AIBU to seek a consensus on who is a socially acceptable recipitent of Mounjaro?

[Periperi2025]

So it seems that much of mumsnet and society judge users of WLI extremely harshly seeing them as fat and lazy people who should just eat less, move more and use more willpower. But apparently not all of us, some of us after divulging enough medical history as 'okay'..."not you just the other fatties!!"

So, are people with diagnosed endocrine and metabolic conditions, acceptable?

What about people with undiagnosed endocrine and metabolic disorders, it's taken me over a decade to get to the point i am now, which is under endcrinology with a confirmed 'problem' and a working diagnosis but nothing more, my story is sadly far from unusual. You don't know who they are, they don't know who they are (although they may have astrong inkling), quite the conundrum!!

What about people with diagnosed Type 2 diabetes, who once were also just fat people without type 2 diabetes (mostly)?

What about people who are just fat now but statistically likely to develop type 2 diabetes in the future, like the current Type 2 diabetes patients were 10 years ago?

What about the people with severely disordered eating? As a society and a health service we deem it justifible and, hopefully preferrable to treat Anorexia Nervosa, including as inpatients at great expense (£500+ per day in the NHS), compared to treating an obese eating disordered patient with Mounjaro at a cost of approx £9 per day to the NHS for the highest dose. Presuambly in a civilised society we think that both groups of patients deserve a chance at a better quality life and improved life expextancy, and we dont think that Anorexics should just eat more and move less?!

So my AIBU is?
Are all of the above groups socially acceptable recipitents of Mounjaro?

YABU - no there are not all acceptable the gluttunous, lazy, weak willed cheats.

YANBU - of course they are all socially acceptable recipitents given that they meet the prescribing criteria for Mounjaro which has been accessed for Risk vs Benefit via peer reviewed research.

But with the best will in the world here, your views are irrelevant because the criteria is set. People could take responsibility for themselves before getting to the stage of being diabetic and in other ill health.

I've been very obese and it was my fault, and mine alone. I had surgery privately.

It’s not something I’ve thought about until reading your post and I haven't read the full thread. But I suppose for me, the qualifying criteria would be that people who have already tried other methods, and who are thought to be in imminent danger of developing other diseases as a consequence of their weight within 12 months, should be offered it.

I guess one big question is whether or not they should continue to receive the injections after achieving a healthy weight. I think that should depend on diagnosis. Those who have the gene that means they never feel full should keep getting it. Those who have psychological issues though should be switched to therapy.

Wouldnt work.

For one big reason.......the vast majority of people are overweight because of lifestyle or illness, anorexia isnt a physical illness that can be cured in that way. It is a mental health issue that needs intensive therapy to help the sufferer to stop seeing food as a means of control.

Do you think that I never felt hunger? Never desired the delicious pudding on the menu? Didnt want the food I was offered? Of course I did, but the need to not eat was far stronger than the hunger. The hunger pains were not as painful as the fear and intrusive thoughts every time I put something in my mouth that wasnt "safe", and there were precious few "safe" foods.

Its a constant fight to not let those thoughts back in. I was told that I should consider myself like a clean addict or a sober alcoholic, I will always have the desire to go back to it. I was sceptical that this was the case, but in fact it is true. In times of stress or pressure my go to is to stop eating, in the same way that an alcoholic would crave a drink.

@Homec00kFraming healthcare as a competition between people with different conditions is just not ok. It’s unhelpful and dangerous. Anorexia is indeed a serious and deadly mental health condition that deserves far more funding, support, and awareness. But to suggest that people living with obesity are somehow “hoovering up” NHS resources, or less deserving of care, is profoundly wrong.

Obesity, like anorexia, is a complex medical issue, not a personal failure. The idea that people with obesity are somehow “taking” resources away from others is also just not correct. NHS spending is not a zero-sum game where one group must suffer so another can be treated. Both anorexia and obesity deserve investment, compassion, and evidence-based care — and pitting them against each other is just cruel.

Mental health services across the board are underfunded. That’s the real issue. The fight should be to demand better funding for all, not to scapegoat one group of patients for the systemic failures of healthcare policy.

It already pays for lots of other drugs for life, including some for lifestyle related conditions and illnesses that WLIs reduce the likelihood of. The principle clearly already exists.

They're expensive now, but personally I expect the rollout to take so long that by the time the NHS makes them available on the same basis the private sector currently does, they'll be much cheaper.

I voted YABU purely because it doesn't matter what is "socially acceptable", what matters is whether a patient fulfills the NHS eligibility criteria.

Fuck me!!! You really believe that?!!! BOTH obesity AND anorexia are eating disorders! Both have the same roots in a lot of cases. You are prepared to say that obesity is self inflicted well then by your measure so is anorexia!!!
BOTH involve choices about what you put in your mouth. Both are rooted in trauma and mental health issues. Both can be deadly! Obesity is just as real and dangerous and difficult to overcome as anorexia. Your ignorance is astounding!!!

https://www.theguardian.com/society/2023/may/18/obese-patients-cost-nhs-twice-much-healthy-weight-study

Obesity is crippling the NHS and on top of all the other expensive conditions it causes it’s the second biggest preventable cause of cancer.

It is very much eating up funding which can only have an impact on other areas.How can it not?

This way of everybody having to pretend it’s not happening because of hurt feelings is frankly ridiculous.

I agree with this. I'm not on it but it's best not to give a shit what judgy pants think about it. Fuck em. Don't give them the rise they're hoping for.

Which is one reason we can't afford to delude ourselves that telling people to diet and exercise is going to solve the problem. Because in fact there is zero evidence that any diet exists that will tackle societal obesity. We need to utilise tactics that actually work. WLIs are going to be part of that, thankfully. We'd be so fucked if they didn't exist.

No obesity is not as dangerous as anorexia or as difficult to overcome.

Starvation alters the brain and stops it from being able to function properly or to increase intake .Anorexia has the biggest mortality rate of any psychological condition. Funding is being cut whereas money is being ploughed into all the areas attributed to obesity.

It really isn’t fair .

Yes I agree.

When you look at the demographics of addicts they are not a mentally healthy set of people.
Most addicts have underlying causes.

Quitting is difficult, many relapse.

Once morbidly obese, bodies work differently. There are physiological changes that make lasting weight loss even more difficult. The approach to treating obesity has been revolutionised by GLP1s because prior to them becoming mainstream there was no program that proved to be effective long term. Studies have shown this again and again.

Obesity is a disease. People persist in assuming it’s just laziness, but we know better than that now.

Unless there’s going to be a way to make sure all children are free from psychological turmoil, stress, whilst simultaneously banning fast food and other foods deliberately made to be addictive, it’s not going to go away.
Unless you can offer real support to those whose weight rocketed on certain drugs (more than you’d think because the issue is so dismissed, once you’re fat you’re just one of the crowd of lazy overeaters), unless you’re going to offer decent mental health care to all who need it, it’s not going to go away.

People generally do their best. GLp1s are offering a real lifeline to many, and no one would willingly fork out £££s if there was an effective option. I’ll say it again: obesity changes how the body works. Losing weight and keeping it off is rare.

There is so much research still to be done on obesity and addiction. It may have something to do with living in ways we are not built to live in. In the end though for most obese people they are, without access to long term health care and long term psychological support (none of these available unless you can fund it yourself) likely to remain obese with all the Comoros associated with that.

They are being reviewed and there is going to be uproar if one demographic keeps on getting more and more of the funding pie whereas everybody else gets less and less.

We are pandering to obesity far too much.

Again your ignorance is astounding. You are wrong in so many levels!
You simply haven’t got a clue.

Ok well then anybody who is underweight or in MH crisis and wants treatment should get it- except that doesn’t happen. The reverse happens. They get next to nothing.

Nope you are.

Perhaps people should stop pandering to those with anorexia too then!

They’re not. All they get is long waiting lists.

So so I, but it's very hard on people in an equivalent position who just can't afford to do that.

Nah, there isn't. Weight is trending upwards, or was before private WLIs became so easily available, and that combined with age means more and more of the population potentially qualify. The 'everybody else' will get smaller in percentage. And the costs of WLIs will decrease over time.

We're not yet at the stage where we'll see obvious savings from greater NHS WLI availability, as it's one of those pay now benefit later things. But in a few years we will be, and that will become increasingly hard to ignore. It'll outrank half baked moral takes from people with unevidenced faith about the importance of diets.

(This was supposed to quote @Homec00k but managed to disappear the post!)

But the NHS and its treatment of obese patients is exacerbating the problem.

You go to the gp for an unrelated issue and they dismiss you as you’re obese, so the problem gets worse and requires more and longer lasting treatments.

The obesity care they offer is laughable. 6-12 week courses to teach nutritional information - most obese people I know know more about nutrition than most GPs! We’re fat, not stupid.
Short term psychotherapy, for which there is little evidence of success.
Prescriptions for weight watchers of slimming world - known to be business models that keep people coming back.

Every single one of your posts is dripping with contempt.

The vast majority of cases of obesity are not caused by trauma or mental health issues.

Every single case of anorexia is.

I was very obese (size 22) as result of having several children and not putting in the work to lose it in between pregnancies. Then, as an adult, developed anorexia as a reaction to severe trauma (my ex husband attempting to murder me). The two were not the same at all. I did choose the easy way of not dieting between pregnancies, I did not choose to become severely mentally ill to the point where I ended up in hospital, starving to death.

The fact that you think that the two are even vaguely comparable shows how ignorant you are about the difference between an eating disorder and eating too much of the wrong stuff. Being obese does not automatically mean ED.

This is very true. I have a great deal of sympathy for people in that position, and look forward to the day when they can access WLI too.

As do those with obesity the wait list to get a first visit with the weight management service (not actually get weight loss treatment) currently is about 7 years.

What’s your answer then?

The diet approach has been proven to not work, even before UPFs were so prevalent.