AIBU to believe the over ‘concern’ about Mounjaro/Wegovy side effects are disingenuous ?

[Youthinkyourefunny]

All drugs have side effects. However AIBU to think The focus on side effects from Mounjaro/Wegovy is not proportional to real life experience nor do other common drugs cause the amount of anxiety and hand wringing as these miracle treatments.
How many people hesitate to take an NSAIDs like ibuprofen for pain when their side effects are GI bleeding, ulcers, and kidney injury.

Do the millions of people on Statins for high cholesterol hesitate to reduce the risk of stroke or heart disease due to the risk of Muscle injury and liver enzyme elevation ?

What about the millions of women on Birth control pills ? Do you see countless posts asking if it’s safe or sensible to use the most effective way to plan or prevent pregnancy due to the associated blood clot risk ?

Don’t even start reading the patient information leaflet inside the gazillion packs of SSRIs antidepressants prescribed everyday. Or you will be in for a long read but some highlights are internal bleeding, sexual dysfunction, withdrawal symptoms, suicidality risk.

What do all the above have in common? It’s simple. They all treat either physical or mental health conditions that are either painful or life threatening and the known side effects are generally considered ‘worth the risk’ .

So why the over focus on GLP-1s side effects when obesity is equally painful and life threatening ?

I believe it is entirely due to the ingrained acceptability of discrimination against the overweight and obese along with a mind numbing ignorance as to its multiple causes . Which in turn feed the belief that fat always equals stupid. Because all ‘they need to do is eat less and move more’ .. (gosh - I’d never considered trying that 🙄) Therefore these amazing drugs are viewed by a large tranche of society as ‘unfair’ .

Why do the fatties get to be thin when they don’t ‘deserve’ it. ? Throw in a bit of religious indoctrination that gluttony is one of the seven deadly sins, along with a dose of ‘sloth’ because we all know that not only are fat people stupid , they are also bloody lazy. Who have bought it all upon themselves.

Once you ‘get’ how undeserving the obese are you will have a clearer picture as to why I believe there is such disproportionate scaremongering about these drugs side effects. It’s the only way to try and keep fat people ‘in their place’.

YABU No, there is no hidden agenda.
YANBU Yes, there is an over focus disproportionate to risk

It’s relentless. There’s a new “news” story every day about the possible risks of WLI.

People forget that obesity is even riskier.

I'm on a SSRI and I absolutely did think about the side effects, I don't take Ibuprofen because with the SSRI it causes bruising.

My mother in on WLIs and she has diarrhoea and nausea all the time. She's ploughing through regardless because she had so much hope and she's not willing to accept they don't work for her. She's been very overweight for a long time and would do stupid things to be thin. I worry about that.

I think describing anything as a "miracle" is just daft. It's a medical treatment which has risks and rewards which need balancing out and a personal decision made. It's right that these medications have all the scrutiny, they've exploded lately and women's health care has always been lacking (it is mostly women taking them). It doesn't mean they aren't worth taking, but being informed is absolutely a good thing.

The other drugs you mentioned have been around a while. Yes, I know Ozempic, etc, have for diabetes, but their use in weight loss is comparatively new.

New things are met with suspicion. There were absolutely people who wouldn't have taken the pill/would have advised against it when it first came out because of side effects. I remember going on the pill 35 years ago and even then I still had older women telling me about the risks and side effects. I also remember the doctor telling me DVT was more likely in pregnancy than from taking the pill.

There was plenty of chatter about concerns regarding HRT when that was in its infancy.

And bear in mind, these days we've got a lot more media exposure. You'll hear a lot more horror stories from social media platforms, etc. Don't you think if Statins/Ibuprofen/the pill were new now, we'd be hearing a lot about side effects as more people are talking on a much bigger platform?

It's the novelty of it causing the talk. And it isn't altogether a bad thing. There's less blind faith in prescribed medicine, more openness about side effects in medication. People don't always read the label, but they do listen to other people's experiences. It's better to be aware, isn't it? Then you can make an informed decision.

I have begun to feel quite militant about this. It’s not just the side-effect thing either . It’s also the way that people feel unable to be honest about using them. They are bloody life changing. I lost nearly 9 stone. Can you begin to imagine how life changing that is after trying virtually every diet for 15 years. Especially in this weather ? Why are people ashamed to say ‘yes’ I’m using WLI to cure a life threatening illness. I take thyroxine. Took a long time to get diagnosed but my God it felt good once I had the right drug - and would happily tell anyone who had my same symptoms to get a check. Wouldn’t have crossed my mind to lie about it or feel ashamed. Yet I personally know at least 12 friends on WLI and the only people they admit it to are really close friends .(btw none appear to have suffered any side effects) Some haven’t even told their husbands.
I’ve decided to take the opposite approach and tell everyone who comments on my new svelt self !

I’m in the age group where increasingly people are considering statins and I talk about medication to people at work as well - many people are weighing up whether to take statins because of the reported side effects, and some people won’t even consider them for that reason.
And people planning on taking a medication should be given a chance to weigh up the pros and cons - everyone doesn’t agree on what an “acceptable risk” is , and as more people take Mounjaro/Wegovy the more information will be out there ( and more studies, more evidence)

They can be life changing. But they aren't for everyone. I think it's great that they work for you, like it's great that SSRIs have helped me, but they're not for everyone either. I do worry that people will lie to get/stay on WLIs. That's because of the baggage that comes with being obese. I think a lot of the people taking them are vulnerable because of the internalised views of obesity and I worry about that too.

It's okay to have a tempered and cautious attitude to this stuff. It's also okay if people want to keep their medical treatment to themselves, though like you I don't hide my medication dependence.

These are relatively new drugs and certainly the way they are widely available is new hence we are learning in real time about side effects on the wider population. The other examples have been around forever so it’s not quite the same.
I can understand why people also feel a little put out when there are many struggling at upper healthy BMI and not qualifying whereas people are allowed to maintain at far lower BMIs.

Well yes, of course. Some people just don't want there to be what they see as a cheating way to lose weight. And it's ironic that they are feigning concern over health because their real concern is obviously the fear that suddenly lots of people will easily get slim and beautiful. It's nothing to do with health at all. As you say, obesity is unhealthy and these are usually the same people who love talking about all the downsides of being fat.

I can't feel it. I lost a shitload of weight years ago and have largely kept it off since, pregnancies etc notwithstanding. Did and do it the rubbish way, no outside assistance. Go me, I did it without taking anything that could, like any medicine, have side effects. Lucky me, that's great for me, I'm grateful. Why should it matter if someone else does take something to help them? Doesn't affect me, it's their health.

I weigh up risks as a profession, admittedly not medical risks, directly anyway.

What I would say is that with any medical intervention you should weigh up the risk against the risk of doing nothing. Whilst unpleasant, my interpretation is that the side effects and complications with weight loss injections are outweighed by the risk of doing nothing if you are obese or morbidly obese. Blood pressure, diabetes, wear on joints, cancer, lack of energy, strain on heart etc is serious stuff and worth risking the side effects to remedy.

That said, it is a very different conversation if you're looking to lose a stone or so for vanity reasons. Maybe the calculation is that the risks and side effects aren't quite worth the pay off of fitting into those jeans or looking better for your holiday or cousins wedding etc.

It is a bit like the COVID vaccine once we realised it didn't really stop transmission. The worst risk factors were probably not worth it for a healthy 20 - something, but the risk of doing nothing and facing COVID unvaccinated for an obese 75 year old is greater than the potential for complications.

YABU but you probably have a reason for this? Have you been called out for GLP usage by someone?

I don't take NSAIDs, birth control, statins for exactly the reasons you mentioned.

I don't think I'm unique in this way.

I tend to do as much as I can, as naturally as I can, to minimise reliance on any drugs.

But, I understand that people have different view points, different risk management and situations, so I don't have any opinion on how others decide to navigate these things.

I don't see any more or less discrimination between GLPs than I do VLCD, keto, calorie counting, food group restriction, gastric bypass etc, etc. I think it probably seems singled out because it's the newest thing so is getting the most attention, atm.

People frequently stop taking stations, despite strong family history of strokes and lots of warning TIAs or minor heart attacks. Stations make people feel foul often.

Then you've metformin for diabetes, practically a wonder drug, gave me my fertility despite PCOS and recurrent miscarriage, got me through gestational diabetes. But it gives you horrendous diarrhea, wind, toxic farts, if I take them and eat eggs at the same time I vomit. I got through those side effects because it stabilisers my weight, I can lose weight when taking medication and can't otherwise. Yet diabetics who could save their feet and sight can't tolerate the side effects.

Mounjaro etc are similar. My sister has had amazing success on mounjaro, she's lost 5+ stone and her life has been changed completely. Despite success on slimming world and the gym and with only a couple of stone to lose I gave it a go. I suffered intolerable slphur burps, bouts of pain and vomiting as it flared up my gallbladder. However it also had a massively positive impact on my painful joints and concentration and focus. However I couldn't keep going with the pain and vomiting. I also lost literally 1 pounds over the course of weeks.

I do think those who haven't taken it a disingenuous but also for some people they can't tolerate the side effects and it disappointing as we want it to be a miracle

I'm not a regular consumer of any of the medications you are discussing but don't prescribed drugs include details of the likelihood of side effects? Are the side effects being highlighted statistically much more likely?

It’s funny how when we talk about side effects about drugs and how we shouldn’t be taking them long term, it is almost always regarding drugs women take long term. Remember how we were told for years how terrible it was not to take a break with the pill but lo and behold, turns out, it’s not a problem at all and we actually can use them to stop the relentless of periods. We’re told to avoid HRT unless we really can’t live with the menopause and going without is treated like a badge of how honour. (See also: pain relief during childbirth). SSRIs are the work of the devil, and now WLIs are going to kill us and we should just accept their fate.

I don't think people forget the risks associated with obesity because there are plenty of posts telling anyone over weight that they should lose weight due to the cost to the NHS/heart disease/Type 2 diabetes/cancer etc etc The issue is, I think, the perceprion of how these drugs work: that somehow fat just melts away, that weight loss is easy and that is somehow unfair.

Jealosy, anger...no longer able to tell yourself you're not fat as there's no longer someone bigger than you in the room. I have developed a dress sense that seems to piss off multiple people!

Tbere are legitimate concerns, I think, about online prescribing and tbe potential for abuse of these drugs. But that should not be the concern of the genuinely obese.

YANBU! It’s no-one’s business except the people taking medication- all medication has potential side effects, even basic pain killers.

The difference is that there is no evidence yet about the long term safety of the weight loss injections. We don’t know if they cause pancreatic cancer, for example. The drugs you mention have well established long term data. Plus, with obesity, eating less and exercising will work.

If you choose to take/not take anything such as NSAIDs, birth control etc - it's totally valid, in the same way if you choose not to take WLI. The difference comes where people feel so compelled to cast judgement on people taking WLIs, in a way that they don't with the other drugs.

Because all ‘they need to do is eat less and move more’ .. (gosh - I’d never considered trying that 🙄)

Do WLIs do anything more than ‘turn off the food noise’ though? ie they make it possible / easier to eat less.

I genuinely didn’t know if they did anything additional so I Googled:
Weight loss injections (like Wegovy and Mounjaro) work by mimicking natural gut hormones. These medications suppress your appetite, slow down stomach digestion, and signal to your brain that you are full. As a result, you consume fewer calories.

Whether weight is lost with WLIs or ‘the hard way’ as some call it, it does still come down to calorie deficit.

I don’t deny that they have been transformational for many people. I do think we should be concerned about the effects on non-obese bodies that don’t qualify - when qualifying means that the pros outweigh the cons.

But there was a huge uproar exactly about statins a few years back, exactly on the grounds of side effects?

I am in favour of GLP-1s and interested in their wider anti-inflammatory potential especially* but I think a robust conversation about side effects is needed. I believe there is evidence that longer term, these drugs are associated with sarcopenia and loss of bone mass too, which may result in problems.

*(I am a healthy weight so wouldn't be taking them myself, just general interest.)

The thing is, with the exception of birth control which you can now get at pharmacy's, and painkillers which you can buy yourself. All the other drugs you mention require an in face consultation with a GP. Most of the time this means the doctor is weighing up weather they are a better option then not taking them.

My biggest issue with weightloss drugs has always been this remote prescribing and that people who maybe shouldn't be taking them are by cheating the system. I agree they are a great tool for a lot of people, but they actually need more support and better understanding by many who are taking them. My SIL didn't even know that they had initially been used at a diabetic drug until her farther started taking it for his diabetes and she been on it around 12months at that point. I'm not saying a lot of people don't do their research first but there are a significant number of people who don't.

Take me for example I'm on a even newer drug (only available for the last 2 years in the UK and 3 in the USA). I'm well aware they don't know the long term side effects of this drug, but it significantly reduces the number of painkillers I need to take, which we do know the side effects for and has increased my quality of life. So I'm currently willing to take that risk. And of course this drug had to be prescribed by a specialist not just my GP.

But I don't know if a lot of people really weigh up the pros and cons properly.

And I'm not saying weight loss drugs shouldn't be available, but I do think it should be an in person clinc, hopefully that would reduce the number of people trying to get them who really shouldn't be taking them.

Yet a new cancer drug comes on the scene and we have stories flooding the news about how Betsy from Bognor has been denied it because NICE have deemed it not suitable for recommendations. We happily raise money for people to take their sick child out of the U.K. for an experimental treatment that is little more than snake oil and berate the NHS for not having this wonderful treatment.

Drugs are tested rigorously before they hit the market. Side effects are well known, documented and considered before a drug is accepted for use within the NHS. Latent side effects can happen leading to a drug being withdrawn, but these are not common nowadays. There are also different types of drugs which work in a different way, those which mimic the body’s responses (as WLI have) are far less likely to have latent side effects. Issues with drugs being withdrawn in the past often come when they have been prescribed “off label” for things they were never intended for in the first place.

People have droned on about the obesity epidemic for a long time. Now we have a drug that has really made a difference, now we have people who are using it being described as lazy and stupid. Turns out people weren’t concerned about the health of the nation, they were picking on fat people. And they are still doing it.

It seems ironic we know the long term health implications of things like alcohol, but any suggestion we restrict access to it is met with absolute uproar, yet something which may or may not be problematic but is being proven to help people be healthier is met with calls for restrictions.

It most definitely is singled out. Mainly that anyone on it s lazy. Lazy if they don't use them, lazy if they do.
But then all us fat people are lazy it seems.
Its from the conditioning to believe that unless you literally bleed trying to accomplish something then you didn't really try (yet we look up to people who make £££ doing FA - hilarious).

We have to suffer to be a normal weight, but do most people who are natural a normal weight suffer to be that size?

I am on them, and I chose them over a gastric bypass. My friend had one, and she has become the most depressed person I know (this is a known side effect of bypasses it seems, very common).

I also take them for all the GOOD things they do for the Autoimmune condition I have (I take coumadin to keep me alive),and its a case of in for a penny, in for a pound. Some of the vitamins I used to take were more life threatening to me (K2).

I’m on antidepressants and I absolutely thought about the side effects before starting. I tried to hold off for as long as possible but I needed them for my ppd.
I want to start wli but honestly I am scared of the side effects. It’s relatively new to he used as weight loss and I worry about what may come out in the future

Publicising the risk of a drug and letting patients make up their own minds about whether they still want to use that drug in the context of the illness they have and the risks from that illness, is not hand-wringing though; it’s responsible medicine.

Yes, I understand that but I remember this being the case with gastric bypass and everyone saying that anyone who did this operation was taking "the easy way out," and all the people who had the surgery telling everyone that it definitely wasn't easy.

It's unfortunate but everyone has an opinion on everything.