Weight loss injections should be advertised as lifelong medications

[weighmoreweighless]

When Ozempic first came out, the guidelines were for usage to be for up to 2 years. I can’t remember if I read the rationale for that but seem to recall it was in the guidelines.
Thinking back it was along the lines of Ozempic was to be used alongside lifestyle and psychological support to address unhealthy eating habits and psychological drivers for overeating. By the end of two years people were expected to be able to maintain these new habits and weight. Happy to be corrected there but that’s meet I remember reading.

Now we have Mounjaro and many users are saying it’s a lifelong medication similar to blood pressure medication or asthma medication.

From reading the weight loss injections topic there are lots of posters who believe they will take the drug for a few months and that will be it, cured of obesity.

Now many of those who have successfully lost several stones are saying that they will remain on these drugs for life because of course they stop working once you stop, just like any other medication.

There are plenty of threads from posters who have regained weight after stopping. A few posters say they have maintained their weight loss but these seem rare on mumsnet at least.

I know diets don’t work and wish that word would disappear beyond being used to describe what we eat eg vegetarian diet, Mediterranean diet etc. I’d love to see diet replaced with another word or phrase such as healthier lifestyle or similar.

The reason diets fail, or one of them, is that so many people drastically cut their food intake for a few weeks, struggle with hunger, lose a little weight and give up because it’s too hard to sustain that low level of calories, food and nutrients.

The focus should always be on eating a healthier diet, achieving a healthier lifestyle by including more exercise within your own capabilities, less alcohol, not smoking, plenty of vitamin D, good sleep and relaxation habits. It should be a holistic approach, not just eat less, move more. Eat better and yes, move more but it’s more than that. It’s a mindset of needing to change habits for life. Sure we all have times and events where we eat and drink more or don’t exercise as much for a variety of reasons but what matters is what we do most of the time.

With this in mind I’m thinking that the advertising should be changed to reflect this. Companies need to be more transparent about the medications so that people are fully informed that these drugs are not going to be a quick fix or magic cure like people seem to think or hope. I’d be so angry if I’d paid out thousands to lose weight and then when I stopped it came back on because the prescriber hadn’t been completely open with me. There’s been posters who have stuck to healthier eating and increased exercise but still gained weight after stopping.

There’ll be arguments for fully researching the drugs before taking but how many people have the time or understanding of research to be fully informed? Most will just trust what they read in the press or on social media and the pharmacist prescribing. Critical thinking isn’t applied or rather thinking about what happens after. It’s the instant gratification and not thinking of the long term consequences or the financial implications of having to pay out indefinitely or at least until they become available for all on the NHS. Not unlike that packet of jam doughnuts I really wanted to buy yesterday instead of eating a healthy lunch . Just to clarify I wouldn’t have eaten them all. Two of the five for sure though and maybe a third after the school run. I’m a terrible sugar fiend.

This has ended up all disjointed because I can’t go back up the page to edit as I’m typing. I’ll try once I get to the edit option. I have ADHD and my thought processes are all over the place and I go off on tangents. Sorry.

TL:DR Should pharmaceutical companies/pharmacies/doctors/pharmacists change their advertising and recommendations to say that WLI (weight loss injections/medications) are likely to be needed to be taken for life to control obesity due to the likelihood of weight being regained once stopping even in cases of maintained healthy diet and lifestyle due to the chronic nature of obesity?

I’m going to try and edit this now into some semblance of order but if it remains chaotic I’m sorry. It at least has paragraphs even if it does jump around like a flea at a fair.

Poll:

YABU: No, people who take these drugs should realise that these aren’t a quick fix and they need to stay on them long term, and be prepared for the financial cost.

YANBU: Pharmaceutical companies/pharmacies/ pharmacists etc should tell people they are likely to need to take this for life and pay for it themselves unless it becomes available to all on the NHS.

The two year guideline was in the NICE document. I think it's become much clearer over the last few years that there is more to obesity than eating habits and exercise habits. It seems that we need to think of obesity as a chronic disease--the evidence is there that diets don't work in the long run and GLP1 drugs are no different.

I've been on ozempic for nearly 4 years. My GP said she was telling her patients to expect to be on the medication for 2 years and then review. She's really clear now that it is a lifelong medication for most people. If you can shift your weight and keep it off after titrating off the med, you're an outlier. Most of us cannot.

I think you are being very unreasonable to say that people should have to fund the medication themselves. Effectively treated obesity will save the state a lot of money in the long run. I think the meds will be more accessible as they come off patent. The pill form of semaglutide seems very interesting and should be cheaper as there's no patented needle system

I agree with you totally. If we have to take mounjaro for life it should be sold as such.

1. ozempic was never marketed or licenced for weight loss, so nobody ever talked about 2 years for ozempic. Are you confusing it with wegovy?
2. weight loss medication isn't 'marketed' as such.
3. these are new medications. They work differently for different people. People have different bodies and impacts of obesity. Some people will absolutely be able to maintain weight loss after stopping WLI. Many won't. That's a personal responsibility issue.
4. very few obese people see WLI as a 'quick fix'. I think it's slightly overweight or normal weight people who are using them as a quick fix. And for them it probably will be.
5. there is a weight loss injection board if you genuinely want to discuss this. Bear in mind it's full of educated, intelligent people who are very familiar with all the discussion points around WLI and will probably run rings around you. Your faux concern isn't needed. Are you even on WLI?

It may well have been Wegovy but it’s the same drug. Whichever it was when licensed for weight loss I did read the guidelines which as pp has said were the NICE guidelines.

Weight loss injections are advertised all over my Facebook and at my local pharmacies.

I know there’s a weight loss injection board but wanted a wider discussion.

Ozempic was recommended for weightloss before Wegovy became available, they're the same drug, semaglutide.

And, no, it's not a simple case of 'personal responsibility issue'. Unless you would say the same of statins?

@3flyingducksarrive I said in my OP “…or until they become available for all on the NHS.” I didn’t say that people should have to fund it themselves. Currently the majority do though.

I wasn't aware that they were allowed to be advertised at all as they are drugs but maybe I'm behind the times on that

Even as someone who wouldnt consider taking them I'm fully aware of the evidence about weight going back on, anyone who is taking them has a whole internet of research available so it's not like they are being duped

I think recently (past 6 months or so) that pharmacies are talking much more about maintenance and continuing on a maintenance dose. It's not something that's hidden or deliberately not mentioned.

You don't have to be on these medications for life, not in the same way that I need to be on my blood pressure tablets for life. I could stop taking the injections and then it would be on me not to regain the weight. It wouldn't be immediately life threatening like a high blood pressure crisis could be if I stopped taking my BP meds.

I knew when I signed up in July 2024 that I would need to be on the injections for around 2 years just to lose the weight, and I never thought that I would just stop taking them the minute I hit my goal weight. I had a lot of weight to lose, so I can see that people who are only just into the obese category might not see it as a very long term thing. But I'm not sure that's a big issue, as people will find out what works for them and then go from there. I don't think it's a big surprise that you'd need to pay for ongoing treatment yourself once you've started with a private process. I think very few people think that the NHS is going to step in take over the costs for them, as that just isn't how the NHS works once you've gone private.

"I’d be so angry if I’d paid out thousands to lose weight and then when I stopped it came back on because the prescriber hadn’t been completely open with me."

That's just you though. If people don't research and use the resources available to them to make their decisions, then they might feel cross but that doesn't mean that's justified. I have paid thousands to lose the weight, and as a result I know that I am not going to allow the weight to go back on, whatever way I need to manage that. Whether that's with continued lifestyle changes alone, or with medication as well, if needed. It's on me to manage that, it's no one else's responsibility.

It was used off label for weight loss, yes. But there was no '2 year limit' or any guidelines really, because it was off label.
I don't know why people think they should be spoon fed warnings about WLI. Of course it's personal responsibility. We all know what happens when we lose weight, most of us have done it many times before. Losing weight via medication doesn't confer some magic special extra longevity to the weight loss. I don't know why you're comparing it to statins, it's obvious that you need to take statins long term, at least whilst you're making lifestyle changes.

"I’d be so angry if I’d paid out thousands to lose weight and then when I stopped it came back on because the prescriber hadn’t been completely open with me."

Yeah this is mad. You'd be angry if you regained weight after losing it? Why? Who expects WLI to continue working after you stop taking them?!

@busyd4y pharmacies are allowed to advertise weight loss services and treatments in general, just not specific named prescription only medications.

At first there was lots of talk about WLI injections helping to reset relationships with food as you lost weight so that accompanied by lifestyle adjustments, when it came to stopping, you should be able to maintain your weight.
There are many threads now and back at the beginning on the board where people are saying they only intend to take it for a short time. Also posters dismayed to find they’ve regained the weight. Plenty of posters using WLI as a “kickstart” or saying they can afford it for a certain amount of time only. Reading the board it’s obvious that lots of posters don’t know that this is very likely to be a long term, if not life long medication. Or perhaps it’s just denial and they do actually know but think they’ll take their chances and hope it doesn’t turn out that way.

Everyone hopes they'll be in the few that manage to maintain weight lost without medication, in the same way that everyone hopes they'll be in the few that maintain the weight lost when they use dieting approaches alone.

If pharmacies should be telling people this medication is without question a life long medication, then the likes of Slimming World, Weight Watchers etc should also be clear that once you sign up with them you'll need to do that for life too.

YABU. It's common sense.

It's a drug that supresses appetite and slows down digestion. If you stop taking it then you will start feeling hungry again. I don't see how people wouldn't know this?

There are many systems like this. SlimFast. Herbalife. These two use a minimum calorie regime for weight loss which isn't sustainable unless you keep buying their products (it's how they make so much money) and you put the weight back on as soon as you stop.

One of my best friends has tried every diet without success. She didn't want to do WLJ as it is no different to the above things she has tried (and failed) and wanted to find something sustainable without intervention. 6 months ago she decided to stop eating UPFs, but eating as much as she likes. So far she has lost about 3 stone and it doesn't feel like a diet so is sustainable. She is so happy and looks amazing! She was never happy on any other diet even when she lost the weight.

I’m not really sure what you want from this discussion.

I certainly knew I was going on WLI as a long term medication. So I’m not sure who you are including in your “people should know”. The evidence is out there and people are speaking about it widely. There is not a secret society trying to hide the information from people.

I have been obese since my early teens for multiple complex reasons, I’ve had many successful attempts at losing weight and it has never ever stayed off and now I’m exceptionally slowly losing weight using Mounjaro. One of my absolute favourite things about Mounjaro is that I’m am not obsessed about food anymore constantly thinking about it. That has been so freeing.

This is a life time battle for me and I will continue fighting it over my life time.

Exactly. They may be partially in denial or hoping they are the lucky few who can maintain it without medication. But so what? For some people WLI will help reset food habits and some people will be able to maintain weight loss. Many/most won't. Again, personal responsibility, and living in the real world where no matter what method is used to lose weight, regain is extremely common.

Are you on WLI OP? Are you obese or formerly obese? What skin do you have in the game?

It’s an appetite suppressant, if you can’t control your food intake once you stop taking it you will gain weight. The problem is those who are turning to these medications are the same ones who struggle to control their food intake hence being overweight (me included) I personally won’t buy these meds without proper medical oversight which I can’t afford. In reality if i actually want to loose weight I don’t need meds, I need self control and to give up booze and not willing to, like my life as it is

You'd be angry if you ate more than your calorie requirements and put on weight?

Angry at who?

Im waiting for the thread about WW or SW or Jane Plan or Cambridge diet and someone to say 'I hope its made clear right up front that you have to eat to your calorie requirements for the rest of your life otherwise you'll need to put on weight.

Funny no one ever seems to raise these 'concerns' about any other weight loss tool. Because thats all it is, a tool to help you manage your intake. Just like all those other methods.

I always planned to be on if for as long as they will continue to prescribe it to me, hopefully the rest of my life.
I have insulin resistant PCOS, it’s something that has been controlled by the medication which my body can’t do by itself. I know that if I stop taking it I will overeat and balloon again. I think many people are aware of this? I don’t think it’s been kept as a big secret?

There is so much to WLI than an appetite suppressant. Suggesting self control is all you need to lose weight and maintain is decades behind the research.

This is a comment from a metabolic research scientist:

"The primary mechanisms for correcting metabolic dysfunction include:

Normalizing fat storage -- rather than over-storing, or storing fat at an alarmingly efficient rate, your body will store fat at the rate of a normal-weight, metabolically normal person, as long as you continue to take the drug.

Mounjaro makes it easier to access stored fat for use as energy/fuel for your body. Rather than resorting to excessive protective metabolic mechanisms to make sure that fat stores are not depleted just in case you need them for survival in the future, your body will respond to increased exercise and decreased calorie consumption. Mounjaro also enhances lipolysis. You are able to burn fat more efficiently as long as you continue to take the drug.

All GLP-1 drugs enhance lipolysis, allowing your body to easily break down fat when a calorie deficit is created, the way normal bodies with normal metabolic function do -- as long as you continue to take the drug.

It corrects the hormonal signaling between the gut and the brain. Mounjaro normalizes this function so that you don't get inappropriate hunger cues to eat.

The reduced appetite is just a small portion of why this drug works when no other type of dieting has worked for someone before. If appetite suppression was all that Mounjaro offered, you could save quite a bit of money and just take phentermine or Contrave -- which does not really address the issue because people have been taking these drugs for decades, losing weight temporarily, and then gaining it back again. This also helps people understand why good habits can improve health, but they cannot correct metabolic dysfunction. Eating less does not change hormone signals or teach your body to store less fat. When the drug is stopped, the benefits stop."

As for medical oversight you can buy WLI from a doctor-led pharmacy if you want/need that. Otherwise a pharmacist (on-line or in-person) knows much more than your average doctor about medication.

Its not an appetite suppressant.

Are you on WLI, OP? Do you struggle with your weight?

You’ve made some pretty big assumptions in your opening post, among them that:

1. Most users won’t do their own research - they’ll just trust what they see on social media without applying critical thinking.
2. That the cure for obesity is really just about a healthier lifestyle.

The reality is, unless you’ve done a survey of WLI users, you have no way of knowing. And no, random threads on MN is not ‘proof’. Also, you seem to be talking about a ‘healthier lifestyle’ and skipping jam doughnuts as though fat people don’t know this. If you were to do a study of people who’ve had a lifelong battle with weight (myself included) you’d probably find we’d done every ‘diet’ out there and maybe even been successful for a while but sooner or later were tripped up by food noise or the inability to stay long term on a very low calorie diet. It’s a long, hard, lifelong battle and yet for the first time in my life, I’ve successfully lost weight. Why is it so hard to just be happy for us instead of expressing all this ‘concern’ about the future?

Your post reads as someone who really doesn’t understand the issues. As others have said, is this an issue that affects you personally?

It’s a discussion forum. Posters can start threads on topics that interest them. All sorts of topics are discussed on mumsnet and people are free to start threads or reply to them. It’s just a discussion, not a personal attack on anybody.

Both your choices, unreasonable or not, make it so the voter agrees with you. 😂

times have moved on, op. Ghey are not advertised, that’s Illegal, but if someone starts them yes you’ve the option of staying on long term, or if you regain, starting again to keep your weight in check and then stopping. Or going it alone. No one is forced to take gnem long term.

so I’m not really getting the issue, it reads like you think they should be advertised as long term to put people off.