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?

@Silverbirchleaf I don’t see any justification for feeling alarmed that there might be as yet unknown future dire side effects. These medications have been fully tested and in use for many years. They have been specifically tested for weight loss alone and then approved by the UK MHRA. Large scale clinical trials are ongoing to identify additional uses or additional benefits. I genuinely don’t understand why these specific medications cause people to be alarmed about future unknown side effects where there are so many other new medications that people just aren’t aware of or interested in.

They will save the NHS millions.
People need to use them to change their habits.
If you haven’t taken them, then why the hell does it bother you?!

Exactly, if the fda, the who, mhra and all other global heath authorities are happy with the safety of the drugs, it begs the question all this concern arising from people not on tnem. As to what’s behind that. I think the answer is very obvious as to what’s driving these people. It’s really sad that weight, and weight loss has them like this. But there we have it.

some of it though is just utterly cringe. Imagine writing about Dexa scans and muscle loss, like it even comes close to the life limiting and life ending results due to obesity, like you can’t prevent that by eating right. imagine haunting on line forums almost hysterical and so desperate because women can now use these drugs successfully to lose weight. The utter embarassment of it.

If you look at posts American doctors who are prescribing via insurance claims you will see that they advocate for regular dexa scans. It’s only in the UK that there is no oversight.

Clearly there is a trade of; for the very overweight better to lose fat and some muscle that to maintain all the fat. But for others, the level of fat might be more cosmetic and the muscle loss may present a health risk. Clearly it’s a spectrum. Just suggesting that the longer term issues could be more frailty / hip fractures etc. maybe that’s better for the nhs overall, I don’t know I haven’t run the numbers. A good person to follow on this is Dr Vonda Wright.

Can you link to this claim please because I googled and it is very clear insurers in the USA do not require this, some may recommended if they see rapid weight loss, but it is not a requirement for prescription or ongoing maintenance at all and over sight is the same as here.

but I’m happy to be corrected so let’s see your links. As people keep making claims on here and it’s all turning out to be made up nonsense,

I would also say that the US has a very different model of healthcare and often recommends or mandates things because they are paid for by insurance.

If one hasn't run the numbers, suggesting compulsory scans after a set period seems rather premature.

@MeridaBrave you’re discussing again that there are people who are using these medications for cosmetic reasons and their level of fat is only a cosmetic issue. So you aren’t referring to the 2 million ish people who are getting prescriptions from mainstream online pharmacies where you need to be obese (BMI 30 plus or 27 plus for some ethnicities) or significantly overweight (BMI 27+ or adjusted for ethnicity) with at least one weight related health condition.

You mean either people like you who originally accessed the medication illegitimately with a BMI under 27, or people who access the medication from a handful of providers who will prescribe off licence to those with a BMI between 25 and 30. Not the vast majority of users of these medications.

I read it in a book about best practice for Weight loss injections called Weightless by Dr Salas Whalen. To be honest from what I read in the book I thought it was standard practise but maybe not.

The same risks exist from any rapid weight loss, and of course those who have historically yo yo dieted are at greater risk due to repeated weight loss attempts.

Not my problem - I lift weights have high levels of muscle mass. Just saying many don’t realise. I was chatting to someone when walking my dog - she’s lost several stone and was delighted that “she barely needed to eat as it’s come off quickly”. I asked about exercise / maintaining muscle and she gave me blank looks.

Given the huge cost of the drugs I don’t see that a periodic dexa scan would be such a bad idea. The aim would be to catch low muscle mass and low bone density before it became a big problem.

There are literally thousands of drugs that millions of people take every day that have some side effects but the benefit of taking them outweighs the risk, then there was thalidomide and one or two others that had horrendous side effects which hopefully the pharmaceutical companies have learned from, yet the only one I ever see people ‘faux concerned’ about side effects is GLP1s, it’s almost as if people are willing them to fail.

Yes they are all getting medications from online pharmacies - it’s easy to lie just once and once you get started there are many who will give at lower BMIs.

But I am mainly referring to people who started off with a BMI over 27 and are maintaining BMIs longer term at the low end eg 20-21 without rebuilding the muscle they have lost. FWIW my BMI is closer to 23, and that’s with bodyfat under 18%. To have a BMI of 20 you have to have both lowish body fat and lowish muscle mass.

Interesting article in the Times magazine this Saturday about the positive effects GLP1 is having on many other conditions, previously not known to be indicated. One case study in the article saw it reduce chronic pain and concussion symptoms she'd had for a decade following an accident. From what I read, it seems the direction of travel is more about the expansion of their use, not flagging up concerns. As others have said, I dont know why so many people are just desperate to see a bad side.

That’s nonsense, I have a very high muscle mass, classed as excellent, and my frame is classed as muscular athletic. My bmi is 20, I work out six days a week, I do a lot of running and I do strength training, it is nonsense to say anyone with a bmi 20 must have low muscle mass. Good grief.

Just because a small number of people are foolish doesn’t mean everyone on the drugs is. I certainly am not. The 4 people I know in real life on them are not, and anecdotally all the threads on here and Reddit show in the main people are not.

sure people do starve the selves on diets, thy have since time began. And no again, insurers in America do not require dexa scans. And quite frankly if someone risks osteoporosis etc it’s still better for them than obesity. It is simply a stupid thing to do and down to the individual. Christ we see people on here not on the jabs on vlcd on 50o cals a day. People do that shit it’s not exclusive to folks on the drugs. And quite frankly it’s clearly a small minority. Most people are fully away of how to diet healthy and normal weight loss is 1-2lbs a week.

Because it’s cheating and fat people need to stay in their lane 🙃

Just working it out - I’m 163 at 61kg, with circa 47.5kg (per a dexa scan) of muscle and 11kg fat (already low for a woman my age).

If my BMI was 20 with the same fat I’d be 53.5kg, so that would be 7.5kg of muscle less.. per the info on the dexa scan would give a lean mass index of around 15, ie under average. If my fat was higher than 11kg the muscle would be lower still.

It’s simply not possible to have “a very high muscle mass” and a BMI of 20 unless you have 10% bodyfat.

Rubbing the numbers - A high muscle mass eg a LMI over 17 for me would be muscle of a minimum of 45kg, so assume 2.5kg for bone that’s 53-45-2.5 =5.5 left for fat ie 10% body fat - not healthy for a woman.

There's quite a big gap between not such a bad idea and should be compulsory for everyone after a year, despite the fact that I've not got the numbers to back that up, assumed it was always done in the US but didn't check and haven't explained what I think should actually be done on the basis of this data.

We see this problem a lot on WLI threads. Someone has the makings of a decent point but feels the urge to pad it out with exaggeration and daft suggestions. It would've been totally fine to just say you're concerned about muscle mass, so would like to see this placed front and centre when HCPs provide any form of weight loss support. And that while you know the NHS doesn't routinely offer this and that's unfortunate, you think it'd be worth those with the resources obtaining a scan privately.

Surely it's relative muscle mass, no?

But I’m not your weight. It’s calculated in relation to our own bodies, not yours. Yours is not the benchmark and in fact it’s been shown mounjaro makes muscles more efficient, its relative not an absolute number,

so yes it is possible. Hugely.

www.thetimes.com/uk/healthcare/article/weight-loss-injections-fitter-exercise-research-8jmg7jftq

The poster has calculated it on her own weight she’s not worked out how to have lean fat and high muscle mass on a lower body weight,.

I am not bulky, that’s not what high muscle mass is. I’m lean with clear muscle definition, and we see examples in every day life. Sprinters, cyclists etc for example.

That's what drew my attention to your post.
I am pretty lean (BMI <19), and really toned. I'm sure my total muscle mass is not very high, but as a % of me, it's seems pretty high.
I do know that lower BMI is a risk factor for fractures, but that is due to lower bone mass and less padding!

It’s the same risks with a high bmi, it has an increased risk of osteoporosis, due to inflammation and increased fat mass.and obesity is known to reduce bone density, the legs tend to be fine, but the rest of the skeleton ie spine , hips suffers increased risk.

obesity also causes very poor quality muscle as fat infiltrates the muscle

so I’m not quite sure of the point people are making to be honest. We all need to work out, eat our protein and keep ourselves healthy.

Oh, I always thought low BMI increased risk of fractures.

Of course they were, and in fact some drugs were not as great as were initially hoped or proved to have problems.

However, you don't normally have people trying to access statins when they don't meet the criteria, and I'd like to think we understand why that is.

yes it does, but so does high, it’s both, the times article though I linked above shows that those on weight loss injections actually have better muscle quality as it removes the fat from within the muscles, thus giving protection against osteoporosis.

but yeah I don’t get the point being made, if you’re obese you’ve a heightened risk of fractures and osteoporosis, if you lose weight rapidly you risk it. If you’re underweight you risk it. If you use the drugs, lose weight at a steady pace, ie 1-2lbs a week which it’s clear most do, and do strength training plus eat enough protein, you protect your muscle and bone density and the drugs also it now shows also improve the muscle quality, thus giving you more protection.

i don’t think it’s hugely relevant though as I think it’s just a straw people are clutching onto when being negative about the drugs.