to that a deep self loathing and it was a pretty miserable life .

I have swapped the bp and diabetic meds for a maintenance dose of Mounjaro since reaching goal in November. I cannot wrap my head around those who are obese preferring to remain so when the KNOWN side effects of obesity include stroke and death .. as opposed to a remote possibility of as yet unknown side effects despite the drug being in use for over 20 years..

Being obese is just so bloody uncomfortable. Your legs rub and it causes sores. Getting in and out of a bath is a mission.. being sidelined at work because. ‘fat =stupid’ (is often subconsciously done because this view is ingrained) .. generally being over looked or having to make self deprecating ‘jokes’ because of size embarrassment..

why would anyone want that .. and even more interestingly, why would posters like @Cityandmakeup get any sense of joy from finding my new found love of life in my now healthy body (that costs the NHS nothing) came with a ‘price to pay’. ? I can only imagine them to be the sort of person who took great enjoyment from putting obese people into that ‘stupid fat woman ‘ box and now has fewer people to take the piss out of …

It will absolutely change your life . I went from 122kg to 64 in 9 months. Unlike you I was already in the grip of comorbidities. I was pre diabetic, have horrendous IBS, High BP, fatty liver.. having injections for knee pain and that was just the physical stuff. Add to that a deep self loathing and it was a pretty miserable life .

I have swapped the bp and diabetic meds for a maintenance dose of Mounjaro since reaching goal in November. I cannot wrap my head around those who are obese preferring to remain so when the KNOWN side effects of obesity include stroke and death .. as opposed to a remote possibility of as yet unknown side effects despite the drug being in use for over 20 years..

Being obese is just so bloody uncomfortable. Your legs rub and it causes sores. Getting in and out of a bath is a mission.. being sidelined at work because. ‘fat =stupid’ (is often subconsciously done because this view is ingrained) .. generally being over looked or having to make self deprecating ‘jokes’ because of size embarrassment..

why would anyone want that .. and even more interestingly, why would posters like @Cityandmakeup get any sense of joy from finding my new found love of life in my now healthy body (that costs the NHS nothing) came with a ‘price to pay’. ? I can only imagine them to be the sort of person who took great enjoyment from putting obese people into that ‘stupid fat woman ‘ box and now has fewer people to take the piss out of …

Very similar to this (started at BMI 30) and I'm microdosing Mounjaro (because I always overreact to medication) and have lost 1 stone in six weeks eating much the same as I was before. Losing weight when you are peri seems to be almost impossible but this unlocks it somehow.

@Vatsallfolks thank you for your reply, it really resonates with me, especially the self deprecating stuff. I do realise how incredibly lucky I have been so far, and do feel like I am standing on the edge of a cliff health wise.

Indeed, but as one poster has already said on here they are finding it hard to exercise with less energy.

Less food = less energy = less fuel for exercise

Agree. I've found Mounjaro breaks the less food = less energy cycle.

I wouldn’t like to say. I’m not an expert at all, my sister in law just mentioned it when we were discussing side effects of weight loss .

I think it’s really important that women focus on their strength as well as their size to protect their bones.

I think it’s helpful for a GP to know a patient is starting Mounjaro. Patients are not always reliable historians and a GP will spot potential interactions (eg a history of problematic gallstones, pancreatitis, renal issues, eating disorders) and monitor carefully. Or they will also be managing problematic adverse effects from treatment. Online prescribing also means anyone can upload a random overweight person’s pics to obtain the drug.

If you don’t have any of the above the risks to you are low but I would allow your GP to be informed about the medication.

I didn’t find that this was an issue. I was still eating enough calories and protein to be able to exercise.

I think adding in weight training will probably counter act some of the bone mass loss/encourage regeneration, its already recommended for peri/menopausal women to protect bone health due to this.

I agree but I don’t think we’ve ever seen weight loss made so easy and widespread as it is with these injections. Loss of muscle and especially bone mass will potentially be more prevalent in people using the injections because they will lose more weight faster - because any other way is really hard and few people can manage it long term. So that’s where I think the potential link between osteoporosis and WLI comes into it. This will be first generation of menopausal women losing weight at such a rate. And that’s obviously not taking into account any of the potential side effects of the drug itself.
Hopefully the popularisation of weight training for women will counteract some of that.

Do you mind me asking what your maintenance dose is? I'm half a stone off target and then looking to maintain. Tealise everyone is different but it's good to get an indication.

I lost 2st 5 around 18 months ago on 8 months without WLI - I most definitely lost muscle , particularly in lower legs - my calves absolutely shrank - so I am very aware of it - I do think the strength/protein/excercise thing is important - I don’t think I ate nearly enough protein last time or did enough excercise ( well did next to none part from walking a lot)

I am not an HCP however I would thoroughly promote to those who do not get weight loss injections prescribed on the NHS to try the Human Being Diet. I had weight I could not shift and an autoimmune condition and all my old weight loss methods didn’t work. The diet is amazing and has to be better than using an injection. It’s also helped with inflammation. However I do recognise some people need the help of the jab and to stop the food chatter in the head. I would say if you cannot afford injections privately but can afford vegetables and protein, do this diet. It’s miraculous.

I was rude? And judgmental, was I? And would know nothing about what others go through in battling to create calorie deficits in their diets? And have no lived experience of medication-induced weight gain? I'm fortunate enough to not need them? Gosh, you do know me so well, don't you.

Everything I said to that previous poster was about my own beliefs on the matter, - ie, it is better for a woman as she gets older to accept that a slower weight loss will be achieved by the same methods, and I would rather not risk my major organs - and frankly I do object to being ranted on. I also object to being scolded by you in a rude, judgmental, and highhanded manner, fueled by masses of incorrect assumptions.

But thanks ever so much for underscoring the fact that we cannot have a single thread on this topic without being heavily censored and/or silenced.

@pirateshirt

Have there been any blind placebo tests for weight loss drugs ( not diabetic medicine)? It would be interesting to know whether the ‘food noise’ phenomenon is totally physiological or has some psychological factor .

edited to add a gif but couldn’t

Are you under endocriniology for your PCOS? If not, get a referral. My Mounjaro is prescribed by Endo consultant (not for PCOS, for a different hormonal disorder), and a friend is also prescribed under an Endo consultant for PCOS - she had her first period for 18 months, 2 months after starting Mounjaro, and has had regular periods ever since!!

@pirateshirt I don’t think you were rude at all - just factual - hence why I pointed out that I did indeed lose muscle mass when I lost a few stone before( not WLI though) I agree it’s really beneficial clearly for many - but I am not keen when it becomes like a cult and no ‘negativity’ at all is allowed - I’m 3 weeks in and will take the 4 and then stop as I don’t like the constant nauseous feeling or acid reflux - appreciate others don’t have it but I do even at very low doses - it has however kick started me back into portion control and ditching some habits which is good.

Yes there have been placebo tests. The people lost a fraction of what people on the actual drugs lost.

Yes, you came across as rude and judgemental when your post to a person saying they used these medications said it was a shame the poster hadn't embraced a healthy diet. That came across as needlessly rude.

I wrote:

There are studies showing regain of most of the weight, once WLI are stopped, which happens after most diet plans, but then most ordinary, boring, slow dieting does not leave you with the risk of stomach paralysis, etc etc etc.

I stand by it. Please go and judge and scold someone else.

I don't know. I expect there are countless studies in the works. But I do know that all or almost all anorectic drugs turn off what is now known as "food noise", as do the class A drugs like heroin, cocaine, speed, and meth.