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.

You make a valid point about the cost to the NHS if people have become ill or die on WLI that have been acquired through dubious means. But even then the fact they’ve become ill or died because of being a fool doesn’t bother me one bit.

Why? They could be a pound or two overweight with a BMI of just over 25. Some can lose that after getting rid of some water retention overnight and having a big poo!

Not to mention BMI has been deemed a blunt instrument for gauging health for years. Of course we can’t really argue with it in most cases when it’s very high but many with a BMI of not far over 25 will be perfectly healthy still. DH’s is somewhere between 25 and 30 - he’s very tall and has a lot of muscle. He’s objectively in great shape, not just to me. He has a full health check with his private healthcare and even they tell him BMI isn’t the best indicator of health.

Well no-one is forcing them to take it. But even being a few pounds overweight can be an issue for some people and it may prevent them suffering from obesity.

But do you not think it’s not hugely difficult - in the vast majority of cases - to lose a couple of pounds? I mean that literally: two pounds.

I just don’t think losing such a small amount of weight on WLI is worth the risks that are greater for those who are not obese and have never been obese - ie people who are a couple of pounds overweight to have a BMI of 25.

I think it's open to abuse BUT I live in a world where we are personally responsible for our own actions, accountability seems to have gone out of the window these days. These people are responsible for lying & putting whatever it is into their bodies.

Are you worried about other types of medication people take for long term maintenance that are also none of your business?

While we have an NHS that we pay for though our taxes it does become our business.

Everyone has to weigh up the risks and benefits for themselves along with their pharmacist and private doctor or GP. Some ethnicities need to be a lower BMI, for example and some people are apple shaped and need to lose weight off their middle even if their BMI is ok. My dad had a BMI of 24/25 and was very fit and muscular but he had high cholesterol and blocked arteries. My mum's BMI was 26 when she became pre-diabetic and then developed diabetes. There has to be a cut off somewhere and it won't be perfect in every case. I just happen to think that the regular cut off should be lower than BMI 30, and it probably will be lowered I imagine in future. As I said, I got it legitimately at BMI 29 for several reasons but it's a shame people have to wait for something like high blood pressure to develop or to get fatter before they are allowed to take it.

I think it will just because there’s so much money to make from it.

Apparently about 15% of the US population is now taking WLI. When you remove elderly and under 18yo, that’s a hell of a lot of people!

Is it a good idea? I dint think so. I believe it’s all linked to this image that thin is better and being fat is a sign of bad character (lack of self control etc….).
That’s the same reason why some people abuse WLI or go on crash diet on the top of it. They want huge losses (always widely celebrated), quickly (so it’s visible). Basically all the crap from the weight loss industry + magazines downloaded into the WLI system, making some insane ‘rules’ that few were able to follow possible.

I think it's linked to so many people being morbidly obese and a really unhealthy food culture in the US that we have partially adopted here.

This is what I wanted to say!

Its their money and bodies - as long g as people who need the drugs (diabetics) aren't going without why would anyone care?

Well OP, I'm very anti! Just another case of the pharmaceutical industry cashing in at the expense of some vulnerable people (either overweight or with various issues that make them obsessed with their weight whatever size), and all the harms and risks will come out in years to come. And then we'll know they knew and didn't care a jot. I'm convinced that if we chucked this amount of money down other avenues we could have a much healthier population but I guess the profit margin just wouldn't be there. Very sad. Really hope your friends are all okay x

A work colleague has been using it for a little while and yes, he was a little overweight when he started, he now looks a little underweight, gaunt and pale.

I am overweight, I've adjusted aspects of eating, exercise and lifestyle to lose some and I have, over time, but obviously the WLI was of interest to me because I've still got more to lose so I asked him about it.
I don't really know the ins and outs because he's really focused on the fact he now feels he has control over binge eating, that because he has no appetite now he feels free from something that made him miserable, and he's worried to stop taking it and go back to feeling like food rules his life, and I can totally relate to that. However I do feel that he's gone a bit too far the other way, maybe because it's happened so quickly and the contrast is stark, and I do think that continuing would risk him being more and more underweight and the issues that brings too.

It's very easy for people to write me off as jealous of him because he's lost weight quickly and I haven't, and I definitely think there is an element of jealousy for some people, but I'm concerned that actually all it's done for him, and all it would do for me, is enable a continuation of a bad relationship with food because of issues with self esteem which I suspect he has, as I have, linked to being overweight, and feeling like losing that weight will solve those problems when actually I don't think it will.

It's a great idea for people who are overweight and I don't see it as cheating, it works for people who are overweight and for health reasons need to lose it, but I don't think it solves the underlying problems some people (me included) have with self esteem and genuinely liking yourself for who you are and actually although yes, I'd lose weight on it, which is something I want to do, I'd be worried I'm setting myself up to just be under another set of control and still have a bad relationship with myself and food.

The problem though is that all our health issues (high blood pressure, etc etc….) aren’t all linked to our weight.

I know that’s often the answer you get - pain in your knees ➡️ loose weight. High blood pressure ➡️ loose weight. Feeling tired? Loose weight.

But the reality is so much more complex than that! Sometimes, it’s not how you’re eating but what’s you’re eating that’s making the difference. Some times, it’s stress or lack of community or light or outdoor spaces etc etc….

I feel saying we should offer WLI as soon as people are falling into the ‘overweight’ category is a very reductionist view of health

I assume you meant then BMI of 25+ but with comorbidities?

I agree with you. I am desperate to get on the injections - my financial situation is stopping me but I am constantly thinking of ways I can save up.

But more importantly, I am constantly thinking of ways I can abuse the system. Most pressingly because my BMI was 31, and I've managed to lose about 12lbs on my own, which brings me to under 30. So having a BMI of 31 gets me the injections, but a BMI of 29.5 doesn't? I am certainly nowhere near a healthy weight or body shape (all fat stored around my middle and I also KNOW I can't maintain this with any consistency on my own (30 years of experience has taught me that). But by the technicalities I won't qualify, and so if and when I can afford it I will DEFINITELY lie.

I'm a 12 and just a few kg overweight. I got it from an in person consultation in Harley Street - felt safer that way. I just asked to be able to micro dose like the Times journalist so that I could lose 10kg which would make me feel much happier. My mental health is quite shot by being the size I am so it will have an enormous difference on my life.

But if anything happens to their bodies that they are responsible for, I imagine just a tiny proportion of the people abusing them only use private healthcare healthcare so the NHS will be dealing with it.

I get mine from Boots and the procedure is pretty stringent, but I actually agree - I think prescription in person and a weigh in now and then at the pharmacy would be safer all round. I’ve lost 6 stone on wegovy so there was never any doubt I’d be prescribed it, I was not a marginal case.

It must be incredibly tempting for people with eating disorders- but very unsafe for them. And a bit of monitoring wouldn’t be a bad thing, imo.

In an ideal world, GPs would be able to prescribe it for people who really need it. Until then, I think the Wild West will continue.

But we (fat people) have literally thrown money at this for years - all the various flavours of weight watchers, gym membership, counselling. The diet industry alone is worth billions of dollars every year. This actually works, which is a game changer.

Agree. All the faux concern is just so transparent and tiresome. I pretty sure that not a single, faux concerned, poster is a healthy weight themselves.

They are never (or at least for another decade) going to be available freely via the NHS so people need to turn to private.

Changing it to be a face to face only prescription will make it inaccessible (due to significantly increased private costs) to tens, even hundreds of thousands of people where it could be life saving.

The GPhC has tightened its prescribing guidelines, what they need to do is up their inspections of the big online pharmacies to ensure they are complying.

For my provider I now need -

Video call
Photos
Copies of medical records/prescriptions
Independently verified proof of height and BMI (Drs records, done at pharmacy and stamped, video with height taken in video etc)
etc

Other providers will have to tighten up in time as they get inspected.

People will always get around the rules. I am more concerned for those that may not have access to the medication that need it than those who try to cheat the system. They need to have some accountability for their own actions, I would go as far to say I would have no problem if they made it a criminal offence.

Me too. I’m two weeks away from my target weight of 85kgs. It’s about 8-9 kgs above my upper BMI but it’s never been my intention to reach that because I don’t believe in it as a means of calculating a healthy weight. I’m tall, I have big bones, my feet are a UK size 10 but must of all I have muscles because even when I was 109kgs (and long before that) I was a serious excercise.

I know what I’m made up of due to dexa scans I’ve had that included body composition so I’m not worried about still being over my BMI. I’m 67 and in the last year I’ve slashed my BP and will probably come off medication in two weeks, I’ve completely turned my cholesterol levels around to excellent and I’m no longer pre-diabetic, in fact my blood sugar levels excellent as well.

I planned my Mounjaro journey like a military operation and adopted a whole person approach to ‘me’ which took care of my head, my emotions/my heart, and my body. So too bloody right when people have gone about losing weight this way, that we don’t want to be involved with the fools who lie and cheat their way to their WLI. Bugger off and give yourselves a bad name, make yourself sick and die as a result if you want to because you deserve all you get.

No, I mean they didn’t even need them in the first place - I’ve known one of them for 3+ years now and she’s never been obese during this time, I wasn’t aware she’s had a gastric band years ago, so she does have a history of weight struggle.

We were talking about the injections because I’ve been considering it (endocrinologist recommended, I’m just wary of the cost) and she gave me this whole speech about them and how to still be able to get them even when you don’t need them anymore (or need a lower dosage?). It was a party so another friend joined in with all the tips.

I’m still considering it but I did feel like I was being recruited into a cult 😭

Im on it, but I weigh over 17st and am going through an online pharmacy. I didn’t have to upload a photograph, but I was honest about my weight. The online pharmacist sent a letter to my GP regarding my prescription!!! I have been under weight management with my GP too. If I was your size 8/10 friends GP I would absolutely be contacting them to get them off it!!

My neighbour is going back down the doses! She did have a fair amount to lose BUT now she looks gaunt and it’s made her look ill. she’s lost over 7 stone in a year.

I’m all for using it if needed BUT I’ve been on it since February and lost around 20lbs in that time. It’s slow but I am happy with that!