To wonder if there will be any fall out from skinny jabs?

[TheLemonGuide]

Everyone I know is now suddenly very slim. Okay, im exaggerating slightly, but genuinely, most of my friends who were previously overweight are all now slim thanks to skinny jabs. I am delighted for them! It seems unbelievable to think that a jab can cure this obesity crisis, but I am so pleased my friends and a couple of family members are able to live a healthier life thanks to this.

My only slight concern is, is this something that is going to be too good to be true? Do you think there will be any long term repercussions, or are we right to just celebrate this medication as a cure for something that so many have been battling for so long?

With all due respect you didn’t even seem to understand what off label prescribing was a few posts ago and now you feel informed enough to be able to determine it’s too risky for well known leading prescriber? You think they don’t know what they’re doing and they’re just ignorantly taking on this huge commercial risk?

I know they prescribe off label because I was prescribed off label with a BMI of 25.1. There’s a thread running in the WLI area full of women with BMIs less than 27 who have been legitimately prescribed. Google it, it’s not hard to find.

Lol. I am a pharmacist so do understandwhat off label is. I think voy are taking a risk and as they state noone rlse is doing it. Although reading the information the only time they say they will do it is when switching from one GLP-1 to another so it is only technically off label.

Judging by all the frothing and animosity there is and has been over WLIs I’m sure many people are hoping that those taking them are all doomed.

and I’m sure Voy would be very interested in @Pikachu150 on MN’s risk assessment of their off labelling process. You can also take MedExpress to task, I suspect the list will only increase.

@Pikachu150 they don’t only doing on switching, I started as a new applicant with them. Though I did manage to switch to another provider who doesn’t accept new applicants with a low BMI, but I was accepted as a maintenance customer.

A pharmacist? Surely not?

I am sure they have consulted their lawyers and decided they can afford the risk. It doesn't mean it isn't a risk though.

@Pikachu150 the link I posted is clear that you can start with Voy with a BMI from 25. It's not just for people who are swapping.

MedExpress have similar on their website:

https://support.medexpress.co.uk/hc/en-gb/articles/18449019056541-Am-I-eligible-for-treatment-with-Mounjaro-or-Wegovy

There are also private clinics that will prescribe off licence in the same way, or with what they call "microdosing".

I am sure that pharmacies like these have decided that it is financially worth the risk, given the level of interest there is that you see expressed on here when eligibility is discussed.

What risk do you think there is exactly?

I’m really happy for people who’ve successfully lost weight on them. My dad has lost lots of weight on Mounjaro and I’m delighted and I hope it means he will be around for longer.

Nevertheless, I do feel a bit uncomfortable about Big Pharma earning billions treating a problem that was largely caused by Big Food and also earned billions causing the problem.

Maybe I know because my friend has actual conversations with me. Yes she lost weight but the possibility of having an organ removed is hardly a recommendation for it. I merely stated that her constant nausea was probably a factor in why SHE lost weight.
All that money to lose weight then having to stop taking it because of what medical problems it may have caused. The jab doesn’t stop you eating unhealthy food, it just makes your appetite lessen. What happens when you reach your weight goal and stop taking it? Appetite reappears and back to eating the same as before? I also know of one person who stupidly doubled her dose and ended up in A&E

There are risks with every medicine and if a prescriber prescribed outside licensed indications and not according to expert guidance they could be held responsible.

The regulators may not agree. Just because they are doing something does not mean it would be considered okay.

As a pharmacist you know off-label prescribing is a standard part of UK medicine. It doesn't mean it's unsafe or experimental; it just means the clinical use hasn't been updated on the paperwork yet. Voy and MedExpress aren't taking a wild guess, they will have massive legal and clinical teams ensuring everything follows GMC and GPhC regulations. If there was a genuine liability risk, I’m sure their insurance and the regulators would have stopped them long ago. They're following the science.

@Pikachu150 Yes I agree that the GPhC or the QCQ might take a different point of view. Personally, I don't think it's an appropriate benefit/risk analysis to offer these medications to people with a BMI under the obese range without any weight related health issues. But I can see the huge financial temptation for these companies to offer it. One of the reasons why I wouldn't use Voy or MedExpress, amongst others.

Why out of interest?

Because in my opinion there aren't sufficient health benefits to merit the additional risks that taking these medications would present.

Also, patients are supposed to be clearly told that the medication is being prescribed off licence and what that means for risk and liability, but I know from discussing it on threads that people were prescribed without fully being aware. Mainly because on the online consultation it's presented as a small tick box with a brief note, which relies on the person to actually read it and understand what they're being told. I don't think it's made clear enough that there's no evidence of sufficient health benefits in comparison to the risk.

But my opinion on it is irrelevant, as I'm not a prescribing pharmacist or doctor.

No I know I’m only interested from a discussion point of view, genuinely not seeking to be argumentative.

People talk about the “additional risks” but I haven’t actually been able to find any of these so called risks. The most widely reported risks seemed to be around things that can occur from rapid weightloss, not something I am experiencing because I only have just over a stone to lose and something I am doing very slowly on a low dose. Side effects aren’t risks, they’re short term consequences, and I’ve literally not been able to find anything that concerns me long term (I am always open to being told differently, it’s why I engage in these threads).

I am actually a very health conscious person; I make my own bread, I buy all organic, I minimise our red meat consumption, I even threw out all old pans as I was scared of PFAS! I am genuinely really mindful of what I’m putting in my body. WLI have meant for me I have hugely reduced my intake of sugar and alcohol (the things I really struggle to regulate myself with and hence the BMI tipping over 25). I am healthier today because of WLI than I was before, even though I was not obese, I genuinely believe from the reading I have done the risk balancing is appropriate. Lots of the health risks caused by poor diet can occur even if you’re not obese. That’s even before you get to the mental health benefits of for the first time in my life not obsessing over food and my body.

You probably don’t care haha but just wanted to put it out there, I think some people think people taking on WLI with my kind of BMI are vacuous or stupid, and I’m neither of those things. I think it’s going to be really freeing for a huge number of people from a variety of health backgrounds, I don’t think it’ll be limited to obesity.

I’m not referring to any additional risks, I mean the known existing risks of taking these medications. If 1000 people take this medication a small number will experience the more severe side effects. That’s an acceptable risk if you are obese and already facing the risks of obesity. If you’re not obese or significantly overweight with an existing weight related health condition, then there’s no significant health benefit to losing weight and you therefore face all of the risks with little to no health benefit.

I don’t think you are vacuous or stupid. I think that people make different decisions about risk. At a starting BMI of 50, my decision making process was completely different to yours at a BMI of 25. I am fairly risk averse but the risks of remaining massively morbidly obese were very much more significant than the risks of taking Mounjaro.

[edit - by “additional risks” I mean additional in comparison to not taking a prescription medication, not additional risks compared to someone with a higher BMI]

@SilenceInside but as I say what risks? Pancreatitis, gall bladder removal etc, that is much less likely to happen to me. I haven’t got a huge amount to lose, I’m not on a high dose and I’m losing very slowly (I’m actually losing slower than when I’ve done it ‘naturally’). My health risks caused by diet won’t be as acute as an obese person, but I was still at an increase of certain cancers, diabetes, liver damage from high intake of sugar and alcohol, you don’t need to be obese to have risk factors from diet. While my risk factors might be lower, the risk of me on the drugs is also likely lower (I say likely as I appreciate I am speculating!) so I feel it is proportionate.

Sorry I’m completely taking this thread off course and I will be leaving soon as I am braced to be torn to shreds when others come along which I don’t fancy 🙈

@pdjafcwtaoa65 I think that I’m looking at this across the whole set of people who will be prescribed by Voy, MedExpress etc whereas you are thinking about it just from your point of view, which is understandable.

These are big pharmacies, they will attract hundreds if not thousands of people with BMI 25 to 27/30, and overall the limited health benefits don’t outweigh the fact that a percentage of those people will get some of the potentially serious side effects.

I was prescribed to last week from Voy with a BMI of 26.1, no other relevant conditions.

I’m curious as to why people think it’s riskier for me to take it as opposed to someone who was previously obese continuing to take it through the overweight BMI range down into the low healthy range? If there were genuine concerns with usage at this BMI surely they would stop prescriptions once people reached a BMI of 27.

My dose amount will never exceed .5/1mg and I will only be on it for 3-6 months.

Having said that, I was honest about my weight and I did think the process for getting it was … lax. I could have very easily gamed the system to get it at a much lower BMI.

I don't know much about off-label prescribing so not commenting on that aspect. But a formerly obese person who's got to a normal BMI with WLIs is at greater risk of becoming obese again than someone with the same BMI who's never been obese. That's why it's allowed for maintenance.