You shouldn't take weight loss drugs. Learn about healthy eating, eat less and exercise more.

[GapTshirtsAreShitQualityTheseDays]

This is like telling an insomniac "don't take tablets, just get more sleep"

I'm 41.
I have tried.

I KNOW all about healthy eating. Probably more than most slim people.
I don't have an emotional/binge eating disorder, I just have a bigger appetite than most people. I can only control it so long via willpower or low-carb diets. The drive to eat is the most powerful instinct known to man (except maybe breathing)

It's the weight loss medication that takes the edge of said appetite and ALLOWS me the space to make sensible decisions on food.

I've gone from 15 stone to 9 stone (I'm short). If these drugs had been invented 20 years ago, my life would have been much better.

And no, I didn't steal the drugs off a diabetic. I got private prescriptions for Wegovy and then Mounjaro which are only marketed for weightloss.

And yes I am quite prepared to take the drug forever if necessary.

And no, I don't care about the "potential unknown long term side effects" because they can hardly be worse than what I was facing with obesity.

And although exercise is beneficial for many reasons, it is a fairly trivial factor in weightloss.

There are self-taught experts here, who can probably answer you in more detail. I would suspect it's definitely NOT something to self-prescribe! Here's why:

Semaglutides work by regulating insulin production and slowing digestion. It sounds as though your meds don't make you hungry, and there is a danger of malnutrition if you're already eating very little but further reduce your desire to eat.

You need to know how your meds increase your weight. If they're messing up your insulin response, semaglutides may help but I would strongly advise talking to your medical team first.

Some meds slow the metabolism by impairing glucose metabolism and increasing cholesterol and triglyceride levels. At first glance, it looks like semaglutides could help with this but, again, discuss it with your doctors.

Most of the medicines that can make you fat are prescribed for their effects on the brain. Consequent impacts on the pancreas, liver and stomach are side-effects of the cascading influences from the brain. Semaglutides stimulate release of incretin, a hormone produced by the stomach. This sets up a feedback loop to the brain, and you'd need to be sure it wouldn't mess with the pathways being medicated.

In short - don't get an internet prescription but do discuss it in detail with your docs!

Your insides are already destroyed, you’re full of bitterness.

Weightloss drugs will destroy your insides (and outsides)

Whilst I have chosen not to go down this route, this sort of statement must make people who are taking the exact same drugs, long term, for management of their diabetes feel great !

How have you managed to miss the entire conversation in society about why these drugs actually work for people?

Obese people DO feel hungrier than the next person. Well specifically the people with obesity as opposed to simply being obese. Their hormones are misfiring telling them that are hungry.

For the vast, vast majority of them their stomach does not get used to what they give it by sticking to smaller portions or a healthier diet, they can only get used to it by taking weight loss drugs, which fix the misfiring hormones and stop the feeling of hunger.

@Cornishcoast1 yeah I only heard of "food noise" when these drugs came out but it explains it brilliantly. Imagine having an itch in your brain 24/7 and trying to carry on your normal life without scratching it.

Have you read ‘Why We Eat (Too Much)’?

@SilenceInside more like a country pile miles from anywhere with the food delivered and correctly portioned so that people can only eat what they are given. Access to a gym and pool and lots of time outdoors. A small cinema perhaps inside the country pile. Not a prison anyway. Lower the time to 6 months maybe and see what happens. It would be interesting to see if obese people really can't lose weight despite eating healthy meals, healthy portions and getting appropriate exercise. If they can't that opens the door for further research.

Obese people DO feel hungrier than the next person. Well specifically the people with obesity as opposed to simply being obese.

@kkloo thank you for this, I am one of the 'simply being obese' people, which is why I personally haven't chosen to take this particular medication, I don't suffer from Food noise, I don't think about food and rarely feel hungry, the only common factor I have with the OP is that when I do eat, I can put away a lot, and I mean a lot, of food in one sitting. And drink far too much wine !
I used to be a bit about people who took it, but do you know what ? what matters is what works for an individual, I have a friend taking it and another who has had surgery and we all celebrate each others losses, because we want each other to be happy and healthy

Isn't that the most important thing ?

I would guess not.

To live in a controlled environment most people would need to give up their entire lives.

I am confident that if I lived somewhere, where I couldn’t leave, didn’t work, enforced exercise and didn’t really have to think about anything. I would lose weight. Sounds like bliss to be honest.

They would also need to tear my PCOS which my doctors refuse to do as I was diagnosed after I had finished having children. Or I would end up just leaving because of the way my body reacts to PCOS. It would be torture. And I am assuming you don’t mean lock people up and refuse to let them leave.

However, not sure I would give up my life for 6 months, a year, 2 years or however long. Not sure social services would appreciate me leaving my kids OR that my boss would keep my job open.

The whole health education thing is weird to me. Not every obese person has been been obese their whole lives. And not every obese person doesn’t know how to eat healthy.

I was a competitive athlete until 8 years ago. I know healthy eating. That’s not the issue.

Or course you could look at the many episodes of biggest loser!

You're inability to understand my point isn't my problem.

No it isn't.
For most people who are not overweight and have never been very overweight or obese then there definitely isn't a daily internal battle.

As someone who has always been slim if I get a craving for junk food and want to avoid it that day for whatever reason the craving is fleeting and passes and then that's it., there's no battle, the craving hits, I resist it, it passes.

There was a thread here about ozempic a while ago when an obese poster said she did a little test on her friend. I believe they were in one of their houses and there was a cake or something like that in the kitchen. After a period of time the obese poster asked her slim friend how many times she'd thought about the cake in that period of time, and I think the friend said she hadn't or maybe just once or something like that, the obese person said that she couldn't stop thinking about it the whole time.

(Sorry if the poster is reading here and some of those details were wrong but that was the gist of it).

As a slim person I have freedom from food noise, and it's only rare that I might get a craving that keeps hitting me. For obese people many say that it's constant and overwhelming.

There are drugs for alcoholics etc now and I don't hear people ever complaining about them, but yet they do for weight loss drugs. It's like people don't want obese people to have the freedom from the food noise and the constant battle in their heads.

Thank you very much for this. I have had an appt with my GP who said pretty much this about the GPL 1 since appetite isn't my issue, therefore it would be of no use. GP is offering Orlistat but I had to take further tests first to rule out thyroids, etc. So our next appt soon would be discussing these things since tests seem okay.

I think it could be the slowed down metabolism or insulin response like you mentioned but of course, I'd be having a proper chat with my GP about my options/solution now that the test results are out.

You're also right that it's usually either deal with the mental health side of things or weight loss side because one medication tends to affect the other. I hope I can find one that would work together. We'll see.

@LegoTherapy If you locked me up and fed me 3 healthy meals a day and made me exercise, I'd lose weight (assuming I was still overweight). But I'd put it back on when you let me go. Probably very rapidly as I'd likely binge.

The education and therapy would make no difference to me. I know about healthy eating and I don't have emotional issues.

I'M HUNGRY WITHOUT THIS DRUG! THE BODY'S DRIVE TO EAT IS VERY POWERFUL!

PS you might find this interesting albeit you are not proposing starvation
Minnesota Starvation Experiment - Wikipedia

I absolutely agree.
People who haven't ever been obese just don't realise.
I've yo yo dieted my whole life since age 10. Mostly just as an overweight person to being the middle of the healthy weight range. But after the birth if my 3rd child I was in the obese range for a while.
I've managed to get down into just being overweight again using calorie counting. But I totally understand what a struggle it is. And for someone much larger than me I could see it being an almost insurmountable struggle.
I have constant food 'noise' in my brain. I have no idea when im hungry or full as thats totally ruined by years of very low calorie dieting since childhood. I struggle with binge eating. I could write a book on nutrition so its not about lack of knowledge.
People will argue in the face of statistics which show how rare it is for people who've been obese a long time to be able to maintain a healthy weight long term through diet and exercise changes alone.
It's not completely impossible of course but it's rare. It's very very hard.
Much harder than someone a bit overweight losing a stone for example.
Most people who've got obese have complex issues with food. It's not simply a case of it being an accident where they just weren't paying attention or they didn't know. Again of course there are some instances where it might be through lack of awareness.. but for the most part it's more complex psychological stuff
There's still this level of fat phobia in society where people are determined to label obesity as a poor choice and due to laziness. Despite constant evidence that it's a disease and is very complicated.
It really is fat phobia because no way would an anorexic person get the same level of abuse and outright denial of their issues. 'Oh you aren't ill you just need to eat a burger! Just do it, you don't need medical assistance! Just try harder!'
No one in their right mind would say that to an anorexic person would they? Because we find it much easier to feel sorry for thin people and so easier to identify that they are ill and in need of medical treatment.
Morbidly obese people and long term obese people or obese people who have medical issues due to obesity.. NEED medical intervention and/or support.

@LegoTherapy of course people would lose weight in those circumstances, how could they not? If they're in a calorie deficit and have no ability to source food from anywhere else then, yes they will lose weight. Not sure how that helps when we don't live in that environment, rather an obesogenic environment with lots of stresses and challenges.

Did you know if you have diabetes you're entitled to free prescriptions? You have to get a form from your gp and you can get a medical exemption.

Wrong. It’s by and large calories in an out. Yes other factors have an effect but not so much that someone will be obese by eating 1500 calories every single day for a year. I 100% guarentee you.
Its a bit like people who say ‘oh my boobs never decrease in size. No matter what I do. Err trust me. They would.

Not really. Truth hurts because so many people are in denial or it’s too hard to face up to why they are over weight. Lots claim that they have tried everything and ‘nothing works’ but they are just lying to themselves.
There are so many good ways to get healthy out there and educate yourself. That might include therapy for some people. Many reasons people put on weight. It’s really hard to get it off and keep it off. For most people it’s a daily battle of choices.

@SilenceInside in response to those saying they've tried everything to lose weight and can't I was wondering what would happen in a controlled environment.

It's interesting what @GapTshirtsAreShitQualityTheseDays says about losing weight in my scenario but regaining it once back in the real world because of her desire to eat a lot of food. If there are no psychological factors at bay, it must be physiological and surely there must be a way to test for this? There must be a way to rewire the brain to counteract this.

They have tested for it, that's how they know what the weight loss drugs do and why they work.

And do it doesn't appear that there is a way to rewire the brain.

https://www.medicalnewstoday.com/articles/does-obesity-cause-permanent-changes-in-the-brain-study-offers-clues#:~:text=In%20people%20with%20obesity%2C%20the,by%20releasing%20the%20hormone%20dopamine.

@GapTshirtsAreShitQualityTheseDays

Good for you, and helpful post. I take medication for ADHD. A lot of people have similar beliefs about it - I think it's just a very well entrenched mindset for a lot of people, the idea that XYZ is a moral failing and therefore taking medication is cheating.

Honestly I would love to dismantle the entire cultural narrative around effort/willpower but who knows how long that will take.

I’m sorry but that’s complete bull crap.
These drugs have only just started to be mainstream and millions of obese people have lost all their excess weight over last decades.
Yes the drugs work. I’m sure they do. But the OP has stated that she’s going to be on them for life and nothing else will work for her to lose weight which I disagree with.

Not wrong. People who have spent their lives on a diet and then gaining weight, have insulin and leptin activity in their bodies, and as a result the amount of calories their bodies will burn is significantly different to someone who has always been slim. Which is why you have obese people eating 1000 calories a day and still gaining weight.

Weight gain is controlled by hormones. The leptin levels in your body provide signals to hold onto weight or not, as opposed to the actual amount of weight a person is carrying providing the signals. So when the leptin levels are off, a person will gain weight on an incredibly small number of calories.

It’s not a simple case of ‘calories in, calories out’ and it’s very naive of you to suggest it is.

But it really is ! People who eat less, people taking weight loss medication and people who have had surgery, all have one thing in common and that is a reduction in the number of calories consumed. Which is why they lose weight.

I’ve considered using weight loss injections, but I can’t work out how they work. I’m not hungry all the time, but the foods I like to eat are unhealthy. I don’t crave them, but if it’s a choice of pizza or salad for tea, I’d choose pizza as it tastes better and is less prep and so easier. So if I took the injections, I assume I’d just still want the pizza but maybe feel fuller faster?