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.

She thinks people are rushing to get the drugs, and not thinking long term and they won’t be able to afford them, so shouldn’t start. Likely as she can’t afford to even start. So is irritated.

But you don’t have to take it for life. I used it for 4 months and then stopped 18 months ago.

I ‘ve been on MJ for 18 months and expected it to be lifelong from when I started it.

I’ve been on MJ since September, it’s changed my life. When I first ordered it, my provider made me jump through hoops and acknowledge so many disclaimers that it simply wasn’t possible to think it was short term and would be the answer to all of my weight issues. There are always exceptions, but weight loss medications are so expensive and controversial that most people go into them understanding the implications. Since there have been very few options of support for obesity from the NHS I can access, I have never considered that the NHS would provide this for me, so I’ve always known I’d need to pay for it as long as I need it, and this could be for life.

I don’t think there has been as much controversy or ‘concern’ for people who have started weight loss programs before this one. There are so many harmful methods out there that are marketed as acceptable that very few people bat an eyelid at, but when it comes to the injections it’s as if it’s assumed the people who choose to take it haven’t researched or gained an understanding of anything to do with them. It’s made very clear that the jabs are a tool which work alongside healthy lifestyle changes. If someone eats more calories than they need then they will gain weight, with or without the medication. That’s not hidden or a secret.

Spending so much money on MJ is not ideal, but despite the “just eat less and move more” brigade I honestly feel like there isn’t another option which works for me.

It also isn’t instantaneous or even fast.

I think you are being accidentally unreasonable.

You are theorising about other people's experiences and reasoning. How other people make decisions and the range of physiological effects of different regimes and medications.

You have made some bold statements which don't accord with my experience. They might describe someone else's perfectly. You seem to be pretty clear you're not describing your own.

Have you ever decided to seek private health care of any kind? If so what caused you to take that path and what did you do to investigate clinicians and treatments? Were you satisfied with the results?

I don’t think there has been as much controversy or ‘concern’ for people who have started weight loss programs before this one

it’d because this one works. A little injection once a week and you can be slim. These threads will continue till the folks who start ghem can get their hands on the drugs,

@SilenceInside 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

Hi there, I disagree that everyone hopes they’ll be in the few that manage to maintain weight lost without medication. In fact I’d go as far as to say that more and more people on the weight loss boards are looking at using it life long. I’m not and as a result it can be a nice surprise to find others on the boards who are of the same frame of mind.

The idea is to take it, lose the weight and continue a healthy regime. However, as MJ curbs hunger it's easy to do it but when you stop the rumblings become more intense amd back to willpower.

I think it's going to be a case of taking it, delighted at weight loss, then going back to normal amd start again.

Don’t live in the UK but I was only prescribed MJ if I agreed to see a dietitian/nutritionist. Slowly she has helped me overhaul my diet. Stopped taking MJ and haven’t regained any weight. I still had a bit more to lose tbh, but am ok with how I look and feel now and I just didn’t feel like taking it anymore. So basically I agree with you. I think unless people change their habits they will just be on the drugs for the test of their life. I honestly think MJ gave me the space and time to
change my habits because I didn’t feel
hungry. That’s the problem (well for me it was). Initially I don’t think I could have coped with the changes as it felt too difficult and overwhelming. MJ can help with this.

hmm, not sure you thought that through before posting it,

firstly and importantly not all fat people eat unhealthy, they don’t all need a diet over haul, its portion size that’s the issue, constant hunger etc.

secondly the drugs force you to overhaul if you need it, because too much fat or sugar and you will have gastro issues,

thirdly, most fat people know exactly how to eat.

im glad you got the help you need to over come your poor diet. Don’t assume everyone is like you, had a shit diet and doesn’t know enough so needs help. Glad you got it though, it’s available in the uk to anyone who wants it too.

Omg could you be more pretentious and condescending ? Yes there are some obese people who have health conditions that have contributed to their obesity. But if you are obese, you are not eating properly. Whether it’s unhealthy food or just too much. You don’t get obese with a ‘healthy’ diet, whatever that is. I didn’t sit around eating chocolate and crisps either. That wasn’t my meaning.

@WellConfusedandDazed "MJ gave me the space and time to change my habits because I didn’t feel hungry." - I think this is the case for many people on Mounjaro, and not all of them will need the services of a dietician to help them understand how to overhaul their diet. For me, I know that I ate portions that were far too large, and then also added on top of meals, extra snacks or treat foods that I absolutely knew I didn't need and weren't healthy or nutritious. I don't need a dietician to tell me that eating a whole tub of Ben & Jerry's of an evening was a poor diet choice!

You have totally missed my point. Is that what you think dieticians do? Tell people not to eat ice cream? eye roll

I know it wasn’t your meaning, hence why I said you didn’t think it through before posting.

and no, many fat people just eat too much of healthy food and yes many fat people recognise a healthy portion, the drugs control the hunger. And yes many fat people know how to eat a healthy diet.

it was you who said you agreed with the op, and that people would have to stay in for life, I was pointing out most people on them do over haul their diet.

good luck with the maintenance.

‘fat people eat too much healthy food’ 😂 yeah that’s what they say, now don’t eat so much brocoli, or you’ll get fat.

Well I am sure that some people might need telling if they struggle with understanding food labels and nutrition.

You’ve missed my point, which is that people don’t need dieticians to tell them what is wrong with their diet and how to improve it. If dietician advice was effective at treating obesity and managing maintenance after weight loss then there would be no need for medication. It’s great that a dietician helped you, it’s not something that is proven to be effective for the majority.

Research has shown that our bodies try to regain weight and get back to our previous size, but that it's "memory" is around two years. So if you maintain target weight for over 2 years it's much easier to maintain from there.

WLI should probably be used for 2-3 years after target weight is achieved and then slowly tapered off. If people start to regain then ramp back up and try again in another 6-12 months.

Isn't there emerging thought that once you keep the weight off for a certain amount of time (granted long, like years) your body will eventually surrender to that being your new normal and it will be much easier to maintain with decent habits, like a metabolism correction or lowering your bounce back ceiling? Maybe it's a bit early to tell still with the drugs but I know it's been said about any weight loss method that if you battle tooth and nail to keep it off you eventually hit a point where it becomes easier as your body has accepted this is its new default size give or take and will not want to bounce back as readily to the old heavier weight, although of course terrible habits and overeating will override that but it's not the same as when we lose weight and the body is actively wanting to regain it

I think they’re now being accepted as lifelong medications.

I think that if you go to your GP with proof of having been on them and proof of responding well, you should get them prescribed to you on the NHS.

Mmm, I rather hope I wouldn't be one of the people who kept the weight off without the jabs. Because I've been paying for my maintenance dose a few months now, and have every intention of staying on them. So if I magically found out I was one of the people who didn't need to do that I'd have wasted my money!

That was the theory back when I started on the meds. Thinking has now changed.

If you want to know more about the science, Dr David Kessler's book Diet, Drugs and Dopamine is fascinating. He's the former head of the CDC and uses ozempic himself. Some people can come off ozempic and keep the weight off but most can't and it's not due to will power.

I can only really speak from my own experience @weighmoreweighless and I think my answer would have to be "it's complicated and it's different for everyone".

I used Mounjaro for 12 months. I had just tipped over into obese category and was borderline Type 2. Lost 3 stone. MJ reduced the food cravings and allowed me to change my diet, establish an exercise regime, etc.

Maintained my lower weight successfully for 6 months without WLI with that fairly strict food and exercise regime in place. Low GI/moderate carb diet. Restricted alcohol to 1-2 days a week. Minimal UPF, sweets, chocolate, etc. Cooking from scratch. Gym 3-5x per week, 2 of those sessions strength training, plus dog walking and animal care duties, a bit of cycling with DS2.

While I could make my health a main priority, it was fine. Then we had a family crisis and I was pulled in loads of different directions. My stress levels increased. Wasn't sleeping. Having to be away from home a lot due to caring responsibilities for elderly relative who doesn't live close by. More convenience food. Work stress increased too, there are likely redundancies coming (though not my role, my department will be affected) and we are short on the on call rota due to sickness and clinical leads/managers leaving and not being replaced, so I'm having a lot of nights of broken sleep at the moment (hence being wide awake at 2am!). That increases my food/sugar cravings because I'm tired in the day. Less energy for exercise. Poor immunity, I've caught every bug going this year so my training has been inconsistent.

Surprise, surprise - prediabetes returned and with it the food noise, weight began to creep up. I went back on a low dose of MJ to try to control it and it's helped with ensuring it doesn't get worse, but the only thing that will actually fix it and help me actually BE healthy as opposed to just being in a theoretically healthy BMI category is being able to prioritise my health in the way I did when I was maintaining without it.

I now view MJ as not a weight loss medication, but a medication that treats the underlying metabolic disease that causes the obesity. However, it doesn't fix the lifestyle based causes of said metabolic disease. There's also a genetic link in my family, so in my case it's genes + lifestyle factors - I'm predisposed to developing Type 2 already.

If you've been obese/overweight and particularly had associated metabolic disease, then staying a healthy weight absolutely is a lifetime project, no doubt about it. WLI may well have to be part of that for some people. IME it's possible to do it without WLI, but it's hard when the odds are stacked against you in other ways.

Agree that they should be labelled as lifelong

Yabu, it's well known that no weight loss method is a once off, then works for life. Even gastric bypass surgery isn't a guarantee of being thin for life, and people often put weight back on.

I get Mounjaro on the NHS because it is the only drug which successfully controls my diabetes. And my diabetes specialist has been clear that I can expect to be on it for as long as it is still doing so.