to feel uneasy about what this means long term rather than surprised by the weight regain itself?

[HazelMember]

I’ve just read a BBC article about research into weight loss injections like Ozempic and Wegovy showing that people who stop taking them tend to regain weight quite quickly.

I’m not shocked that weight comes back. That happens after most weight loss attempts whether they involve medication or not.

These drugs are increasingly talked about as something people might take for years or even indefinitely. That raises questions for me about what happens when someone cannot afford them anymore, when supply changes, when side effects become an issue or when a person simply does not want to stay on a medication for life.

If stopping leads not just to regain but to a fairly rapid rebound, it feels less like a temporary aid and more like something that is very hard to step away from once started. That sits oddly with how casually they are sometimes discussed.

AIBU to think the real issue here is not that people regain weight after stopping, but whether we are quietly normalising a treatment that may be difficult to discontinue once begun? Or is this simply the reality of managing a chronic condition?

But if you are not using them, wanting to use them, don't have a person you care about who is at risk of buying fakes or using it inappropriately, then why even be interested, let alone "Uneasy"?

Can you tell me what the long-term implications of being on WLI are?

Or what the long-term implications of being on WLI for several decades are?

Can you tell me what will happen over time to children born to mothers on WLI?

Same as happens to the people using the drugs to manage diabetes.

Well, no. Because as has been pointed out many times on these threads, the dosage is dissimilar and non-diabetics are now using WLI.

Botox and fillers.

@velvetgeranium is it just WLI that you’d want that information on or would it apply to any relatively recent medication?

From what is currently known, it is unlikely that babies born to mothers who were taking a GLP1 before knowing they were pregnant would have any issues. Of course there is little data because it is unethical to test it on pregnant women, the same as for any other newly developed medication. Which is why you are clearly told not to take it if pregnant or if trying to become pregnant.

What do you worry would be the implications of long term use of GLP1s, so perhaps a decade or longer, that wouldn’t be an issue for t2 diabetics who would be expected to stay on it, albeit at a lower dose. But that would perhaps just mean it might take a bit longer for issues to appear for them rather than it being definitively safe. Is it cancers, or some other issue?

Here is a quote from David A Kessler, former FDA commissioner, from his book "Diet, Drugs, and Dopamine". He is the former dean of Yale School of Medicine, and other prestigious universities. Kessler has tried GLP-1s himself.

"I am deeply troubled the FDA approved GLP-1s for long-term chronic use without requiring the pharmaceutical companies to conduct enough studies.

The pharmaceutical industry argues that these drugs have been around for decades, but not in such large doses and not for the treatment of obesity.

Some people may be able to handle the drugs for life, but we juct don't know. Right now we only have about five years of data at the current doses."

Do you not understand that with any medication the risks of taking it vs not taking it are being considered? Recommendations are being made accordingly? I don't care about the next decades or future mother that hasn't even been born. Im obese now and want a chance at a higher quality of life and longer life. Nothing worse can happen with WLI that can't happen without it.

Oh, you should hear me on Botox and fillers!

Point me to the paracetamol and statin threads. I am generally keen to discuss topical health and/or medication issues. HRT threads are a wash, as one is similarly policed if not on them.

The risks of remaining obese, particularly morbidly obese, always seem to be totally ignored and forgotten about. My BMI was 50, now it’s 25. My overall risk of serious health issues has massively reduced even with the threat of possible future issues from having taken WLI or continuing to take them.

I certainly know the risks of obesity and they're dire. There's a growing body of evidence that's currently being researched that the benefits of weight loss injections may go beyond the benefits associated with weight loss due to them decreasing inflammation and targeting visceral fat.

That is fantastic. I don't think anyone would suggest you not be using them.

Obviously the risk/benefit ratio needs to be weighed up. Massive health problems come with morbid obesity, but the same level of health problems do not come with being just overweight (or in the first class of obese BMI). People conflate the three.

And GLP-1s are being used worldwide by people a raft of different sizes, many of whom would be better off just increasing a diversity of plant fibre in their diet.

There really should be an expert regulatory body to weigh up the evidence and create prescribing criteria based on evidence. Oh wait....

Indeed @DarkForces the MHRA decision making process came to the conclusion that the benefits outweigh the risks for anyone with any level of obesity, as well as for those who are overweight with a weight related health issue. They obviously think that being overweight or class 1 or 2 obese carries enough health risks to merit the use of GLP1s. I wonder what it is about that decision making process that was flawed or incorrect?

I know. I mean they regulate every drug in the uk and decide which population should get it based on a risk benefit analysis of evidence and who can prescribe it and what the criteria should be. I'm not sure why suddenly they'd have had a brain fart over Mounjaro or wegovy and suddenly gone rogue.

Agree!
People are allowed to remain on them at bmi of 20-21 but people on bmi of 24-25 aren’t allowed to start! No sense in that.

I think a lot of obesity is caused by the crappy upf food that is normalised in this country. I also think that it suits these companies to sell us addictive food and then also sell us a "solution" you need to take for life. Yay money.

So I think these drugs treat the symptoms, not the cause, in many cases. I think that's sad.

(I'm not including people who are obese due to other medical reasons)

Yes, I think fat will become much more a class thing.

Of course, nobody anywhere in the world is bypassing their country's regulatory body. People have bragged on these threads that they are normal weight and have a history of eating disorders and how they got around the guidelines.

I'm going to repeat my quote from a book I read recently by David A. Kessler, because absolutely nobody responded to it. He has, you know, "concerns".

Here is a quote from David A Kessler, former FDA commissioner, from his book "Diet, Drugs, and Dopamine". He is the former dean of Yale School of Medicine, and other prestigious universities. Kessler has tried GLP-1s himself.

"I am deeply troubled the FDA approved GLP-1s for long-term chronic use without requiring the pharmaceutical companies to conduct enough studies. The pharmaceutical industry argues that these drugs have been around for decades, but not in such large doses and not for the treatment of obesity. Some people may be able to handle the drugs for life, but we juct don't know. Right now we only have about five years of data at the current doses."

I mean, ok, he has concerns. He doesn’t say about what, in the quote you’ve included. Just unspecified concerns based on people taking higher doses long term than people who take the same medication but for T2 diabetes. He’s not concerned about them, even though if there are issues then surely they would encounter them even if at lower rates and after a longer period of time.

I’d like to know what the concerns actually are, as in what is the issue that makes him concerned and what it is he is concerned about. Of course he’s an expert and much more knowledgeable than me about any of this, but I’d like to understand what is actual issue is here.

I think it's quite clear, if there are not enough long-term studies from pharmaceutical companies, that we don't know what the longterm effects are.

It's the unknown unknowns.

There are already enough known knowns to be concerned about longterm implications on a global-wide usage. These are listed on the product insert, as I understand it, but newer concerns (sudden vision loss, eg) are being reported.

Diabetic patients taking these drugs are at risk of all sorts of serious things if they don't - that's known. The serious adverse consequences of GLP-1 use for some diabetics are known. (Diabetics are at risk of losing eyesight, for example, anyway.) There is a lot of data gathered over the last two decades on this. The risk/benefit ratio there is fairly clear.

There is not enough length of time to say what the consequences of GLP-1 use on a different population might be, and on the massive general population now on them (many of whom are not that overweight), seemingly for life in many cases.

Off the top of my head, slowing gastric emptying over a period of many years will surely have some implications. We don't know what, and we won't know until a certain amount of time has passed. But stifling conversation is not the way to go.

He mentions in his book that at all the medical conferences he attends almost every physician speaker has received some kind of financial compensation from the pharmaceutical industry, so it is hardly an unbiased conversation there also.

I do wonder what “for life” actually means. Are people expecting to take these meds in their 70s, 80s, 90s (seeing as we’re living longer)? Will we see elderly people in care homes being given these GLP-1s along with their other meds? Or is the expectation that with age something (not sure what! Metabolism?) changes so we automatically want to eat less? My DOs in their 80s eat less but my DM remains obese. I think actually think losing weight would be the end of her!

I lost 5 stone naturally and it was incredibly tough. soem of the weight creeped back on and im only lighter now for awful reasons - a side effect of drugs I had after I went psychotic

It’s not. It raises valid points.

I’ve a friend who takes it and due to changes in finances she’s getting quite desperate, moved to a cheaper version, but now that doesn’t work. As I say, she’s getting desperate- whilst now at a healthy weight but just can’t stop.