Weight loss drugs. Actually no, it's about perimenopause.. and being tired... and fed up as well....

[LankylegsFromOz]

I dont want to offend anyone, although I'll put money on someone on MN getting offended regardless 🙄

Just 4 years ago, I was incredibly unhealthy and a heart attack waiting to happen. Then, I pretty much gave up drinking, took up exercise and managed to loose 20kg over 2 years. I've maintained this over the last 2 years and I'm happy. I sometimes have nightmares that I'm overweight again (I had the same after giving up smoking), then wake up so relieved that I still fit in my brand new wardrobe.

But recently a few things have happened.

Firstly, my already hectic life, with working full time, sick parents, sick husband, kids (thankfully healthy, but 1 with SEN), got even more fucking busy! Next up.. I am unable to continue affording my PT sessions and I'm struggling without this motivation. And now (of course it happens now).. perimenopause has smashed me in my face and I am starving all the time. I cannot control my appetite, it's scary and I'm worried. I've put on about 5kg recently and it's not water weight!

Yes I'm going to get my hormones checked etc (more time I dont have!)... But what really pisses me off and the reason for this thread, is why do people have to wait until they are obese, in order to be eligible for weight loss drugs? Why do people (particularly former chubby people like me), have to wait until they are fat and unhealthy (again) to get them? Even when I was 20kg heavier, with sky high blood pressure, I still wouldn't have qualified! It doesn't make sense, to start already on the back foot? Why can't we get prescribed low doses, to avoid an unhealthy future?

Yes, I know what the hoards will say to me, when they descend! But I've already done the fucking hard work!! Now it's biology, sociology and all other 'ologies' that are against me! I'm fighting a losing battle and I'm tired, yet apparently I need to prioritise my sleep?!

And I quite enjoy exercise, but I don't have time to exercise 4 hours a day to maintain my weight. So, give me a pill for that, please?! And while I'm at it, I don't have time to eat 5 fucking steaks a day either... so give me a pill for that as well (or invent one... I've already asked).

I know there is a billion variables, including people with eating disorders etc. But this is about me (and middle aged people like me, or you dont even need to be old).

AIBU? If heaps of people agree with me, I'll take this rant to my Dr. Heck even if no-one agrees with me he's probably going to cop an ear-full anyway.

Apologies for all the swearing 🙂

Consider adding protein to you diet. Not steak but protein powder as shakes , or even better to mix it with food like cottage cheese and yoghurts or even soup.
It adds the satiety of meat without the fat, bulk, or time and complexity.
Its also going to mean if or as you lose weight it will make it much harder for your body to dump weight at the 60% muscle to 40% fat ratio that is its preferred method.
Its not totally cheap, maybe £50 a month? But healthy and easy.
Menopausal women are frequently very low protein eaters in an attempt to keep weight off as its the highest calorie, and most expensive component of eating.
Anyway you can google it yourself if you are interested.

I'm the same age as you OP, so I understand. Up until my mid 40s, if I ever put on a few pounds, it was fairly easy to lose. And I never put on weight around my middle. But it changes in menopause, exacerbated by the fact this period of life can be quite stressful for all sorts of reasons.

I'd get some full blood tests to begin with. All the best.

You can go on WLI if you want. Plenty of prescribers are doing off label prescriptions for BMI 25
I wouldn't do it personally; I would rather not be dependent on expensive medication indefinitely to stay healthy but here I am.

Thank you, I actually will google this. Especially the dumping the weight stuff, I've never heard that before!

Can you? Since when? I thought you had to be heading towards obese category for them. I'm 26.4 and would be interested in using them to get down to about 22 then ease off and just manage my weight through healthy eating.

OP - I really feel for you and your situation. Can I suggest that you look for bootcamps in your area? A fraction of the cost of PTs. And look up 8-30 minute weight training and bodyweight workouts online. Save the ones you love. When you are shattered, just do the 8 minute workout. When you feel perky, do 30 mins. They really make a difference. I started with those to make me strong enough to workout with a PT then once I felt confident with the PT, moved to local bootcamps. They have now - sadly - shut down again and I am getting back to the online workouts. They don't give you a proper 'me-time' break as you are still at home, but they are great to fit in with needy and sick family.

For food, I focused on adding healthy things rather than getting rid of foods from my diet. 8-10 a day, not 5, at least 6 of those being veg. And lean protein: tuna in spring water is best, then chicken breast, then steak, white fish, eggs, pulses. I'm not yet healthy weight - but I lost a stone (about 6kg) very easily without dieting at all and have maintained at that weight for two years.

Menopausal weight gain is still caused by excess calories. Cortisol doesn't create fat from nothing

@Tonissister you can get private prescriptions in the UK for that range, though not where the OP is.
I think so far it's only Voy and Medexpress who offer it. There is a thread in the WLI forum for those on lower BMIs that has lots of info.

If you are sure that perimenopause is the root problem then get some HRT, do this first.

It is likely that in the future wli will be available to a larger cohort of patients but this needs to be safe and evidence based, and this takes time. It is early days and frustrating, but morbidly obese people have been literally dying over the last 30 years since these drugs were invented and before they were licensed for weightloss, so maybe have some perspective.

I really hope so.

Bit more complex than that.

It is also possible to be in a cushingoid state and normal bmi. But with abdominal obesity (plus skinny limbs) and the poor health markers to go with it. Rare but it happens.

I had pesudo cushings secondary to untreated perimenopause (too young, periods too regular!!) and ended up with sick euthyroid syndrome which is a condition normally only seen in critical care and end of life care patients.

These conditions can be extremely serious and debilitating, and definitely aren't just a reflection of poor moral worth and lack of willpower.

Again, not being arsey .. but how do you know this? Are you 53, a Dr or even a PT? I want to take your advise, but I'm online , menopausal, hungry and feeling kinda volatile 😀

Everyone keeps talking about monjaro, but there were plenty of older drugs before now and that's actually what I was thinking.

I'm Australian and had a number of different weightloss dugs.

Contrave is probably the easiest to get but not cheap although cheaper than wegovy.

Qysema (or however you spell it) is cheaper but you need a compounding chemist that regularly makes it to get it cheapest. I found d it good but didn't continue as amphetamine part wasn't good for my head.

The off lable one that is for migraine or epilepsy made me so bloody slow. I just lost words and trailed off mid sentence.

It's worth talking to your GP to see if you qualify for a chronic care plan as then you get an exercise physiologist and dietician at reduced cost.

I'm 46 also peri, onHRT and mounjaro, formerly obese. I'm not a PT but I don't need to be in order to understand the basics of thermodynamics. There are lots of reasons why it's harder to lose weight in peri but the fat still comes from ingesting more energy than you consume.

The fact that you use the phrase 'its just thermodynamics' shows you know f all about obesity and the human body, because you're implying that something incredibly complex is just oh so simple.
It might make you feel better to be smug on the internet but posts like this are about as useful and wanted as a fart in a spacesuit.

Thank you. However, my BMI rules me out for these drugs. There is no way my own Dr would prescribe them. But I might see if I can get an online Dr to prescribe it. I'll talk to my Dr about a care plan though.

Utter rubbish.

I am about to start mountjaro. Been in hrt for 2 years increased bomb size and weight. Heaviest I have been. Seen a fantastic GP who stated 1 in 4 menopausal women are taking them. I have tried calorie counting exercising etc. My bloods regularly have high inflammation. I have two chronic illnesses. Interstitial cystitis and adenomyosis which can make regular exercise hsrd. WLM helps with inflammation too. I cant completely afford it but figured cutting back on other things and for my health it has to be worth it. Its bloody hard for some women end of

Almost. In menopause thanks to two tumours in my womb and having that removed. Lost 50lbs the last 18months, 6 years post surgery.
You can buy off label, plenty of threads on here to help support you but getting the nhs to prescribe a drug for something that you don’t have an issue with is not going to happen. You aren’t morbidly obese, you don’t need it for that reason. I’d explore off label if the drugs are the road you want to go down

If been concerned if an online doctor was prescribed when an in person one won't. The medications do have serious side effects.
Are your hormone levels sorted? Lots of those meds are on the PBS.

It's bloody hard.

I'll be starting the process this week. To be honest, I'm pretty lucky to get to almost 54 unscathed. I think my body was just so happy that I stopped being a functioning alcoholic.

There is some evidence that ozempic/wegovy that can help with stopping drinking. It could be an angle to discuss with you GP.

@DrJump, I've already stopped. And if I told my Dr I'd gone back to drinking, he'd kill me 😀

If your going to keep giving smug advice, you could at least have the courtesy to read the OPs info as off label prescribing and what the NHS rules are is irrelevant for someone who doesn't live in the UK.

I think the reason they never took off like the GLP1s is that they didn’t work very well and/ or had horrible side effects. There were amphetamine based things in the 60s and 70s that were addictive and made you high and that one that ease gave you diarrhoea orlistat if you ate anything fatty but basically none of the older drugs is very good I’m afraid.