To think that if people can take Mounjaro forever for maintenance (which I support FAOD)

[Fragmentedbrain]

Why can't everyone just buy it when they feel the need?

Basically this means that people who lost weight in a different way are denied this long term amazing support tool while those who started off on it can keep using it. But if you purposefully regained a bit of weight to become "eligible" for the injections you could take them and then have Mounjaro available for life.

This seems very unfair to me.

I think “I tried everything” means different things to different people.

I did the 1200 calories a day, I did the intense exercise, I did the shakes etc.

But as someone who was class III obese, it didn’t work, because my brain and body were working against each other. This medication has saved my life.

I agree. People who have had issues managing their weight should be allowed to pay for a private prescription to help maintain their weight.

I technically qualified for it last year but was too scared about being cut off without time to taper or denied maintenance use if I needed it. I’m finding it harder than ever to lose weight at the moment and the side effects of obesity and unmanaged PCOS are really starting to kick in now.

@ThatCyanSheep I think you’re misunderstanding. Imagine 2 people, Mary and Jane. Both of them are obese, exact same BMI, exact same issues with food.
Mary goes on a massive diet. She virtually starves herself for months on end, it’s really hard work and she’s miserable, but she manages to get to a healthy weight.
Jane uses WLIs and loses the same amount of weight. It’s not easy but the drugs really help.

Now Mary and Jane are no longer overweight.

Mary has to continue to watch everything she eats. She thinks about food constantly, every day is a battle to not eat the wrong thing. She misses out on social events because food is involved, she can’t have treats, she is worrying every moment of the day about gaining weight again.

Jane is on maintenance WLIs, so whilst she has to be careful, she is supported by the benefits of the medication, making it less of a struggle to keep the weight off.

Surely Mary should be allowed maintenance WLI too? But she’s not, because she is no longer overweight. Jane isn’t overweight any more either, but she gets to have the injections. That is the unfairness OP was referring to.

Personally I think if it can be proven (by medical records etc.) that you were obese, then yes a lower dose of WLI should be made available to ease your maintenance. That’ll be the next step I’d imagine.

Yes I agree. That would prevent the “slim but want to be slimmer” people getting it, but allow access for the people who were genuinely obese to start with.

I think the issue is around the messaging for these jabs. They’re painted as a quick weight loss fix, and not an actual medicine

I suspect that will come, as the drug is tested more (we have a pretty good in-the-population test going now it’s become so popular!) and we understand it better.

I think it’s a bit of a miracle drug - not just for weightloss, but the effects on addiction, inflammation, blood sugar, PCOS symptoms, women’s health, mental health, possibly even gut health… it seems like so many people could benefit. Once it’s understood, tested - and crucially, out of patent so other companies can explore and experiment with it and market it differently - then I suspect in the future one day everyone will be able to access it.

Equally, I hope it’s much more widely available on the NHS at some point - it’s about to become insanely expensive privately, which doesn’t seem right or fair either. Barely anyone qualifies for it on the NHS at the moment.

I would support everyone having (monitored! And supported! It’s a prescription drug!) access to it.

It’s a balance of risk. If you had those conditions then life without medication might mean you cannot cope. If you can’t manage your weight without drugs then you can.

I remember sitting, sobbing, in a private ‘health-check’ appointment provided by a former employer after being told, yet again, that I needed to lose weight and all I had to do was was eat less move more. At that point I’d been dieting on and off for over 30 years, been bullied on and off about my size for even longer and felt completely hopeless. No HCP, PT or alternative medical provider could explain to me why I was always hungry and never felt full, why I never felt remotely satiated unless I’d had carbs or refined sugar and why, despite committing to exercise and a sub 1500 calorie diet I kept putting weight on. I was weak, I was a failure and I just needed more willpower.
WLI showed me, within 48 hours of my first dose that I was not weak and I was not a failure but that something clearly had been faulty biologically because I no longer craved carbs or sugar, barely thought about food and was full for the first time in my life.
I don’t think people should have to lose the battle and become obese to get the help I’d been crying out for my whole life, a meaningful intervention earlier could have saved years of pain, heartache and self loathing. I’ll stay on MJ for life if I have to, the difference to my quality is worth the risks 10 x over.

With respect, you will be doing this on WLI too.

You can't eat whatever you like. You need to maintain a calorie deficit. Many people find they can't drink on the jabs or that they can't eat certain foods.

You do feel more full and less hungry so it is easier to stay in deficit but you still need to calorie count.

It’s different because MJ works on resetting the way your body sends signals about hunger and fullness. If your body already sends signals correctly, why would you think the drug will help? If your GLP1 hormones are working normally, evidenced by being in a normal-overweight range without the drug, taking the drug won’t help.

Jane will also have side effects of the WLI - gastro upset is common, more rarely gallstones or acute pancreatitis.

Doctors absolutely will stop or avoid drugs where the risks outweigh the benefits. If Jane gets gallstones she'll have to stop WLI and it's unlikely she'd be able to take a similar drug in the future.

The NHS can barely afford WLI for morbidly obese people- you're dreaming if you think slightly overweight people will get them anytime before the patents expire (which actually isn't too far off - 2036 probably for Mounjaro)

Beware the miracle cure - it doesn't exist.

But if you're body isnt sending the wrong signals why would you have been obese or even overweight in the first place?
What I see with the gate-keeping here is that some obese people, after years of being told they're lazy / lacking will-power or whatever are now kicking down to the overweight people in the same way! So if you're obese it's because of a medical issue with your brain sending the wrong signals, but if you're just overweight it's because you're lazy / lacking will-power or whatever.

@Parksinyork

surely that’s the same for any weight loss diet. Be it slimming world, weight watchers, Cambridge diet etc

Unless you continue to watch what you eat any weight you have lost will go on. To me the op is saying why should someone who has worked hard to lose weight be the more conventional ways still be subject to those hunger pains/desire for food they are working hard to suppress all the time to maintain the weight lost, when those on MJ get it forever even once they have attained the weight they want so don’t suffer thise hunger pains and desire for food

I sort of agree MJ should be available to those who lost weight conventionally

No, I won't. On MJ my appetite is pretty much nil so although it's been brill for losing weight I don't think I would be particularly health on it longterm, due to not eating enough to get enough nutrients. I will taper off when I reach my goal and then see how it goes. I'm hopeful I can maintain my lower weight but it's great knowing that if I ever find myself in trouble again I can go back on it.

Have not read whole thread but I can see the argument if you see these drugs as addressing addiction. I know someone on it (privately) and she is noticeably a different person. It's not just the weight loss it's the impact it's had on her inflammatory condition which had changed their life. They have not lost a huge amount of weight from what I can see but it's noticeable. They had dieted all their lives and lost and gained weight.

I do see some issues as I think there is a risk in coming off the drug and weight going back on but maybe people will be on low dose maintenance amounts for their lives. As an asthmatic I am on drugs for the rest of my life (unfortunately) so it's not uncommon.

I'm with you, OP. I'm holding too many extra kg, but am waaaaaaaay off being able to qualify for the jabs. So I'm trying to lose weight the normal way, and it's utterly miserable. I'm addicted to food and suffer constant food noise. Trying to stay away from it is torture.

Maybe I should just let myself gain weight and then I would qualify and then I could stay on a maintenance jab for life.

Quite. I was prescribed mounjaro privately at BMI 29.6 because of having PCOS. My current BMI, taking the full dose of 15mg is 24.9 and I intend to carry on taking it and to get to BMI 24 or 23.

I'd love everyone to be slim and I don't care if that involves WLI or not - I'm simply pointing out that there are potential unpleasant side effects (a friend used it with success but had to stop due to the gastrointestinal symptoms) and some people cannot safely use the current drugs - whatever their BMI. It also doesn't fix an unhealthy diet - you could lose weight then end up with serious nutritional deficiencies.

The cost will come down longterm and I'm sure the drugs will be used more widely - but the NHS is there to treat health problems. It's only justified for the NHS to pay for WLI if the person's health improves significantly with weight loss. That's easy to show at a BMI of 40. At a BMI of 27 I suspect there wouldn't be enough long term health benefit to justify the side effects and cost.

I had a BMI of 27 a few weeks after starting on Mounjaro and it was definitely worth it. I have had very few side effects, even on the full dose.