To think it will be revealed WLI cause physical aging

[Tuliptana]

Obviously the pictures of Kelly Osbourne are both sad and terrifying.

But a few women i know have also used this method for weight loss and their skin has lost elasticity. They look at least 10 years older. Is this side effect being under played?

I agree that sizes are inconsistent, but if someone says their friend is size 16, they mean that in general, size 16 is most likely to fit them, with of course exceptions. They don't mean a generally size 10 person who may have some clothes in 16. And an average height person who for the majority of their garments fits into a size 16 is at least overweight if not obese. I certainly would have been.

I think it's pretty obvious that several things are true:

• these drugs are going to be massively beneficial for obese people whose health is at risk as a result of their weight gain
• many of these people will be on those drugs for life
• the drugs will, like all drugs, have some negative side effects, with a minority of people experiencing extreme negative effects
• people who are not obese, and are not struggling significantly with their health as a result of their weight, but who want for various reasons, to be thinner will also continue to use these drugs
• they will also likely need to maintain use for a long time to maintain weightloss
• they will damage their health by taking the drugs to a greater or lesser degree (but perhaps will think the payoffs are worth it, as our culture reveres thinness above all else)
• people who have taken weight-loss drugs, especially those taking them off the black market, are hugely defensive about the benefits vs costs, imo, naively so.

I know about six people in my family and close friend circle who have tole me they have paid to take mounjaro. Two look thinner and seem to have lost excess weight and achieved a healthy medium, have come off and maintained with diet and lifestyle. One is very thin and continuing to maintain with jabs, but looks undeniably fab. Three look god-awful, literally skeletal and ill, with sagging discoloured skin and visibly aged by the process — they are delighted about the weightloss and are continuing. My feelings are that for all of these people the drugs were unnecessary (hence not being able to get a prescription), and for some have fuelled physical and mental health problems that are going to be expensive to the public purse in the long run. We have already seen a backlash against body positivity, and it is once again going to be more difficult to be in a bigger body. No one should be taking drugs meant for health issues they don't have for cosmetic reasons.

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Wot she sed.

This is what I have been attempting to say but needed someone to word it better.

This isn't a case of something being all good or all bad. It is, like most things, a case of cost benefit analysis, and that includes the situation of the person involved.

All the moralising about are people cheating, are people just jealous etc injects negative and counter-productive confusion around something that needs to be approached with full knowledge and objectivity and a respect for the context - which will differ.

@Soontobesingles you know 6 people who have all accessed Mounjaro via the black market as none of them would qualify for a prescription, and they have all told you that's how they've accessed it?

Or do you mean that they wouldn't have got an NHS prescription for Mounjaro? Because hardly anyone meets the additional criteria the NHS apply. I didn't, and I had a BMI of 50 and high BP before I got my private prescription for Mounjaro.

You say "people who have taken weight-loss drugs, especially those taking them off the black market, are hugely defensive about the benefits vs costs, imo, naively so." - I access Mounjaro legitmately via private prescription, so maybe I am less defensive (?!) about it, but can you explain why I would be naive about understanding that the benefits to me massively outweigh the risks and costs to me? The only cost is financial for me, and otherwise I have only seen benefits.

I don't know you, I'm not talking about you. I know six people who pay for mounjaro, yes. Three cousins (sisters) and three friends. I know they pay because they have told me and discussed the price; I know one friend gets a private prescription and one gets it illegally (no one would prescribe for postpartum weightloss and so she went off-market). No idea how the others access it as I haven't asked, just discussed the use. None of these people were significantly overweight to start with, one maybe was verging on quite noticeably overweight, but has herself said she had not had health issues due to it, she just wanted to be thinner.

If you think that the costs outweigh the benefits, brilliant. If down the line you suffer side effects from long term use, only you can know if that was worth it. I don't suggest that the drugs shouldn't exist, I just think when I hear people who have lost weight on them (and finally feel thin) discuss them, there is some cognitive dissonance about what is really going on (and how they look to other people). You'll see how I said 'naively so' was an opinion, based on discussions with people I know personally.

Not necessarily, I look 10years younger than I did 10stone and 1 years ago

I was responding to the claim that the points you were making were true, and you are talking about me, as I am a person who has taken weight loss injections. You stated that those people (therefore me included) are defensive and naive when discussing the benefits versus the costs (risks?). I wondered why?

I know that the benefits outweigh the risks for people like me. That's not a naive opinion based on hopefulness, it's based on a full understanding of the risk/benefit analysis for people in my circumstances. I am not alone in that opinion either, as it's backed up by the decisions of the MHRA when these medications were approved.

I wonder if some of the 'looking skeletal' comments come from people seeing that someone has a skeleton for the first time.

I know that one of the big changes for me as I lost weight was that jaw, cheekbones, wrists became much more visible. Previously hidden under a layer of fat. My neck appeared, seemingly overnight, which was weird.

7 stone down, another 4-5 stones to go. That will take me into a healthy BMI. Already my diabetes blood tests show as being 'healthy'. This doesnt mean it's cured, it means it is managed.

You do seem defensive tbh.

I was clearly talking in that part of my post about people who are using the drug and don't need it medically — is that you? If so, can you fully understand what the risks of long (life-long for many) drug use will be and whether this is worth it, particularly if the NHS views you did not need the medication?

As my post said, for those using it with a medical need these are life changing, life saving drugs, for those using it for cosmetic reasons (and yes that is lots of people, even if they've found an online prescriber) there are unknown risks and imo it's naieve to think you can take a drug meant for a chronic health issue you haven't got and will suffer no ill effects from that.

But most people pay for Mounjaro. It doesn’t mean that you’re not eligible or shouldn’t be taking it if you pay for it. It’s legitimately prescribed by private pharmacies. I certainly pay for mine, my starting BMI was 33 and I have no health conditions so I knew I wouldn’t be eligible on the NHS. In fact I don’t know anyone who has been prescribed it by the NHS, everyone I know who is taking it is paying for it.

Just because people are paying for it doesn’t mean they’re not eligible. There are so many misconceptions around this drug.

The NHS doesn’t view that people don’t need the medication. They have strict prescribing guidelines at the moment. I think due to cost, although I may be wrong. That may change in the future but if you don’t meet them you have to pay privately. The criteria for need is BMI 30 (or slightly lower in some cases). That’s what private prescribers use. It’s all legitimate and based on need at that level.

For someone who knows so many people on WLI you seem very uniformed. Most people are paying.

I'm not sure it's possible to avoid a charge of defensiveness once made, if one responds with further questions. Perhaps the only non-defensive response is to accept your points without debate.

Anyone with a private prescription, legitimately acquired, has a medical reason for accessing WLI. So you can only be talking about people who don't meet the prescribing criteria who are acquiring it illegitimately, and who therefore do not need to use it. I wish that people would make that abundantly clear in their posts, rather than including those of us who legitimately access WLI privately. I don't think that was at all clear from your post, as you talked about people who paid for Mounjaro rather than being clear you meant people who accessed it illegitimately rather than simply privately.

The additional NHS criteria is not based on medical need, but on the practicalities of delivering this as a service. The 12 year rollout prioritises patients by seriousness of their weight related health conditions, and I would have had to wait probably 6 years or so to access Mounjaro on the NHS, despite meeting the MHRA criteria easily.

Worth spelling out here that 'cosmetic reasons' isn't a very useful definition because it's perfectly possible to be obese and doing it primarily because of appearance. If a person meets the prescribing criteria, the potential health benefits are the same regardless of whether they give a shit about them or not. In the same way as the risks.

The descriptions you give of your friends weights are sufficiently vague that we don't know if this applies to them or not, but this is why terms like 'verging on noticeably overweight' are really unhelpful in themselves. I wish we could retire such subjective language from these discussions!

You can also get from online prescribers without going in person to have your weight and so on checked (I know this is true as my cousin did this) — so yes, people may be getting prescriptions, but I think we will see a lot of lawsuits when the shit hits the fan and it becomes clear that (shock horror) taking drugs you don't need over a long period is bad for you. If the drug has helped you personally, great! I obviously hope you don't suffer ill effects and it continues to improve your life.

Vague because I wanted to keep vague and they all have different circumstances, including, as I said, one using for postpartum weight gain while still breastfeeding. I guess it depends on whether you consider lying in an online consult to be illegal? Certainly dark web purchase is. Anyway as I said, if you are taking them and they benefit your health great - it is also undeniable that many people are taking them in ways that are likely detrimental to their health, and DEFINITELY detrimental to their appearance. But we will see in years to come how many I suppose.

As discussed upthread, the NHS doesn't require in person attendance for a lot of medication reviews and things like blood pressure and weight checks already. I've submitted both of those without any scrutiny or checks. As WLI drugs eventually become cheaper/tablet and available to more of the population on the NHS, my guess is that a similarly trusting approach will be taken there.

If there's going to be legal consequences due to that level of monitoring, there's a lot of potential candidates!

That’s true of any drug though. I know someone who died because their liver was damaged by using too much paracetamol ivwr the years. We do t have people getting their knickers in a twist that anyone can buy that for pennies at the supermarket though.

i don’t know why you keep talking about ‘taking drugs you don’t need’. Anyone who meets the prescribing criteria is deemed to need the drugs.

If people are cheating to get the drugs that is very different. But that’s not me, or other people commenting here.

my point is that this is a drug for a chronic health condition, with known quite serious side effects for a minority of users, whereas paracetamol is an over-the-counter analgesic for general use. So not really equivalent - although actually that is sort of my point, if you take any drug excessively (especially for a drug formulated for a condition you don't have) you are going to be harmed by it. People are interested in this specifically because it is a new game changing medication that a lot of people will (and do) want to take when they don't need it, because it makes them skinny and they want to be skinny. That doesn't apply to most other drugs.

well then what I said doesn't apply to you because you fall into my first bullet point 'truth' which was: 'these drugs are going to be massively beneficial for obese people whose health is at risk as a result of their weight gain'

And there’s known serious side effects for a minority of paracetamol users, contraceptive pill users and, well, more medications than I can mention. It’s funny how this is the only people are getting wound up about. Funny that.

Lots of people take pain meds they don’t need, anxiety drugs they don’t need, etc. hardly anyone on MN getting all wound up about that.

Anyone who wants to avoid what they see as defensive responses from WLI users would do well to make sure their points are clear and sensible.

I don't mean obvious idiocy like our long departed OP, but for example I often see people blurring legitimate concerns about off label use with their own subjective beliefs that people who they think don't look that fat haven't done a sensible risk/benefit calculation.

Another drug that I think a similar thing applies to is PrEP... a massively game-changing drug that will probably eliminate HiV in a generation of people, but will also be used by people who don't necessarily 'need' it as a long-term solution to barrier contraceptives, at a detriment to their health overall in the long term. Again, some/many of these people are being naive about the risks of taking it long-term, but that doesn't counter the fact that it's a necessary medication to alleviate a greater risk overall.

if there was a thread about people taking anxiety meds they don't need, I'd say the same thing. I don't and have never taken the contraceptive pill because of the risks and generally only take meds if it's an emergency, so maybe I am just more risk-averse than most towards all medications.

I think what's different about weightloss drugs is that the people taking them seem sort of religiously convinced of the fact they look better and are healthier (which is true for some), even when their appearance suggests otherwise.

I do find it quite interesting how many people clearly consider themselves to be a reliable determinant of others BMI and health simply by looking. Obviously there are some cases where it's bleeding obvious, like if someone is morbidly obese or is dying of cancer. But the descriptions given are seldom of this type of thing. We've had multiple examples of people doing that whilst also using vague and unscientific descriptors in this thread, and that's not at all unusual.