Depressed that I can’t afford WLIs

[Velveteengreen]

I am ‘obese’ according to the BMI calculator.
I’m 5’7 and 16 stone 4.
I have lost about a stone through calorie counting, so was even bigger before.
I am now a size 18/20, instead of 20/22.
But it feels like everything has significantly slowed down and it’s much harder to shift any more of the excess weight.

We are on a very low income and I’m unfortunately in significant debt to my credit card. I have several long term conditions that stop me from working full time.
I do get Pip but that covers the necessity costs for my disabilities.

I have started swimming twice a week as any other exercise is awful for my joint pain - in doing that I do feel physically fitter.

I have spoken to my GP and I don’t fit the criteria for jabs on the NHS.

I think that is the thing I have come to realise now also, I am not going to look how I did before as I'm a lot older but health plays such an important part esp for menopausal women and is way more important than fitting in a certain size! Hopefully the jabs will come down in price, there is a lot of talk re a tablet form that I believe is being tested so the more competition the better.

It’s already approved and in use in the USA, wegovy pills. They are cheaper than the injections, but it’s marginal. Injections start at 199 usd, and the pill is 149, expected to rise to 199, for initial doses, but high doses are expected to be 349 usd v 299, so yes, cheaper but not much.

i suspect el Lilly will do the same, they’ve already said the price isn’t based on cost, but market value and they don’t expect much difference.

what will drive price down is when patents expire or new competitors come to market, or governments force it.

I'm looking into WLIs after losing lots of weight, regaining it all plus a stone. I'm disabled and on medication that causes weight gain by slowing down the metabolism & my disabilities make walking and exercise very difficult. This is a genuine question as I don't understand why the injections start at 2.5 mg then are increased? Why is this please? Also, if you start at 2.5mg and lose weight, why can you not stay on this dosage, or can you? Thanks all.

@CherryRipe1 the reason for the dose levels is that the 5mg, 10mg and 15mg doses were the ones that were specifically studied in the research trials to see how much weight people lost long term once they got to those doses. The inbetween doses were used for 4 weeks to move up to the next main dose level. The 2.5mg dose was used as a starting dose for 4 weeks to make sure people could tolerate the medication before moving to 5mg. The reason people are suggested to move up doses is that in the trials people lost the most weight on the highest dose of 15mg, and more on 10mg than they did on 5mg. So the data says that if you can tolerate the 15mg then you will lose the most weight. But, not everyone in the trials could tolerate the medication. Some dropped out on the 2.5mg or 5mg. Some couldn’t tolerate 10mg so went back down to 5mg, and so on.

In a non-trial setting when you’re just taking it as an individual patient you just move up each dose level when you feel you need to. You can stay on 2.5mg if it’s working consistently for you, and pharmacies are unlikely to suggest you move up if you are losing weight well and feeling the full effects of the medication.

I do get what you are saying OP and it must be frustrating but there are loads and loads of state of the art treatments that would benefit all types of conditions that the NHS won't fund.
They just have to prioritise what does the most good.

@SilenceInside That makes sense now and thank you for explaining it so well!

She's calorie counting, that's no different to SW/WW who just use a point system instead of numbers for calories.
She stops counting her calories, the weight will pile on like everyone else.

There are kids waiting for wheelchairs who have to rely on charities. I think they come before obese people who have the ability to reduce their food consumption.

It’s not that simplistic.

If you reduce obesity, you reduce cancer rates, it’s the leading cause, you reduce heart disease, liver disease, diabetes, skeletal and muscular degradation, strokes, and many other issues, when you reduce those, you free up the resources that are currently used to treat and manage them, billions, and you can then spend it on other things, improving all other services.

of course kids needing wheelchairs should get them, but one of the reasons they don’t, is as two thirds of the population are over weight or obese, and we spend billions treating the results of that.

Free gym membership 15 quid a month for those who cannot afford it. A bit more effort required from the patient, two hours a day, rather than a weekly jab and the sofa.

I don't care if people take the low route effort to weight loss, but evidence suggests you need WLI for life, so I disagree with NHS funding when there are people who have not brought on their ill health and are waiting for treatment

Could you point us to the evidence that gym membership reduces obesity on a population level? Because that's an expensive intervention you're advocating for otherwise, not least because the NHS will continue to pick up the tab for obesity if it does nothing.

Of course NHS gym membership doesn't reduce obesity on a population level, nor does NHS funded dietary advice. They require effort, persistence, resilience, so of course they don't work.

The NHS does not have enough money to fund people who have not looked after their one body. Kids waiting for wheelchairs, old people dying while they wait for an ambulance, overworked staff. It's cheaper for everyone if people treat their own obesity

They don't work. I agree. In which case, why bother pissing money away on them? Because instead of spending all the money we currently do on obesity related diseases, you're advocating for spending all the money we currently do on obesity related diseases (because that won't change) plus gym memberships.

My guess it that it'll be a while yet before we see NHS rollout to all obese people, for reasons not just of budget but also logistics. But free gyms are neither here nor there really.

Ah yes it’s oh so easy just a bit more willpower, eat less, move more, do you think that most people with obesity don’t already know that? You think we are lazy and stupid? Never spoken to people who have tried, got the weight off (the easy bit IMO) and have struggled to maintain? Ever wondered WHY some people can get through life without overeating whereas others never feel satiated? Why there are highly intelligent obese people so no we’re not any more stupid than anyone else in the population.

I agree that children and everyone else should get the treatment and service their condition requires from the NHS but to lay blame on obese people for all this isn’t right.

How can something both be free and 15 quid a month.

weighr loss is only 20 percent exercise, 80 percent diet, adviocatinf people spend 2 hours a day in the gym shows you’ve completely detached from reality. People have children, disabilities, jobs, very few people have two hours a day they can just fuck off to the gym for, where will all these gyms come from to cater for the 20 odd million people who would need to do that.

of all the crazy suggestions on here, that’s a new low.

@CinnamonJellyBeans I'm not sure there's quite enough judgement and contempt for obese people dripping from your posts. Try harder.

Meanwhile, I'm sure you've considered ALL the other demographics who could be considered, in your judgy little world, to have brought about their own need for medical intervention. Because of course you wouldn't want to be seen just to be picking on weight loss as unworthy of NHS investment versus the heartstring-plucking innocents waiting for wheelchairs. So! Out with spending £££s on chemo for lung cancer, or maybe even bowel cancer. To hell with treating alcoholics or drug addicts. Drunk drivers? Twats who get into fights, hurt others and and clog up A&E? Sod them all. The NHS will be in fine fettle then!