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.

72kg is ok if you're 5'7" though. I know as that's what I now weigh after 16 years of being between 79kg and 91kg. It would be interesting to know what the height distribution is like these days. Though I'm not doubting that there is an obesity problem.

I think people need to get over their hesitation here. These drugs are here to stay and will be used in all sorts of health applications in the future.

I self-treated my PCOS with GLP-1s (I get compounded versions in the US) and it really helped with certain symptoms that I had been trying to treat for years. There seems to be some anti-aging effects to them as well, I can well imagine that most Western people of a certain age will be using some form to extend their lifespan. Needless to say, I plan to micro dose these drugs for the time being.

You conflate two different things here.

There is evidence that healthy lifestyles mean lower obesity. There is no evidence whatsoever that telling an already majority overweight and substantial minority obese population to adopt healthier lifestyles will tackle that. And there is evidence that long term WLIs assist formerly obese people to stay at a healthy BMI, in greater number than diet too.

Japan is not a relevant example here because they have never been a majority overweight society, unlike us. What we need to undertake is a reversal process.

@MizzeryGuts in 1950 the UK was still under rationing.

There’s an argument that rationing contributed epigenetically to the current obesity epidemic (contributed to also by access to cheap UPFs).
One of the things that comes out time and time again is that following a restrictive diet results in overeating and weight gain, even in the absence of junk food.

I remember my grandmother criticising me for being treated for asthma 50 years ago. She felt it was weak spirited to need help in this way.

I think we’re seeing a similar reaction with GLP1s right now, compounded with the poor and judgmental attitude towards obesity.

Why don't you lie and say you have xyz and therefore you are allowed to have it?

I've been very low upf for almost 2 years, and it wasn't a huge shift from by prior diet.

It has kept my rising HbA1c in check, but that is it, no weight loss and cholesterol continued to rise.

I also exercise regularly (all my hobbies and socialising have been outdoors sports based since i was a teenager) but with limitations as recovery from exercise is really tough with very low testosterone.

It is great that it works for you, but for people that have an underlying endocrine/metabolic condition (whether diagnosed or not), it is unfortunately not that straightforward.

Obviously, that doesn't mean we shouldn't all be striving to eat less UPFs and the government should definitely be leading on this, and I'd recommend every one reads ultra processed people (just for the description of ice cream processing and their future hopes and for the history of nazi coal butter if nothing else!!).

And before that, hunger was a very real problem. People often forget what a recent development it is to have whole societies with the resources to give their entire populations 3 meals a day for their entire lives- I realise that doesn't always happen in the UK even now but it's not because the food isn't available. Most of us probably are not very far removed from a malnourished ancestor.

There's also smoking rates. In the 70s, half the population were on an appetite suppressant drug.

Hmmm people were literally starving to death in the final year of WW2 in Japan. It was a very very serious situation.

There are certain things they do now to avoid that experience—if you ever wonder why they have rice fields in inexplicably urban settings. If anything the Western countries (minus Germany) were very well fed at the time.

Have you ever considered that you obvious deep hatred of obese people could be a contributing factor in your childs mental health condition?

Thanks for your story. I have to admit, despite 25 years in the NHS i've only really learnt about Lipoedema since being on Mounjaro and reading other peoples stories, then noticing it occasionaly on the women i see.

It sounds very tough and unpleasant.

Mounjaro seems to be amazing for certain conditions and is being recommended by forward thinking doctors off label, for obesity with.....

I certainly feel way better than my weight loss alone, so i hope it is having some postive impact on my underlying endocrine condition, but only time will tell, and since what i am suspected of having (Cyclical Cushing's) is so vanishingly rare, it will be back of the line for any research funding.

There isn't evidence of it because it hasn't happened before. Obesity is a modern phenomenon. There's no reason to believe that a push towards better nutrition and more active lifestyles wouldn't make a difference. We need to look at what healthier countries do that we don't. We can't medicate away problems- it doesn't work.

@Periperi2025 brave post!

Personally, I think that if you are self-funding then it is entirely up to you and your prescribing physician and there is no moral judgement to be made at all. I don't even think it should matter what your BMI is, as that should be a judgement call by the physician, particularly as more people want to use WLI for maintenance.

I think there is a wider conversation to be had around the NHS. I think that obesity costs the NHS so much money it would be really, really sensible to get people on WLI asap. I really hope that the clever people at NICE will do their cost benefit analysis and this will become a no-brainer in a few years.

Despite what all the fat haters would want you to believe, people become obese for a very wide variety of reasons, not because they are scum of the earth sloths, who lack will-power, motivation etc etc etc. The causes are so deep rooted in so much of what is not working well in society generally that I think it will be harder to tackle all of it in the short term than just prescribe WLI. That is not to say that all the issues do not need to be tackled, but that is such a heaving, ginormous can of worms I don't see it happening any time remotely soon.

That's interesting. I was recently looking at all the ongoing and planned studies for new Mounjaro indictations (alcohol misuse, heart failure, PCOS, Fatty liver disease etc) and one thing that jumped out was they were all 'x condition' with obesity and no attempt to look at microdosing for these conditions in normal weight individuals which i found strange and a obvious missed opportunity.

Do you think there might be a degree of jealousy that we (obese people) are getting to play with the shiny new toys and they (normal weight people) aren't?!

Yes, exactly. There isn't evidence of it, becaue it hasn't happened before. So you're guessing. You overstated your case when you said such societal change was 'certainly possible'. There's no certainty. And not one example of a society that's successfully managed obesity doing what you suggest, so it's not clear what you think we'd be studying.

Whereas we do actually know that ongoing WLI use works. There is one example of a country that has successfully reduced their obesity rate, and that's the US in 2024. It certainly wasn't because of food quality. Their WLI rates went up though!

The issue with WLI isn't effectiveness, as we know it works. It's with cost, which is going to come down over time. But what youre actually saying here is that we should reject something that we know works because of some idea you have with no evidence. That is not a risk we can afford to take.

Because nobody should have to lie or feel shame, and doing this supports the attitude that there is something inherently shameful about obesity.

We don't know that mass medicating will work long term on a societal level either. Because that's never been done before either. It's just swapping one problem for another. It's a not a real solution for anyone other than the individual currently being medicated.

Yes so did i have surgery privately but had i not been able to afford that i would still be obese and by now would more than likely be suffering from other health complications and costing the NHS an absolute fortune!

Couldn't care less if you are self funding.

The NHS funding is tricky because in theory yes because I believe in preventative health care but that is not what they NHS currently provides.

I also know the NHS has a finite budget and would like to see money spent improving other areas first. There are many drugs or treatments for conditions which the NHS won't fund or don't adequately investigate and diagnosis and therefore people not getting treated for.

Yes. There have been threads on here from people who struggle to stay slim and say they're jealous they can't access WLIs to make it easier. When it's pointed out to them that they could stop struggling long enough to hit the necessary BMI they usually ignore that.

I don't know how common it is though. People complaining about MJ on MN are probably not a representative group!

People whine about it because they are jealous IMO that there is a solution for so many people which is inaccessible to them (it’s expensive).

im pregnant currently so not taking it but I was up until I conceived and will again once baby was born. For me it has fixed a lifetime of bulimia and disordered eating, if people have never had problems with food they couldn’t possible understand. I don’t care what anyone think.

Most people are paying for their own medication so I have no judgment (or opinion) on that, a prescriber has agreed it and they meet the criteria.

I do agree it is life changing drug, which is why I agree the NHS has started with people who need serious intervention due to significant health issues including known cardiac problems.

There is a difference between being overweight and obese (clinically) and I think there must be a cut off or a starting point.

Opening it up to everyone with a BMI of 27+ would crucify the NHS overnight it has to be slowly brought in. People do get enough side effects to be visiting their GP for help or guidance and monitoring would be involved.

For this reason I am also sick of seeing people complain about the NHS criteria. It is what it is. I would try to focus on what you can appreciate rather than demonising the broken NHS. There are many people dying or in agony waiting for surgery or can’t access life saving or life changing medication as it is. I know it’s expensive - blame the manufacturers for that, not the NHS.

Im not judging anyone for taking it or wanting to take it and feeling hard done by, but the continual complaining about not being able to get it on the NHS is creating its own narrative about who ‘deserves’ it. Yes, this is how the NHS works unfortunately it’s not a free for all for everyone. You aren’t the only group of patients who can’t get something you think you should be able to, and you won’t be the last. We just don’t have the funding it’s not an ideal world

We have more evidence for it than we do for your proposal. If your argument is that the evidence for WLI usage (since the 00s) isn't sufficient, you cannot argue for something has much less on the basis that hey, it might work. Your proposal is about ideology and vibes.

Mass WLI rollout, which is happening, isn't enough by itself because you're right that we do need to address diet and nutrition. Thin people can still have poor diets. But it's a necessary plank, and will remain so until the evidence shows that telling people to diet and improve lifestyle actually succeeds at tackling obesity. We can't indulge ourselves with wishful thinking when it comes to an issue of this importance.

I am 5”3, 70kg. Don’t qualify for it on the NHS. I have PCOS and I’m from south-Asian mixed background as well.

Do you realise that GLP-1 can be increased naturually using food? Rather than relying on medication to microdose, up intake of eggs, nuts, unsaturated fats, vegatables. Decrease intake of foods that spike blood glucose (e.g. processed carbs, flour, starches etc). I completely cured my cravings by changing my diet. I am sure many others relying on these drugs could do similar.

I don't think normal weight people are in the slightest bit jealous of someone reliant on medication for the rest of their lives and at the mercy of drug companies putting up prices.