Sky News discussion about weight loss pills this morning

[ffsarewedoingthis]

They’re going through the daily papers and as per usual, three thin women are saying the same things, “there’s no long term data” (incorrect, these drugs have been in use for decades), “people who don’t need them use them” (very rare, and we don’t ban things like alcohol because kids sometimes get hold of it), “there’s a pressure to take them” (no, there’s not, if anything it’s the opposite).

AIBU to be utterly fed up of this discourse? I’m on WLI and have been for the last two years. I’ve lost ten and a half stone. It has quite literally saved my life.

Why, when they’re having these discussions, do they never discuss the fact that being obese is much much worse than any potential side effects of these drugs? Why don’t they discuss that almost every study coming out has been overwhelmingly positive, with noted positive cardiac benefits? The benefits in terms of addiction etc., are known as well.

The news trying to put people off these drugs is scary, especially when it’s three women who have obviously never experienced what it’s like to be morbidly obese and feeling like you’re suffocating in your own body.

Yep - missed the point.

How am I clearly talking about redistribution when I am saying clearly the opposite? I am talking about new services from a new funding source and no raise in current prices. The levy would not be so burdensome as to put prices up. Just like with the gambling levy, the money would be redistributed among clinical care, awareness and research. I don't know how it is going with the gambling levy at it is new (used to be voluntary payments into services like gamcare), of course there is a big risk that the money will be eaten up by non productive work rather than direct clinical care. Have you looked at the immense profits the producers are making from these meds? We are talking doubling of profits by 2024, billions. It is thought that the development costs of the meds (substantial of course) have long been covered and they are the most commercially successful drugs ever developed. It's estimate that £2billion a year are being spent on GLP1 agonists in the Uk alone while the whole spending on all Eating Disorder treatment in the UK is about £250 million.

Of course it would be a disaster if Trusts were allowed to improperly use the money and it would have to be strictly ringfenced. Part of the picture of today's lack of resource for severe mental health conditions in England is that, when IAPT was introduced to primary care mental health at the end of the 2000s, staff and funding were quietly reduced from secondary and tertiary care services that were not reporting targets to government. Only Talking Therapies, EIS and, more recently, under 18 eating disorders have to report to the government and this has allowed quiet stripping out of other services with target chasing rather than truly well developed care in those that do report. Millions have been wasted on staff who are trained into Talking Therapies (IAPT as was) and burn out due to the impossible target driven culture. Dreadful state of affairs.

As I also wrote, this is not all about mental health at all. It is also really important that people are screened to remain healthy while restricting. Already if you have the money you can choose to do bloods, dexas, abdominal screens to monitor yourself. So people who are struggling to just pay for the meds are disadvantaged now and may suffer other long term health issues through simple lack of monitoring of all the relevant markers.

What sort of regulation were you thinking of?

ok. The point is that what I put in my body is nothing to do with you.

You're talking about redistribution because what you talked about doesn't create new MH specialists to provide it. We need to look not just at money but trained people to do it. Your first post didn't do that and neither does this one.

This happens quite often with people making suggestions about things they'd like to see around WLIs. We have a global healthcare worker shortage, and specific issues in the UK. Talking about why you think there's a need is only one part of that. You either have to explain how you think your proposal would create extra capacity in people providing the services or why it's better for society that they do the work you're proposing they do instead of what they're doing now.

This is true of physical as well as mental health, albeit mental health does seem to be a particular staffing nightmare. But it's equally applicable to people who want, say, weigh ins in person.

On the financial point, can you explain how the levy would not be so burdensome as to put prices up? This isn't the same question as whether the manufacturers would need to do it, because we all know it's not just needs based charging. If you're proposing legislation to prevent it, happy to hear that, but again needs to explain how it would work.

If you’re stupid enough to inject yourself with an unknown substance you bought from yoof in a hoodie on a street corner, no amount of pamphlets and information is really going to help you!

The vast majority of people on WLIs are sourcing them legally through licenced pharmacies. To be prescribed, you have to fill in a comprehensive medical questionnaire, provide pictures of yourself in form fitting clothing and sometimes also provide a live video of you standing on a scale (using their website’s own camera to reduce the risk of people uploading doctored photos/videos). Some pharmacies request a live video consult and every box comes with detailed warnings and instructions. Many pharmacies also won’t prescribe unless you also consent to them informing your GP. My poor GP now gets a letter every time I re-order.

It’s really not the Wild West you think it to be. It’s strictly regulated and yes there’s always going to be people who try to beat the system but the majority of people are doing it ethically and through licenced channels.

Mine didn’t. I thought it would but I didn’t give any kind of measurement or proof. I just said my bmi was 27 - 28 and it turned up. This was from an advert on Instagram from a registered pharmacy.

My private provider now takes my word for it on BMI and weight, though I initially had to do a video consultation.

But this is also true of various NHS monitoring I've had. I think people don't always realise how common that is within healthcare. There isn't as much capacity as we might like.

This sounds like an AI response?

With regards to therapists, there are now a lot of therapists actually chasing jobs in Talking Therapies due to continual training of staff and no current expansion of posts, so there are staff out there. Ask anyone working in Talking Therapies recruitment, whereas before you were chasing candidates for posts, over the past couple of years there are now sufficient applicants for most advertised places. There is actually big difficulty for some newly qualified coming off the hi intensity training courses at the moment because of lack of roles, just like has been discussed and seen with doctors and nurses recently in physical healthcare. Additionally there are, as previously mentioned, the hundreds who have left the profession due to burnout and unsustainable working practices. Many would return if they worked in an environment that was sustainable e.g. as discussed here explore.bps.org.uk/content/bpscpf/1/363/26

on the maths, none of us know the full spend in the UK over public and private and illegal GLP1. I have read that it's estimated conservatively around 2.5 billion a year. Your AI can do the maths on what a tiny percentage a levy to fund some services would be.

Those orgs who are enriching themselves from the production and prescription of these meds love to trot out arguments around lack of resource and passing costs on to the poor consumer. It's all solvable if there was a will and not such powerful vested interests to privatise the gains and socialise the losses.

Well of course, what are you talking about?

It's not.

I'm glad to see some attempt now to address the issue of human capacity. The improvement in TT recruitment you mention is very encouraging. However, there's also no reason to presume the working environments will be more sustainable than the ones that drove people out. It sounds like you envisage this provision being within the NHS rather than private. Again I'm happy to hear any proposals about how this would work, and it'd be better for all concerned if that happened, but it can't just be assumed.

As for the maths, if you're going to assert it you need to prove it, not tell someone to go on AI. I'm actually not only quite bad with AI but don't trust it, so it won't suffice to prove your case. Again, it's not just a question of whether Big Pharma could afford to absorb a cost, it's whether they will, and potentially how they could be prevented. You've not explained that. It takes more than correctly pointing out they're wadded and immoral.

I have never once had any discussion when being prescribed any medication online and as I said above, recent (but also lots of times prior to this) requests for new medidation for a new condition at the GP resulted in the medication being sent straight to the pharmacist.

Why is that different?

In my immediate circle I can think of 5 ppl who do abuse WLI. So not confined to celebs and not that rare, although maybe my experience is an anomaly.

Wow, in my circle I’ve now 6 mates/family members on it, all legitimately and using healthily.

very odd you’ve 5 abusing it. You maybe move in those circles,or of course you could be lying. Who knows/

Absolutely. Seen it on here, people bend over backwards and upside down to say that people are only using ozempic because they couldnt be bothered to eat healthy.

Of course there is a correlation but there are plenty of other reasons people can be overweight which isnt caused by a poor diet. Those of us who fall into this category shouldnt be shamed or denied things that make us healthier.

It was a discussion on tv. And now we are having a discussion about a discussion. And as usual people are reacting as if having a discussion, whether on tv or here, is going to somehow remove their access to WLI.

Fully agree that it's not going to remove WLI access, because there's no chance of any of the usual back of fag packet suggestions being listened to. But personally I think it's worth spelling out that when people want extra steps, that not only functions as a barrier to access but also means those resources aren't available to use elsewhere. Both of those things clearly come as new information to some posters.

It's true that many of us find the social attitudes to WLIs interesting in themselves, the reason why these discussions so often follow a similar formula. I appreciate if you don't then they're probably not so interesting!

I would like to be able to have a discussion. I find it all very interesting. But a discussion is so threatening to those on WLI clumps of whom arrive on these threads apparently upset at a discussion occurring and it always goes the same way - which ends the discussion.

Well, let's give it a try. What is it you'd like to be able to discuss that you feel is being ended?

I haven't said it is being ended. I said it is always ended. Watch this thread...

A lot of people don’t need them though. The NHS have very strict criteria to access them, I think you’re supposed to be morbidly obese from memory or obese with certain health conditions. You can buy them privately as many do, some women may only need to lose a stone or two so very slightly overweight. I also know of some women who just use them to stay skinny, my mum is one such case.

So she’s lied to obtain them?

Oh I see. Well let me know!

Two stone actually is the difference between obese and healthy BMIs for a lot of women, and the number will be even higher if we include 27-29.9 BMIs with a comorbid condition. And you'd have to be very tall indeed if a couple of stone overweight was only slightly.

And the NHS imposing their own extra conditions for access doesn't mean a person who doesn't qualify through them doesn't need WLIs. You can have a 39 BMI and multiple comorbid conditions but still not meet their stringent criteria.