Do you agree there should be more checks before drugs are prescribed.?

[RedHillLady]

There has been a lot in the media recently about how the current system is too weak and needs to be more robust.
I think we are going to see increased regulation soon and I see that as a good thing.

@MargoLivebetter it's a dilemma isn't it? I really think the long term benefits would outweigh the short term costs. Maybe specialist NHS weight management clinics?

Whilst it would be nice for GPs to be able to dedicate that time, it’s not realistic. My mum has dangerously high BP and is monitored but in reality she rarely sees the GP and in fact her most frequent interaction is with the pharmacist who is much more knowledgeable about the nature of the medication she is taking than her GP. Sometimes people believe GPs have loads of knowledge about the drugs they are prescribing but that isn’t actually true - pharmacists are highly educated specifically on the nature of medication and are also able to monitor people and increasingly to prescribe themselves (eg you can get antibiotics from them for some things).
Also many of the providers do monitor or require people to keep them updated on weight and side effects.

Those suggesting a GP needs to see each case are not operating in the real world
The government does not want to fund GPs working in primary care
That's why there are plenty of unemployed GPs
In my practice even a newly sick child is diverted to a 'physician associate' who knows far less than a good GCSE biology school child.
We're so many miles off GP oversight of obesity treatment, it's beyond a joke to suggest this at all

PS people fake symptoms all the time to get whatever it is they are seeking, for many reasons. It's not a reason to cut off treatment to genuine sufferers, especially when the genuine sufferers comprise 1/3 of the adult population!

Get real

They do have those. They have a months if not years long waiting list and you’re not eligible for them unless you are morbidly obese by which time a lot of damage will have been done already.

@Searchingforthelight maybe GP was not exactly what I meant. I just think there needs to be far more regulation of the market and the NHS needs to step up or intervene to try to prevent abuse of the system. I've got a colleague who was a size 12 and now is a size 8 thanks to Ozempic (or maybe MJ, can't remember), she certainly shouldn't have qualified. But she gamed the system. She couldn't have done that if her initial consultation had been face to face

I know they exist but I meant a much wider spread/easier access. So people could easily access proper support and MJ or whatever is only prescribed after other methods have failed, a bit like what currently happens with diabetes

@AnnaQuayInTheUk personally I don't think there is a dilemma. Some people will always be reckless and stupid no matter what. People drive drunk and under the influence of drugs, they drive without insurance, drive using their mobile phones and so on and all of those things are technically illegal.

I think that the benefits of getting a whole load of people not to be obese at their own cost far outweighs the abuses that would happen anyway via the black market.

Also what does it matter about your friend who was a size 12 and is now an 8? She paid for it, so who really cares. She was clearly up for lying, so would probably have got it on the black market or some dodgy overseas supplier anyway. In the meantime, just looking at the threads here on MN, there are literally thousands of posters who are now no longer obese, where they once were.

Why does there need to be more regulation? No one seems to provide any stats to back this view up. The only stats I can see is hospital admissions in all global markets where it is available the same way, and for anything serious those are incredibly low. Like a .0 of a percentage point. 274 deaths out of 16.5 million in the USA, not one due to correct usage of the drug, all due to reckless usage or fakes.

same as the uk, no deaths, even the nurse wasn’t due to the drug, hospital admission due to folks taking fakes or reckless usage. All with things like the runs or dehydrated.

so when you consider the huge benefits to those taking them correctly. Why does it need to be more regulated? It makes no sense.

While overdosing can definitely cause harm and some people have bad reactions to it, I think some people are too hung up on those who “cheat the system”. Frankly, if someone already slim loses half a stone on Mounjaro rather than naturally, I don’t really care. It can obviously safely be given to those of a lower weight because there are people on maintenance doses.
Also there’s a huge black market in pharmaceuticals so whatever measures you put it place there will always always be ways of getting hold of it if you really want it.
The vast majority of people on WLI are a) obese and b) benefit from them.

Reckless and stupid is an interesting way to describe people with a mental health condition.

Although, in the same vein, people with obesity could be deemed reckless and stupid for overeating could they not?

I’m fairly sure fhe poster wasn’t meaning the mentally ill. But clearly there are many people who are reckless and stupid. You see posts from them on here.

@Frequency who said I was talking about people with a mental health condition? Certainly not me. Are you saying that all those people who drive drunk on drugs, without insurance and using their mobile phones have mental health conditions? Are you saying that no one is ever reckless or stupid?

We are all challenged in all sorts of ways. Some of us are food addicts, some of us are drug addicts, some of us have behavioural addictions, some of us have mental health problems. We have to go forwards as best we can and WLI seem to work for people looking to tackle their issues with obesity. Just like cars seem to work for getting people from A to B. Some people will abuse WLI and some people will drive illegally. It is not for me to judge the reasons why. However, I think both WLI medication and cars are good things and I think people should be able to access them, even if some people will use them incorrectly.

@ThatCoralShark most posters who are voicing concern about the aggressive marketing and easy availability around these medications are focused on ED sufferers rather than slim people who fancy loosing a few lbs and can and will stop once they reach their goal.

Telling someone with restrictive ED to simply "stop being reckless and stupid" and "take personal responsibility" is just the same as telling an obese person to eat less and move more. It doesn't work, hence the need for medical intervention.

Sure, no one disagrees, but clearly that’s not what rhe poster was saying

and folks with eating disorders quite frankly often abuse anything they can to lose weight. Doesn’t mean we make it harder for the millions who need it to get the drugs.

What next, locking up the chocolate cake so no one can binge?

Yes their behaviour is reckless and that’s not controversial. That is the case with many many mental health conditions - it causes reckless behaviour.

The suggestion that obese people are reckless doesn’t hold. Obesity is a medical condition that is in most cases not easily solved by move more eat less, as your body will literally fight you to death to make you gain weight if you lose it. The medication helps obese people deal with their condition. They are no less reckless than someone being labelled reckless because they have asthma or diabetes or any other condition requiring treatment.

I’m a size 12 and had a BMI of 31 when I started Mounjaro 2 weeks ago. So I was (and still am) obese.

Same here - I could squeeze into my size 12 jeans and was actually wearing size 10 M&S stretchy jeans but I weighed almost 14 stone and was obese at BMI 30.4. I have good posture and very even distribution of weight, which helps to hide the extent of my obesity.

@Boohoo76 my colleague really wasn't obese. She wears very tailored clothes and always looks amazing.

I've got a BMI of 27 and there's no way on earth I could get into size 12 jeans!

Edited to add: although I think BMI is a fairly crap measurement

In the USA the drug needs to be prescribed by a doctor in order for it to be covered by medical insurance. The drug costs far, far more there than it does in Europe and the rest of the world. So abuse is relatively rare.

In the UK the story is completely different. If pharmacies such as MedExpress are paying influencers to advertise and are encouraging the use of advertising via discount codes - which are strictly prohibited for prescription medications in the UK, the clearly they need more oversight and more regulation.

We are in the first year of these drugs being available. The numbers are now exploding. It isn't a matter of deaths and percentages, it is a matter of simply ensuring that regulation is there and adhered to in order to protect both the pharmacies and the consumer.

It doesn't need much. No-one realistically is going to sort out the actual criminal side of all this - Tracy the hairdresser and her vials of insulin diluted with soap and fuck knows what that she purchased on AliExpress. But at least the fallout from consumers harmed by going down that route will not impact the millions who will be safely purchasing from properly regulated pharmacies.

@Finallydoingit24 So it's ok to call people with ED reckless but not people eating themselves to an early grave? I'd say that's pretty reckless tbf.

I think we have lost sight of what is obese. Very few people would think that I am…but that’s because we regularly see people at 20 stone plus nowadays. I wear tailored clothes myself, the majority of my extra weight is concentrated on my stomach which I am pretty good at disguising. But the fact is that I weighed almost 13 stone which at 5 ft 4 made me 2 and a half stone over a healthy BMI.

And yes, I can easily wear size 12 jeans as long as they have some stretch. If I go up to a 14 they are too big on my bum and legs which is another reason for me needing to lose weight. I can’t just size up to a 14, they hang off my hips and bum.

@Boohoo76 yes, as a society we seem to have normalised obesity. I'm overweight (11 and a half stone) but lots of my friends would say I wasn't.

Clothing sizes have also got much bigger. I've got a beautiful vintage dress which my grandmother wore to my parents wedding in 1963. It's labelled size 18 and it doesn't fit over my shoulders and bust

Reckless and stupid is a state of being
In various circumstances

Please don't confuse this with mental illness

This