What do we REALLY think about the weight loss jabs?

[Newbabynewhouse]

I've put this on AIBU rather than weight loss jab because I want a neutral audience rather than people who are all using the jab.
What are peoples thoughts on the jab? I'd love to hear from someone educated in the medical field about whether these are actually safe for people without diabetes.
I'm obese and I have lost a stone so far by dieting although it's taking me a long time! I know if I keep trying hard I can lose what I need to. Lots of people I know have started dropping weight from using the jabs and I am tempted however, can't shake a feeling that there's something not quite right.
What I mean by this is... these jabs have been around for years for diabetic people, so why have they only just been 'released' to people despite obesity effecting the NHS for years?
I know a woman who fainted in work the other day with gallbladder issues, she's on the jab.
Also, I'm going to sound a little conspiracy theorist now, but, isn't it odd these jabs became popular straight after people starting refusing to have more covid jabs..?.. I'd love to hear from people with a bit of background info or medical professionals to tell me whether I'm overthinking or if I'm onto something?

@Fatasawalrus Yes but the NHS rations them. If they were bothered about preventative medicine, they wouldn’t. They are a game changer in terms of reducing weight and that’s beneficial on so many fronts. My issue is my clothes are now way too big! More expense in replacing them!

I don’t drink and I’ve never joined a gym, and I’ve never smoked. My one expense is Mounjaro!

They have over 40 years of data, how much do you need 😂 and they don’t need to lie, some pharmacies now prescribe at bmi 25.

I'm educated and in the medical field (in an area related to this) - there are no long term safety data on these medications and I wouldn't touch them with a bargepole.

Lots of people manage to loose weight when they are on the injections, as they stop eating so much food. It turns out that is a way to loose weight!

I wouldn’t put any barriers in place for you to make an adult decision to use whatever medication you want. This is a thread about opinions and I’m expressing mine. My personal opinion is that if you are taking a medication that is going to suppress your appetite in order to lose weight then it is worth looking at the physical and the mental in tandem with each other. If someone is anorexic they need the physical side of treatment to be dealt with urgently which in this case would be getting them food and nutrients, but there is always a deeper reason why they got to that physical state in the first place that needs acknowledging and talking through. I think it’s unfair that people at the other end of the spectrum who are morbidly obese are just sent on their way with weight loss medication as if that’s the end of the story, wouldn’t it be better to explore why these eating habits started in the first place? The two can co-exist.

It's not fair on people who have lost weight through use of exercise and willpower.

Not fair...?

Not a general sense of unfairness at the universe that some people can't take them for whatever reasons. But actually unfair that others can?

Well tell me something I dont already know FFS. Yes it’s the food noise that is the main helper! Of course it is. Every person I know on these drugs has said it was like flicking a switch in the brain. When pre WLI they never felt full, now they do. They aren’t constantly hungry. They can eat normal meals that those with the noise cannot fathom, or for which, like me, will be a constant monitoring and will power not to give in to food craving. I know it’s not a pull that makes weight drop off. Again, I’m not stupid.

You think people don’t know that you have to eat less to lose weight? Do you think fat people are thick?

@mulberrymilk The only thing there not concerned with general weight loss, whether it be by WLI or other means is suppression of gallbladder motility, if you read the rest is due to actual weight loss irrespective. It would be odd that you would be bothered by lessened motility alone, if losing weight you would have all the rest, so your gall bladder is bung anyway really.

Also a thing for this who are obese, female, over 40, have Crohn’s disease, diabetes, the list goes on.

@Scottishskifun So, you'd want it to be a real life face to face appointment only, so not available for online prescribing at all?

I think I could just as easily lie or omit medical history in a face to face appointment as I could when filling out an online consult. If you inflate your BMI you still need to pass the verification checks, which these days are likely to be a video, either a live video consult or a video recorded live rather than submitted later. Various other approaches to the checks needed. Pharmacies are constantly being inspected and issued with improvement notices if issues are found. But, your argument would apply to any medication available online in this way, of which there are many.

You say "there are cases of people who have ended up seriously unwell because they have been given way too higher doses or a dodgy batch because they have gone for cheapest cost and it turns out to be black market."

You can't be given "way to higher doses" or a dodgy batch if you use a legitimate pharmacy. Or if there was a rare genuine prescribing error, there are at least channels for that pharmacy to be severely sanctioned and forced to improve their practices. If people can't tell the difference between a legitimate online pharmacy and a black market supplier of fake illegal medications, then there is certainly room for education on that. But, that has got nothing to do with legitimate prescribing and nothing to do with the online pharmacies themselves who are not supplying fake black market medication.

I think that a lot of the alarm around this is because WLI in the media might be the first time that a lot of people have heard of the idea of getting online private prescriptions and previously had no idea that this existed as a concept. There are millions of online private prescriptions yearly for all kinds of medication and has been for years.

I struggle to believe you are all that educated and in the medical field when you use the word loose instead of lose.

all this talk about long term safety data, ALL medications were “new” at one point or another.

That only seems to be a problem for GLPs though. No one has ever mentioned any other medicine.

I’ve never known people have such strong opinions on other people taking a medication that they themselves have no interest in taking, for a condition that they don’t have.
I wonder why people who don’t take WLI and don’t have any intention of taking WLI have such strong opinions on other people taking WLI? Do you feel the same about other people taking antidepressants, when you’re not depressed and don’t need them yourself?

I actually worry for people who are prescribed it in the nhs as I am presuming when the weight is off, so stops the prescription. If the person struggled before with food noise and difficulty controlling portions due to never feeling satisfied.

Yes even if they have learned better diets added exercise etc. Because for yo-yo dieters, we know possibly everything we need to about food, nutrition, calories, exercise and while we are determined, yes we learn new ways of eating. But it’s often still an almighty battle to feel “normal” and satisfied as the food noise remains.

So what happens to those people prescribed who stop? Are they monitored? I actually think it would be kinder to accept some people will need the off switch help that are WLIs forever, as I expect many who pay privately will do (as I would too so I’m not being all bitter and judgmental!). Basically treat obesity like other conditions - if you stop taking prescription meds, the condition can come back. Like taking statins - sometimes all the health measures are still not enough, and a statin is prescribed. If you stop then what.

I think loss of gallbladder motility is a bit concerning. I'm not bothered by it, as I am not on WLI. The meta-analysis concluded there is a mechanism - on top of the rapid weightloss - driven by how GLP1s work, that is leading to the noticed increase in the risk of gallbladder disease, requiring removal of the gallbladder.

Edit to add
It's interestingly similar to how the digestive process is also considerable slowed down - which can lead to gastroparesis for some, and worst case scenario intestinal blockages. The thought of food effectively rotting in my stomach and digestive tract is not appealing to me. YMMV.

I think they are a fantastic tool for fighting obesity. I wish they were cheaper though. I think while they do have side effects obesity has far bigger side effects. Mentally, emotionally and physically.

I have had gallbladder issues (cholecystitis) in the past, although not at all for several years now. I think a fat free diet is relevant. Eating some fat, especially unsaturated good fats, keep the gallbladder moving. No fat for a while, followed by high fat, can be a disaster. Obviously just after I had the problem, I was sensitive to fat of any kind, and I think that’s what confuses people. Several months later i introduced it gradually.

I don’t use or want to use injections, although I wouldn’t be allowed them anyway. I suspect that some people lose weight too quickly on them.

(And definitely they aren’t related to Covid 😂😂)

Is there any need to be so rude ? No I don’t think you’re stupid - I was simply recounting my experience with my DH. He is on Mounjaro for type 2 diabetes and says that if he really wants to override the appetite suppressant effect it’s quite easy to do so - for example on the rare occasions we go out to eat, or have a takeaway. The main effect of the drug as far as he’s concerned is that it stops the ‘food noise’ so it’s easier to control intake. He still needs to watch his fat intake as there are unpleasant side effects to that, and there still has to be a calorie deficit, which I acknowledged is easier to achieve with WLI’s.

I have a relative who recently reached their goal weight with the help of WLI’s. Her doctor has prescribed a maintenance dose which will eventually taper off, so as to avoid what they described as ‘rebound’ weight gain. Her treatment was NHS so not really sure what happens with those who get it privately.

1-1.5 per week for me …… perfect!

The success of the injections does demonstrate that all of those claiming they were obese even though they only ever ate a plate of lettuce were not being honest because all the medication does to help them lose weight is reduce their appetites so that they actually eat sensible portions and, miraculously, the laws of physics which they previously denied applied to their bodies have been proved to work! 🤣

However, I think the fewer morbidly obese people there are, the better. Far less needless suffering from avoidable diseases caused by morbid obesity and the mental health difficulties that also often result from that, and it will much better for the NHS to pay for effective preventative interventions rather than far more expensive treatment for related conditions developed later as a result of ongoing morbid obesity. The NHS should do far more preventative medicine in all areas of health because it has far better patient outcomes and cuts costs significantly.

It seems there can be very unpleasant and significant side effects like with many medications so it would be unwise to take them unless everything else had been tried to control the obesity first so I don’t think it would be appropriate for the NHS to start funding this for anybody over a certain BMI without them having support to try other options first without such risks attached. The risks also need to be thoroughly explained to people and the patient’s medical history and family medical history should be thoroughly reviewed beforehand to assess suitability.

People buying the medication online without proper oversight from a doctor is quite concerning but as it’s legal currently for there to be private prescriptions, that is their choice. I would question whether online prescribing ensures patients do actually understand the risks? I also think though that the NHS should be recording the cost of medical treatment required due to adverse side effects caused by private prescriptions of these drugs and if this becomes significant perhaps allowing private pharmacies to prescribe it should be reviewed/ have stricter criteria imposed: there should be a proper cost/ benefit analysis because there’s still a cost to the taxpayer associated with private prescriptions: the cost of treatment for associated pancreas/ gall bladder/ digestive issues and other side effects and adverse reactions treated via the NHS, and given that the significant risks associated with obesity-related illnesses aren’t present in people who are just a little overweight in these cases there is not the associated cost saving to the NHS/ taxpayer to outweigh the cost of treating the side effects in the unlucky ones who are just a bit overweight and obtain private prescriptions outside the NHS criteria then have an adverse reaction. It may be good value for money, or not, but data needs to be collected by weight, BMI, dose, type of side effect, cost of treatment so that rational and evidence-based criteria for the permissibility of private prescribing can be issued.

It’s interesting and positive that research is uncovering health benefits from these drugs in addition to them being appetite suppressants however, there are clearly significant risks and we need to ensure these are being accurately recorded and managed and weighed against the benefits (excuse the pun!). There’s certainly a risk that some people may be taking them as a lifestyle drug rather than due to medical need when other interventions would be far less dangerous and equally effective if diets etc were actually followed because ultimately that’s exactly what the drugs get people to do, but with these added risks. Overall though, they seem to be helping a lot of people be healthier who couldn’t manage to eating sensible portions/ healthy food of their own accord and it seems to have been transformative for many. It’s annoying that these topics often descend into polarised extreme views often ignoring the facts that don’t fit a poster’s personal viewpoint or narrative so it’s good to see (some!) posters here having a balanced discussion.

Educated you say?
in the medical field you say?
Involving weight loss injections you say?

To aid your excellent education it is lose not loose! And you’ve made the same mistake twice!

Education isn’t what it used to be!

I find it difficult that you know anything about weight loss!

To be fair, she could mean that she has a GCSE in food tech and works as a slimming world consultant 😉

Oh and it’s there is not there are!!

You’re not someone I’d ever listen to!

It's not just the slowing of the gallbladder emptying. From the quoted para:

"Furthermore, fasting keeps the gallbladder inactive, leading to a buildup of thick bile, which eventually leads to the formation of gallstones."

So, although several posters claimed it was nothing to to with the WLI themselves, apparently it is. Care of:

• Reduced gallbladder motility: GLP-1 slows gallbladder emptying, causing bile to remain longer in the organ, which promotes stone formation
• Rapid weight loss: Accelerated fat loss can alter bile composition, increasing the likelihood of gallstone formation
• Changes in bile metabolism: GLP-1 RAs may influence bile acid secretion and flow, further contributing to gallbladder disease risk

Meta-analyses of 76 randomized clinical trials involving over 100,000 participants show that GLP-1 RAs increase the risk of gallbladder or biliary diseases by approximately 37% compared to controls (RR 1.37, 95% CI 1.23–1.52) (He et al., 2022) Specific conditions affected include gallstones (cholelithiasis, RR 1.27), gallbladder inflammation (cholecystitis, RR 1.36), and overall biliary disease. The risk is dose-dependent, duration-dependent, and higher in weight loss trials than in diabetes trials, with weight loss studies showing more than double the risk (RR 2.29)

That's a suprisingly high increase in risk. I'm not sure how accurate that is. But it is certainly something to bear in mind if you're on WLI and having symptoms.