To think weight-loss injections should be prescribed in person only. The scale of abuse must be shocking.

[Thisisdrugabuse]

Hear me out here. I have had 5 friends in their 30s and 40s tell me they're using weight-loss injections from online sources. Fine. Except one is a size 8 and another a size 10. Oh, it's so easy to get, just upload a photo of a day you looked chubbier a few years ago and change your height/ weight a bit. Out of my friends that recently told me they're taking it, the size 8 is on the highest dose. She looks ill. Only 1 is over a size 14 I'd say.

Am I being unreasonable

No-to think these medicines are not licensed for normal sized people. They might be at risk of osteoporosis, liver problems and who knows what else. It all seems dangerous and completely unregulated.

Yes- jog on op. These are important medicines helping lots of people and if people lie, that's their issue.

I mean, whatever happened to personal responsibility? Why should the rest of us suffer consequences of the idiots?

Real-world data from social media is now collected as part of post-marketing surveillance. As a medical device (injectable pens) these would also potentially fall under the new regulations that came into force on 16th June this year.

Yeah a personal trainer is great for getting strong and other things but it won’t do shit for weight loss. I gained scale weight when i started strength training because muscle weighs more. Weight loss is much more about diet like 80%.

But this is not data. It’s a few anecdotes and a lot of opinions.

As social media will always be. But look at all the posts of people showing they're using the medication off-label. Not for the population it has been approved for. In line with reporting requirements, this will get picked up.

We know someone who is a size 10 who has got hold of mounjaro and is using it.
I cannot believe how widespread these WLJs are becoming.

I have recently retired as a clinician and share your concerns about misuse. I reported MedExpress to the GPhC and MHRA for social media posts where there was clear evidence of misuse but they ignored it and posted comments like "Congratulations on your weight loss". I hope that may have contributed to their recent inspection woes.
On the other hand, we have to accept there is widespread misuse and abuse of medications prescribed by the NHS. Just in my own practice we were aware of people lying to get medication, sharing medication with others, selling medication down the pub and sending medication abroad. Even with the will to stop it and more controlled prescribing it is hard so I suspect this may be a losing battle and we may just have to accept that some people will put themselves at risk and that's before we look at the unregulated market where nobody even knows what is in the injections.

I have to agree with others though that things are tightening up with the registered providers. I have used 3 providers over the last year, all have asked for proper ID, full length photos (the first wanted just the photo, the second wanted me holding a piece of paper with that day's date written on and the most recent wanted it submitted via their site where the photo was taken and went straight through rather than a previously taken one being uploaded), all have asked for GPs details and evidence of previous prescriptions. Seeing as there are not enough prescribers to see all patients F2F it is hard to see what more they can do without undermining genuine users

I agree. I’m a bmi of 25.7 but have high BP. I’ve put on 2 stone since having kids and have never got below 10 st despite going to the gym x 3 per week, very active job and generally in life and not really overeating or snacking on sweets etc. My partner is on it legitimately and has lost almost 4.5 stone and he was a massive binge eater.

Thank you for your considered post. I understand and do agree with all your points.

https://investor.lilly.com/news-releases/news-release-details/open-letter-eli-lilly-and-company-regarding-certain-practices eli lilly seem very aware.

I know of someone who’s no more than a size 8 using it (is a hairdresser and got it from someone working in the salon). I also am aware of someone who recently ended up in hospital and was wrongly advised about the right dose after obtaining it from another beautician. The vial it came in wasn’t labelled properly either.

I've no idea where the poster got 23 from but there is a correlation between higher BMI and better bone health. Which do you choose indeed?

I'm on monjaro & I need to not only take a full length photo of myself but also a photo of myself on the scales with my weight visible. No amount of looking chubby would allow you to cheat from a relatively low bmi to a bmi over 30!

Yes, it is OP @Thisisdrugabuse , an alleged clinician, that made the 23 BMI statement. Personally, I'd go for healthy BMI over the currently unsubstantiated bone health claim.

I think obesity helps builds bone health from carrying a heavier weight, so formerly Obese people may not need to stay over 23 for the benefit and can maintain above a healthy 18.5 to 20 and have the best of both.

Of course they're aware 🤦🏻‍♀️ Apart from any ethical concerns, their profits could be impacted if misuse leads to more restrictive regulations.

This isn’t really about “abuse”. It’s about thin women hating fat women getting thin.

Seeing as there are not enough prescribers to see all patients F2F it is hard to see what more they can do without undermining genuine users

But this is the opposite of what you are calling for in your OP.

A little by-the-by, but here's the link to the abstract of the meta analysis. The 23 figure is used as the start of the overweight category and can be found in the full article if you have the full access https://www.clinicalnutritionjournal.com/article/S0261-5614(23)00341-2/abstract

It's a valid point. It would be hugely difficult to implement. My post was written in a couple of minutes over coffee this morning and so sadly, I raised a concern in an anonmous forum that I don't have an answer to. It's the beauty of debate and I genuinely am enjoying the different issues and perspectives identified within the thread. It may also be that we find the drug is perfectly safe and has benefits to non-overweight people. The point is, at this stage it is not approved or tested for that use.

@Thisisdrugabuse if you have access to that article could you perhaps include here the relevant extract that indicates that 23 bmi was the start of what they used as overweight, and what the rationale was for that?

It may also be that we find the drug is perfectly safe and has benefits to non-overweight people.

No, Mounjaro has already been found to have side-effects of varying frequency. So it is not going to be found to be "perfectly safe". Like all drugs, the benefits vs safety issues are studied, and licensing and prescription restrictions are based on those studies.

It has also been found to have very positive effects that were just as unexpected. For drug users, Alzheimer disease for example….

I agree but what can anyone actually do. People take drugs etc that are not meant for them since the beginning of time.

These weight loss drugs look like they are just something your body naturally makes and so far so good, but who knows if they will be harmful in few years or not, they might actually be even good for you.

Maybe these people taking them off label are actually doing research.😁

its a personal choice. I wouldn’t do it but can understand the attraction. Nobody can stop them and it is happening.

As a layperson it seems to read that your statement of "BMI 23 is best" is based on the study you linked:

"The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis"

As most people on legitimately prescribed WLI have already had a lot of bone health benefits from having been Obese and Overweight, often for many years, surely we can strive for a healthy weight (currently measured mostly by BMI), therefore 18.5+ is appropriate?

Yep and £150 a month would get me a decent personal trainer who will provide meal plans alongside a manageable exercise plan rather than injecting myself with stuff when I don’t need it and just need to be better with my choices

ETA my first post should have said I AM a nurse not I’m with a nurse 😂