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.

80% of healthcare budget is spent on people the last 12 months of life.

So I'd like to see a cultural shift towards a more pragmatic approach to death and dying, including providing medical assistance in dying to patients with dementia who have either made a clearly expressed wish prior to losing capacity or chosen to assigned a LPoA to make that decision for them. But i think that cultural shift is going to harder to achieve by some people in the UK even than accepting that fat people aren't inherently morally inferior. (But this is a topic for an entirely separate thread).

That would free up huge amounts of money for preventative healthcare, of which i believe WLI are a key part.

However, i started the thread about societal attitudes to fat people not to NHS funding, and since the majority of people currently on WLI are self funding but still getting heavily criticised it demonstrates to me that many of these attitudes are not stimply about people's passion for the NHS and that their negative attitudes run deeper.

I'd be curious to here any views from people abroad living in countries with differently funded healthcare.

Diets don’t work.
Is it 5% of people who can lose weight and maintain it?
Thats not diets working.
The diet industry would cease to exist if diets worked.

Your other comments about people not caring enough to sort it out shows that you don’t understand. It’s not about caring, it’s about having a drive to eat that overrides logic. There’s actually research going on at the moment about this - why some people have a faulty driver. Why some people are susceptible to obesity - is it genetics? (In some it is), is it trauma? Neurology? Ancestry?

It's also the fault of our food industry. If fresh fruit and veg, and decent proteins weren't so expensive, a lot more people would be eating healthy meals.

Some of us avoid UPF and still manage to
be obese.
Of course availability of addictive shit food is a contributing factor, but that’s always the assumption - fat, oh he/she eats shit all
day long, and that’s not always the case. There’s far more to obesity than people’s base judgments.

Yes I don't understand why governments haven't done something about this. Tax the shit out of processed foods, use the proceeds to subsidise healthy food and invest in infrastructure that supports healthy lifestyles. Far better to invest in societal level changes than dependence upon medication that will end being passed down between generations.

But your post assumes that once people are allowed WLI then they no longer need “good choices” when actually it’s the reverse.

Good choices are essential on WLI and what the jabs do for me is ensure that I feel the consequences of bad choices rapidly and firmly!!
It also makes it easier to make those good choices in the first place.

Therefore, my children are benefitting from this. On MJ I go shopping and fancy apples and blueberries instead of chocolate and crisps so I buy those and now they are used to having them in the house and choose them for a snack.

So, for me, everybody wins really.

Agreed. Roll on the time when these drugs are out of patent or whatever the term is and they become a lot cheaper.

Why on earth weren’t you buying those things for your children before? The NHS should not be paying to parent your children

Fresh fruit and veg are absolutely not expensive. Thinking you need out of season strawberries and mango in order to eat fruit and veg is ridiculous. Eating healthily is so much cheaper. Highly processed food is more expensive and so is meat. We should be cutting down on meat.

I have none of the above illnesses, I just have tried and failed multiple times to lose weight and I was on a doom loop constantly, felt awful about myself which perpetuated the vicious cycle of eating crap.

I honestly don't care what people think and if they think it's cheating, why would I do it in the same way I have done for years and failed at and not an easier way?

I paid for it myself, and anyone overweight and not yet obese should be able to get it. Although criteria on NHS is wild, someone I know is type 2 diabetic, obese and has struggled massively with losing weight despite calorie counting and was told no, you have to do through diet and exercise - when told this hadn't worked, they just shrugged.

Right so having lived a life costing the NHS double that of everybody else you now want end of life care cut so that even more can be spent on the same group of people that are getting the most already.

No

I think the problem we have as society is people accept those underweight as having an “acceptable” ED.

Not enough is made prominent about how overeating can also be a form of ED. We often talk about “comfort eating” and it’s a thing. Some people with trauma will cease to eat and some will overeat.

That’s aside to the obvious other causes of both forms for disordered eating - illness is one.

Bit also CoL is having an effect as UPF are cheaper and more filling.

It’s such a huge amount of factors that input into it but I think anyone who is overweight and doing something about - however they are - is a great thing. Especially as people on WLI are often sacrificing huge amounts of their income to do so.

The people getting left behind are those who live with little money and their weight is directly related to that and cannot afford WLI.

Are our government even competent enough to take this on?
The Change4Life campaign was funded by nestle.
Whatever societal changes are needed they are up against the might of food corporations who employ many people to make their food more and more addictive.
If you’re poor and you’re looking to be satiated it’s very difficult to avoid UPFs totally. Protein is expensive. Healthy fats are expensive. Poverty is heavily linked to obesity.

Well it's the consequence of short term politics isn't it. These changes should have been made decades ago. We need the sugar tax on steroids.
A full belly isn't expensive. We would do well to take note of how poor people in other countries, or in our own history ate. A little bit of fatty meat is enough to meet protein and fat needs and is far cheaper than adding healthy fats to lean protein.
I did also mention subsidies to make these choices more affordable. I'd rather government spend money on healthy lifestyles than medication. I appreciate you don't agree but I believe longer term, wider reaching solutions would be better.

I think your figures are out somewhere as 8st 7lbs is not BMI 22 for someone who is 5'7, it's BMI 18.6. I know as BMI 23 is about ten and a half stone, which is my goal.

I have lipoedema, a connective tissue disorder, sometimes called ‘painful fat disease’. I carry large amounts of nodular, unsightly fat on my limbs and upper arms.

I am on Mounjaro because it helps with the pain and inflammation. It is helping me lose any non-lipoedema fat and ready myself for much needed lipoedema liposuction reduction surgery, which is not available on the NHS and will cost me tens of thousands of pounds.

I am otherwise fit, active and healthy so have to pay for my Mounjaro and I will continue to take it. I eat very little now and will soon see my ribs and collar bones sticking out, lose hair and my face look gaunt - whilst still remaining a fat-legged high BMI.

My boss, a GP, won’t even prescribe privately for me (so I can obtain at cost price through our dispensary) even though she can see how much it helps.

I do admit to being mildly irritated by type 2 diabetics, who have brought on their condition entirely due to their unhealthy lifestyle, being given the drug for free but there is absolutely nothing I can do to influence NHS England’s prescribing criteria (I am also annoyed that my GP will prescribe different/special erectile dysfunction meds privately. 🙄) As I have a disease that only affects women, there is barely any research into how GLP1 drugs help the condition, despite all the anecdotal evidence.

It is clear that one of my daughters has the same condition as me, which will only worsen with each hormonal change so I’m saving now for her to be able to access surgery should she wish, before she gets to the stage I am at.

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?!

you clearly know nothing about anorexia. it's a severe mental illness from which people (if they restrict eating) would die very quickly. Its a very very different illness. YABU unreasonable to link it to the conversation.

YABU for thinking it’s any business of anyone other than the person either getting it for free on the NHS under their extremely stringent guidelines or paying for it out of their own pocket, and their respective doctors.
Societal approval/judgement is neither expected, welcome nor wanted.
MYOB people!

I’m diabetic and use it, I wish it had have available before I became diabetic

@spoonbillstretfordi am 5ft2. I’ve lost 5st7.

I think the reason why a lot of people view WLI negatively is because of how it started. It started with rich and famous people who carried a few extra pounds (if even that) who bought up medication (I think mainly Ozempic back then) that was desperately needed by diabetics who because of it had to go without. It was seen as a greedy, vain and quite cruel. The situation and production volumes have changed since then but I think the reputation has stuck with many.

I think any way to safely reverse the growing obesity crisis is good and needed. It will cost us all so much more in the end if nothing is done and if this is what works for people right now then great. Something else might come along eventually and then that will be seen as controversial and WLI will be the old trusted method.

I expect we all think they would be better. If they existed. But there's no evidence they do, whereas there is evidence that long term WLI use keeps the weight off. Your argument is essentially that there must be a way to deal with societal obesity in an environment completely different to what humans evolved in, because you want there to be.

We ought to address the obesogenic environment anyway, and improve access to healthy foods. Thin people can be malnourished, skinny fat is a thing, so MJ doesn't deal with that specific problem. Being a healthy BMI doesn't mean a person can access adequate nutrition, their 5 a day. But we also can't afford to indulge ourselves with people's vague ideals when we have a societal obesity crisis and a drug that actually works and will be much cheaper in a decade or two.

Ah, sorry. I can't find my reading glasses at the moment. Also, well done on your weight loss!

In 1950 the average British woman was 5’2” and weighed 59kg.

By 1993 according to the NHS average height of a woman had increased to 5’4” and weight was now 66.6kg.

By 2019 the NHS reported average weight of a woman is now 72.1kg and obesity prevalence among the overweight has shot up to 29%.

There are lots of reasons why this happened, but there hasn’t been a genetic or evolutionary shift towards all of these complicating conditions that you mention in the OP. So it’s - combination of lifestyle choices and environment.

I am overweight and I absolutely know that I have caused this situation - not entirely by choice but certainly I could have done more to stay fit and active. I was clearly educated at school on the benefits of healthy food and an active lifestyle.

So I think that’s what there is judgement. It’s not that people don’t understand there are conditions causing obesity but that many people have made choices that trigger or drive these conditions to become worse.

Of course there's evidence that healthy lifestyles reduce obesity. Medication may be easier, but societal level changes are certainly possible. Japan is a good example.