So tempted but only got a few kg to lose - advice

[WindsChange]

Hi - looking for advice from those who have been through similar.
I’ve got a strong family history of diabetes type 2, stubborn belly fat (despite exercising 6 days a week and being very fit). I’m mixed ethnicity - all of which are risk factors.

However I’m only actually a few kg overweight (BMI 25.9).
I know there are ways around getting weight loss drugs (please don’t judge, I’m feeling desperate and wanting to protect my health).
I cannot do it alone - I have tried for years dieting and I eat pretty healthy generally although I’ve got severe ADHD and impulse eat at night.
Has anyone else tried with only a smaller than recommended amount to lose?
How did it go?

Certain ethnicities, including mixed ethnicity counts generally counts for a reduced BMI threshold due to ethnic risk factors. A reduction of 2.5 points is stated by Medexpress, for instance. With comorbidities, apparently BMI 25 can be considered, as shown on Monj.

There is another thread on maintenance after people have met their goal weight with people clearly stating their BMIs being under 25 and continuing to be prescribed for jabs.
If it's a health risk to take if you are not in an obese category, why is it not a health risk to take for those people that are maintaining on it.
It's hard to get my tone right in a message but I'm genuinely trying to understand the difference.
Clearly a health risk if someone is lying to get the drug or from other means. So that's not my question.
What I'm asking about is what is the risk of weight loss injections to the health for someone that always had a BMI of 24 and wants to be 22.5, vs someone with a BMI of 22.5 that used to be a BMI of 40.
Just seems to be a common response here when someone asks about it that they're risking their health. Or are those comments relating to getting them from a random down a back alley?

It would be great if there was a clause meaning the GP had to weigh people on them throughout to prove they were a healthy weight now and prescribe some piece of paper to confirm that to these companies. But the NHS is under too much strain already

@SparrowFeet one part of it is that there’s no way to legitimately access an obesity prescription only medication if you don’t qualify, other than taking the risk of sourcing something from illegal sellers, or lying concertedly to a prescriber.

The other part is that the MHRA prescribing guidelines are for a starting BMI in the obese range (or 27 plus with a weight related health condition, or a qualifying ethnicity). So the risks are outweighed by the health benefits of moving out of the obese category to a healthy weight and then staying there. There are no health benefits when you are already in the healthy weight range and want to get to a lower weight for non health reasons. No one will prescribe a prescription only medication if there are no health benefits at all.

Furthermore, when someone has been obese, particularly if they have been morbidly obese or obese for a long time, and then have spent a long time in a calorie deficit to lose weight, their body will react differently to being a healthy weight to someone who always has been a healthy weight. Obesity disrupts the healthy responses of your body to food, and we all know that people have a very high tendency to yo-yo back up to previous weights and often higher still. So there is a clear benefit to keeping a formerly obese person on medication to stay a healthy weight, rather than rebounding, that just doesn’t apply to someone who has always been a healthy weight or only slightly overweight.

It’s a piss take OP. You could be one of the many people with a BMI of 29 saying “ but why should people with a BMI of 30 get it but not me”. You are not obese… you are barely overweight at all. You don’t need a drug to help you lose weight you just want it. ( and the continued abuse of these drugs by people who don’t need it contributes to the relentless news articles all about how we’re all cheating etc etc etc.) It’s painful.

If you'd like to take a look at the board there are dozens of threads where people have asked this and had it answered, but to do so again:

A person who formerly had a BMI of 40 has a medical history of Class III, sometimes called 'morbid', obesity. That medical history does not change once their BMI is at 22.5 after treatment with a GLP1. They may need that medication for the long term to manage their chronic health condition. In the same way, a person who is given statins to manage high cholesterol does not have those drugs removed from them once their LDL cholesterol levels are in the normal range. The person with a BMI of 24 who wishes to have a BMI of 22.5 has no history of being overweight, let alone of obesity.

Take a look at The Glucose Goddess and try out her lifestyle suggestions.

I think this is really unfair. The OP has stated reasons - mixed ethnicity, belly fat and family history of diabetes - why she believes she is at risk. Maybe her reasons for wanting to access WLI are cosmetic but maybe she is genuinely concerned about her health. Depending on her ethnicity she may have a significant amount of weight to lose before she is considered at a healthy BMI. Considering so many people on this forum are on WLIs because they have suffered for years with weight related health problems and the misery that comes with being unable to lose and keep off weight I wish we could all show a little more compassion instead of the aggressive gate keeping that is so common.

whatever her motivations she asked a question - I don’t see why you felt the need to respond so unkindly.

they only have a BMI of 25 so won’t get it even if they have a history of WL, different ethnicity or weight related health issues. She’s too light.

I agree with this!
I have a BMI of 29.5. This is in the overweight range and the medical advice is I should lose weight for health reasons.
I am not obese, but I have always been overweight.
I am 50. have not been thin since I was 12.
I have tried every diet. I have never successfully lost weight. I have spent all of my adult life either on a diet or not dieting and hating myself for being overweight.
Anyone on WLIs must surely understand how it feels from experience to be told "You should just eat a calorie deficit and go to the gym to lose weight".
If that worked, they wouldn't have to be on WLIs.
But suddenly some obese people who are on WLIs feel free to say to people like OP, "You should just eat a calorie deficit and exercise more".
That has not ever worked for the OP, hence their question.
That has never worked for me. Believe me I have tried, just as you did before you started WLIs.
I get that the benefits outweigh the risks for obese people.
But are the risks actually greater for overweight but not obese people?

There’s less evidence on how safe these drugs are when used by people who are only mildly overweight. There hasn’t been enough studies yet. The genuine chemists won’t prescribe them for most people who have a BMI of under 30 and certainly not OP who only has a BMI of 25. so it’s them you can take it up with.

The criticism of my post is fair enough. I apologise OP for my tone which wasn’t very nice. As you add doubtless aware now you don’t meet the criteria for a legitimate prescription and I think it would be dangerous to try it through illegitimate routes ( although god knows there seems to be plenty around). Good luck finding a solution that works for you.

I have taken Mounjaro with a starting BMI of 25. It’s been amazing and I have lost 11lb in 4 weeks. I am hoping to shift another 7-10lb. I will do no more than 12 weeks.
I was very similar to you in profile - my weight hadn’t gone back to pre pregnancy after my second child at 41. I am generally healthy, active, exercise and eat healthy meals. I just ended up reaching for snacks and feeling constantly tired and hungry, and craving sugar.

My belly fat has almost gone. Very limited side effects and lots of positive things like being able to break my sugar habit, better gut health, no desire to drink either. It essentially enables me to follow a healthy, calorie controlled diet without feeling starving and thinking about food the whole time. Totally worth it.

Where are you getting it from with a BMI of that weight?

The OP doesn’t have comorbidities though, I don’t think a family history of type 2 or having stubborn belly fat would count.

I didn't say she qualifies, so not sure why you are quoting me.

If she is an average height, she is currently only about 5kg / 10lb away from legitimately qualifying with certain mixed ethnicities. Maybe 2 or 3 weeks off her current diet would see her BMI rise enough to qualify.

Comorbidities are not also required by many providers due to NHS approved BMI adjustment for the ethnicity risk of comorbidities. Medexpress and others state this as a reduction of 2.5 BMI points.

Sorry, I assumed your post was meant to be relevant to the OP so just pointing out it isn’t 👍

(You might as well point out that with a BMI of over 40 and four out of five specific conditions she could get it on the NHS, that’s also a random MJ fact that’s neither here nor there for the OP’s situation.)

Have you tried the nhs bmi calculator ? It measures BMI according to your ethnicity.

there are people on lower BMI being prescribed if there is underlying health issues such as high cholesterol and diabetes but very few providers do.

if you only have a few lb/kg to loose I wouldn’t personally recomend the jab route as you tend to loose multiple lb/kg even on lower doses

have you tried a low carb high protein diet?

I am doing a seven week shred with a coach from instagram.
like you I was struggling with belly
fat and only wanted to lose a few kg, I thought it was impossible as thought I was doing all the right things already.
anyway have stuck to the plan and lost 5kg.
Have only had to slightly try my calorie intake and up my protein and walk every day.
i feel so much better.
i used Rob Swaine. Would recommend.

It is relevant as the majority of posters are not taking her ethnicity into account and saying she is "barely overweight" and nowhere near eligibility, when in fact she might be 10lb away from being considered obese and qualifying with a number of online pharmacies.

The ethnicity risk of comorbidities is very relevant and some doctors would prescribe, even at her BMI, due to this. However, they are likely to want to see her in person and be more expensive than the online pharmacies most of us use.

But NHS approved lowered BMI threshold due to risk of comorbidities is apparently irrelevant to the OP with a mixed ethnicity . Understood 👍

I also only had a few kg to lose. I went with SheMed. I have PCOS (albeit no current symptoms) and borderline high cholesterol, which showed up in their blood tests. Doing it as have run out of willpower to continue dieting, and type 2 diabetes in family.

The weight verification was during the day so already I knew I would be 1kg more than morning weight. Also, I ate a very large carbohydrate meal the night before, and I was over the amount (just) at the weight in. If need be you could put some weights in the back of your trousers eg 2 1kg dumbbells.

either way I know I am doing this responsibility.
i will ensure I eat enough protein and calories. I just need some headspace to not have to focus on not eating treats.

re; the comments about “harming health” from all the people who will continue to take it when their BMI drops below 27 (or 25, or 23 etc)

The reality is lots of people who are just under the BMI threshold are shaving an inch off their height or adding weights on. These are people who are overweight but not obese.

7 of my friends are ‘on the pen’.
Of those only one had a BMI of 30.
One had a BMI of 27 but high cholesterol.
The others adjusted their weight/height online (all are overweight).
All are using private providers (mostly Lloyds pharmacy etc).
All are staying on a 5mg dose, eating more healthily and exercising regularly. All are drinking less alcohol.
All are approaching or over 50.
None have had significant side effects. All are steadily losing weight.

Im not on injections (and not overweight) but I would never say to my friends they should just eat less etc. I’m pleased that they will hopefully be at lower risk of heart disease etc and I will have them around longer.

Some people can lose on a lower dose. Not everyone has awful side effects.

My bro in law has been prescribed them for years by NHS for diabetes and obesity. It’s changed his life. He is healthy, exercises and is likely to live a longer, healthier life. He has had no significant or long term side effects.

I've done similar - i think I might have been pushing 27 bmi. Best thing ive done in a long time, and so worth it. I feel like myself again.

Gosh it shows why they're starting to tighten up with regulations doesn't it.

The bigger issue is those taking it long term when their BMI goes below 20/21. Likely to lead to long term problems like osteoporosis and sarcopenia.