Regulators looking to cut off maintenance below 25 BMI

[Bigfatsunandclouds]

Oushk have said that they are currently trying to fight with regulators to stop people being cut off from MJ at 25 BMI.

Apparently regulators don't like prescribing below that and that basically means unless you continue to remain at 25 or above you won't be able to be prescribed even for maintenance.

This is worrying as many see this as a lifetime medication after years of obesity but at least to maintain at a lower BMI for a little while to ensure the weight stays off. This seems like utter madness - this is surely going to lead to yo yo use of the meds which seems counterintuitive.

BMI in a lot of cases is a stupid archaic measurement anyway.

If you KNOW how horrible it is to feel this way, why would you want someone, who is paying for it, not to experience that? If they can take a medicine to stop all that noise whilst getting healthy and reversing some of the damage of years of obesity to prevent it happening again, why would ANYONE object?

You say it isn't jealousy or martyrdom, but it is.

It really is. She's resentful that she can't use medication to avoid food noise because she's 'better' than people who aren't as disciplined as she is and have allowed themselves to get obese where she has lived a miserable hungry life and stayed slim. She thinks people who lose weight with medication should have to suffer to stay slim as she does. Doesn't make any sense apart from in the context of jealousy.

@CowboyFromHell
I get what you're saying. But, I honestly never had this 'food noise' which lots of obese people talk about, I never binged (I've never eaten 6 creme eggs or a multibag of crisps or a packet of biscuits in one sitting) and I definitely ate less and lived a healthier lifestyle than many of my slim friends (I was a competitive sportswoman for much of my teens and 20s). But I was just made different, I was intermittently obese from childhood and had to exercise like a demon and restrict calories to get and stay for a little while at just overweight. I don't deny some slim people have to work hard to stay slim, although many don't (being mindful and careful and eating healthily is not hard work compared to what we have had to do over the years, believe me). Now I'm comfortably slim at 58 for the first time in my life and refuse to justify or feel bad for using WLIs, which I pay for myself, especially when other people take a whole host of medications to address all sorts of self-inficted or lifestyle-related disorders, injuries or illnesses, without any challenge or disapprobation from others.

An irrelevant one, however.

The merailing this subject inspires is incredible. We know how formerly obese bodies are likely to behave. The science is settled.

All I’m saying is that there are many slim people who have comparable levels of hunger and food cravings but we’ve been able, to an extent, to manage these without medication.

And that's great for them. They aren't what WLI, or this thread, are about though are they? You wouldn't, I hope, wade into a thread about serious MH conditions and say well lots of people feel a bit down but we manage to not self harm/ drink to excess/ fall into crippling depression, would you?
For whatever reason some people need more medical support than others, be it WLI, anti depressants, statins, glasses, anticoagulants...
For me the only decent response to that is to think thank fuck we live in a time when those supports are available to us. It's amazing that we can help MH conditions with meds rather than asylums, amazing that we can help nicotine addictions and obesity with meds rather than leaving people to eat and smoke themselves to early deaths.

All I’m saying is that there are many slim people who have comparable levels of hunger and food cravings but we’ve been able, to an extent, to manage these without medication. It’s not a morality thing, or an ‘I’m better than you’ thing, it’s just a fact.

What do you think the difference is then @CowboyFromHell ? What do you think is the difference between you losing weight and those of us using WLI to lose weight?

What do you think the difference is then? What do you think is the difference between you losing weight and those of us using WLI to lose weight?

Well, seeing as you asked, and seeing as I’m not going to be making any friends on this thread anyway - here’s my honest response (and I’ll bow out of this thread afterwards).

I think the difference is this. I think someone losing weight without WLI is like someone studying at university diligently doing the course reading, attending lectures and seminars, writing essays, thinking deeply and so gaining a deep knowledge and understanding of their subject. They can then go into a job that requires these skills, confidently knowing that because they put in the hard graft during the degree they will be up to the challenge of the job.

And then imagine someone on the same course has used chat gpt for all their essays. They may on paper have the same degree grade as the diligent student but they don’t have the same knowledge, skills or abilities as the student who actually put in the effort and ‘gets’ their subject.

So replace a 2:1 degree with a BMI of 25. And what this thread is showing is that those on WLI are like people in this second group - they’ve found themselves in a position where they’ve got the equivalent of a job interview and are panicking as they’ve realised they’ve not got the qualities needed to make a success of it.

Ah, I think I can see where your misconception is. It wasn't really my question though, I worded it badly. I would have meant, what do you think makes someone a diligent student who puts the work in, and what makes someone a student who cheats and uses ChatGTP? (Although, perhaps that's the answer? You are one of the hard-working, conscious students and we are the lazy, cheating type? A difference in moral fortitude?).

Thank you for answering though. I won't explain my thoughts further because I respect your decision not to participate in this discussion any more.

Wow - well it’s not a surprise that some think we’re cheating - they’ve lost the worth that being skinny gave them - it’s achievable for so many more now.

Are you equally annoyed by people like me who got good degrees without having to particularly exert themselves, just through the good luck of how we were born?

Are you equally annoyed by people like me who got good degrees without having to particularly exert themselves, just through the good luck of how we were born?

Well, to continue my analogy- not really. As long as you aren’t then getting a job interview then throwing a wobbly as you can’t actually do the job, and expecting preferential treatment to other candidates.

Oh, why didn't you just say you thought 'its cheating' to start with? We could have had a collective eye roll at a thought so basic it's on the WLI bingo card and all moved on.
FWIW in your flawed analogy WLI would be the equivalent of a dyslexic student being awarded extra time in exams, to level the playing field. But you won't care about that because you're one of those 'lazy fatties are cheating' lot.

How very incoherent of you.

@CowboyFromHell, your analogy is misguided.

Another possible analogy could be: (pre internet) student #1 happens to live next door to a library and student #2 lives 10 miles away so has to get a bus.

Student #1 got lucky and student #2 has to pay to get to a library.

I still don’t understand why you care so much about the choices made by others. The vast majority of people on WLIs have tried and failed to lose weight many, many times. It’s not an easy fix - much easier to remain obese. Is that what you’d prefer we do?

You can wag your finger and tell us to get a grip as often as you like, but it won’t change the fact that some of us (a large number of us) need a little more help than others.

Are you also against reasonable adjustments in the workplace and access arrangements in exams?

(edited for typo)

I suppose those on antidepressants are cheating as well, then. Silly people. They should just go for a walk and be grateful for what they have. Other people have it so much worse than them.

What about anorexics, if there was an injection that made them hungry? Would that be ok? Or should they just get a grip and eat more.

Or is it just the lazy, uneducated, gluttonous, fatties it applies to? I think we all know the answer to that one.

It’s been a while since we got the bingo card out, so here goes. Credit to @1clavdivs

What about
statins to lower cholesterol
insulin to lower blood sugar
anti-hypertensives to reduce blood pressure
antibiotics to treat bacterial infections
pain-killers, thyroid medication, anti-convulsants? Anti-depressants, ADHD medication and medications to manage anxiety?

I for one am extremely grateful to live in a modern society where medicines can help a wide range of conditions.

Also I've never needed anti depressants or really had depression, so we should make sure we talk about me and centre my experiences, however irrelevant, in any discussion about how to manage MH issues. Because ultimately, I'm what's important.

@Orangeandpurpletulips I guess you go into the mental health section of Mumsnet and tell them all to get out and have a walk and be grateful, even though you’ve never struggled with depression yourself, but you’ve had a couple of off days? So you do understand a bit and they should just be able to do what you do?

Blows my mind, honestly. But I don’t expect anything less.

Otherwise they're cheating me of my natural, unearned yet apparently totally deserved advantage.

Just try harder, dammit.

Oh mate. No. If you want to use the university metaphor, you are getting your degree as a person with average intelligence and no learning needs but nothing special so you have to work really hard to get your 2:1. We are the people with dyslexia or ADHD or a history of poor school attendance who need a level of special accommodation to achieve our 2:1s. We aren't cheating, we are doing it with the help that we need.

God only knows what the job interview represents in this weird analogy!

Actually, if I can cheat my genetics I will. My Grandma died prematurely from ovarian cancer and all of my female relatives have been overweight and obese.
I worked hard to avoid the inevitable and managed to bob around with a BMI of 24 - 26 most of my adult life. Then the menopause did a number on me and I ended up with a BMI of 28, pre-diabetes and raised cholesterol. All whilst exercising, avoiding most sugar and UPF and eating a ton of vegetables.

So yes, if I can “cheat” my way to better health, by taking an appropriate, prescribed and evidence based treatment, you bet I will.

Thread seems to have been derailed away from the original topic, but for anyone still interested Oushk latest post on Facebook discussing "changes" to maintenance -

Some things I’m considering will be:
-Anyone interested in maintenance will need to move to Oushk before a BMI of 25.5.
-At 25, the maintenance consultation will happen with a prescriber where you discuss a goal weight / long term plan / lifestyle etc.
-Every 3 months there will be a weight verification call to ensure patients are still within range
-Once at goal weight we will then give patients 4kg/8lb wiggle room either way to try and maintain within
-Ongoing support will always be there
-The maintenance plan will be lead by Oushk GP with pharmacists supporting the service.
-We are already introducing a nutrition programme so that will also be available
-Maintenance patients will have their own little assigned team (email / calls / prescriber and weight verification support team)
-Anyone wishing to maintain at a BMI above 25 can always book the call in for when they are ready

Don't think there is anything too controversial to disagree with there, some movement towards making sure maintenance patients are monitored more consistently/careful through maintenance by restricting access to the plans for new customers below 25.5 and assigned to a sub team of prescribers/support staff to be accountable for that monitoring. Many others I thought they were already doing, so they might just be reiterating them.

"All I’m saying is that there are many slim people who have comparable levels of hunger and food cravings but we’ve been able, to an extent, to manage these without medication. It’s not a morality thing, or an ‘I’m better than you’ thing, it’s just a fact"

But therein lies the difference. Slim people are able to manage these levels of hunger and cravings.
Obese people manage the levels for a while, manage to lose some weight, and then lose the ability to manage those levels.

So there is a difference.
And that difference is seen as a failing on the part of the obese people.

Edited to add - I see the thread has moved on. Ignore me!