Has anyone started WL injections with a ‘normal’ BMI?

[Kettlewithyourmetal]

Just that really

my BMI has always been around 22-24 but it’s been a lifelong battle of eating vigilance and massive efforts of daily exercise.

Since my 50s it’s just such a huge effort to fight to slow drift into weight gain and I’m not winning.

Im exhausted by it and honestly would love to shut out the food noise and just be able to eat small portions with satiety and not constant mental restriction.

I don’t think this would meet the current prescribing guidelines but I feel like I would hugely benefit mentally. I would love to see if a few months of shutting out the relentless appetite and 24:7 battle against the drive to eat would reset me a bit.

I could easily lose a stone and not look underweight or suffer from it so if that happened too it wouldn’t matter iyswim.

Has anyone started WLI for this reason and how did you access it/ how did you get on?

I used to work in pharma industry, including company that now makes one of main weight loss drugs.

do not take it if not over bmi. anyone who prescribes it to you in those circumstances is breaking the law. And you are playing a dangerous game with your health to get it prescribed by falsifying your weight.

ALL drugs have side effects. Adverse reactions as they’re called. All drugs are about weighing up risks of that and benefits. To get any drug approved in any country, the drug companies need to submit data from clinical trials to evidence that in certain circumstances the benefits outweigh the risks.

beleive me, if drug companies could have provided data to show these drugs were effective in weight maintenance they would have done. There is no evidence yet to show this. Currently the risks are therefore deemed too high to make this an indication that could b registered for approval .

not enough is explained about the risks of these drugs. Especially if you’re not taking it through a face to face contact with Gp, and just online.

these drugs, whilst older in mechanism re treatment of diabetes, and still very new for weight loss indications. During the next few years, adverse reactions in a wider population are being gathered through the “yellow card” system. We simply don’t have long term data yet on what these drugs are like for long term maintenance. The drugs are indicated only for actual weight loss phase…even though the drug companies already knew, when registering them, that once you stop taking them 20% or more people put all with back on. In that sense it is no different than weight loss surgery, but less riisky (re anaesthetic, risk of infection and invasive). And more cost effective. Hence why they were approved.

you’d not ask for a gastric band to help maintain your weight due to mental hurdles with your weight. So don’t think you can do it with these drugs.

Is this not what micro dosing is for? There are reputable clinics that offer this

@Kettlewithyourmetal , GPL1 medications target blood sugar, they were initially developed for type 2 Diabetes. You can try strategies for blood sugar control, take a look at The Glucose Goddess and you could also consider taking Berberine.
I agree with you by the way, obesity costs the NHS a fortune and has knock on implications to our benefits bill. One day these medications will be widely available and cheap and when that happens I hope they can be prescribed for anyone who wants and would benefit from them.

No it isn't, and they certainly aren't reputable if they are prescribing to anyone with a healthy BMI.

But is there an argument that if those who met criteria initially are then able to continue on them once at a healthy BMI for maintenance, couldn’t those of us who are really really struggling with maintenance via other means not be allowed them to help us?

One of the reasons they are not used with a healthy BMI is that the resulting weight loss in that group is almost entirely muscle mass, not fat loss. This differs from the higher BMI groups.

Muscle mass loss is not good, desirable or safe.

Irrelevant in the current legal position around the prescribing of the medication.

Nice to have I'm sure but let be clear - people like me who started with a BMI in excess of 44, at over 21 stone are using these medicines to work on complex issues.

I've lost close to 6 stone in 9 months through an enormous change in diet, exercise and lifestyle. My chronic migraine is remarkably under control, I'm sleeping better, my sleep apnoea vanished in the first week (so not down to weightloss at that point!).

If all I had to lose was a stone, there would be no need for prescription medication to assist me

Ultimately I still have to put in the work of counting calories, controlling my diet, exercise, lifestyle etc just like anyone else looking to lose weight.

I’m 55, 4’ 11” and in the same boat with wishing I could curb my eating with a bit less effort, my weight and my BMI (which is a bit higher than yours, going up, but still just in the normal range). I’d like to lose a stone at this point to improve my chances of weight not becoming a problem going forward.

I won’t say the WLI didn’t cross my mind for a minute when I first saw ‘everyone’ using them seemingly without any problems at all but that’s all it was, a minute.

The injections are a not-to-be-taken-lightly medical treatment for obesity and its consequences. I am grateful to have no such conditions and would rightly never be legally prescribed a GLP-1 however much I wanted it, and neither will you.

I think it would be unwise to lie about your BMI to get a prescription as I gather the risks of pancreatitis and other serious side effects are increased if you start them at a ‘normal’ weight. The pharmacies seem to be better at checking your stats before prescribing now though so that would be harder to do.

This comes up over and over and over again, so once more, with feeling:

A person who formerly had a BMI over 30 has a medical history of obesity. That medical history does not change once their BMI is at 22 after treatment with a GLP1. They may need that medication in 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.

I have previously had a BMI higher than it is now and potentially at the treatable threshold given strong FH diabetes.

a person who had a BMI of 30 and has continued on WLI to maintain at 22 seems to be no less worthy than someone with a BMI of 25 who has had a lifetime of weight watchers, macros, daily cardio sessions, hypnotherapy etc etc.

It’s not about “worthiness” it’s about the damage that obesity will have caused to that persons health.

I know a few people who have obtained it online by taking a few inches off their height in order to increase their BMI.

Theyve lost a lot of weight as they are simply eating much, much less.

there are also others who I am convinced are using it but haven’t admitted it.

im thinking of doing it myself. I’m 5’7 and 12 stone 4. Think I’m in perimenopause and just don’t think I’m ever going to shift the weight naturally.

It's not about being worthy. The WHO classifies obesity as a complex and chronic disease. You can understand that people have to take medication for diseases and continue to take that medication after the symptoms are resolved in order to stay that way. So, someone takes blood pressure medication or antidepressants after their blood pressure/mood has stabilised so that they can stay well.

At the moment, these medications treat the disease of obesity. If you don't have that disease, there isn't a safe option for you to take them. I'm sure that pharmaceutical companies are testing and researching and doing everything they can to bring them to market for people in your position because it will be an absolute goldmine. Right now though, there isn't a safe way to do that.

Sorry, editing to add that the person with the BMI of 30 in your example also has a lifetime history of Weightwatchers, dieting, fasting, low-carb, cabbage soup, VLCDs, hypnotherapy etc - but those measures didn't work in preventing obesity for them.

The drug is licenced for maintenance for people who were previously obese because there are robust randomised control trials that show maintenance prescribing is safe and effective (the Surmount studies). The drug isn't licenced for prescribing for people with a starting BMI below 30/27 because there haven't been the research trials to show that this is safe and effective. Drugs are licenced on the basis of their evidence base.

My friend got it with a BMI of 26 by layering up and saying she was short. She’s lost a stone and is microdosing. Sheens a lot happier without food noise and is just back in her old clothes. Sometimes the internal battle is hard even if people don’t look fat. So many of us have disordered thinking around food that this is what the WLIs relieve us of.

BMI for me isn’t an accurate tool for judging how overweight I am, so I was wondering this too. I am almost 3 stone heavier than I was all through my teens, twenties and thirties. I put on weight in my forties after having babies and my thyroid going awry. My BMI is just under 25, but if you saw me in my underwear you would see I am carrying far too much weight. It’s just that my frame is very slender for my height. I am currently trying to just eat very, very carefully through the week and not worry so much on weekends, this weeks the only way I can sustain a slow weight loss as if I try and stick to a diet I just give up.
I did wonder whether mounjaro might help and in terms of actual fatness I have seen people who are around the same level of overweight go on it, as their BMI must come out as higher than mine.

I did all of those things and still ended up at a BMI over 30 - please don’t fall for the propaganda that it’s lazy people who lack willpower who end up obese. WLIs are an absolute last resort for me, I’ve tried everything bar starving myself.
WLIs have proved to me beyond doubt that something was biologically ‘broken’ because for the first time in my life I feel full after a normal portion of food and am able to stick to a high protein, high fibre, low(ish) carb diet of 1200-1300 calories per day. I still get hungry, I still get an amount of food noise but I can now satisfy that hunger with a normal portion of food and remain full for a normal amount of time, rather than fighting a constant internal battle not to eat every 2 hours. Obesity is a really complex problem and effort has very little to do with it.

I hear you op.Early 50s bmi 25 but hs e to fight for that lots of exercise and food restriction. Would love an easy way to lost that last stone. I know I am being unreasonable. 5 years ago I just needed to IF and it fell off mid peri menopause it’s much harder.

I started on MJ with a BMI of 27.7 (I think - can't quite remember but it was 27 something). I'm prescribed it on the NHS as I have Diabetes T2 which wasn't responding to my other meds.

It has worked brilliantly for me in terms of stabilizing my blood sugar BUT it has come again a cost. I had some very bad side effects when I first started - I shat myself in a work meeting 3 days after my first dose, thank god it was a virtual meeting. My stomach still reacts to the jabs albeit not as dramatically, and I have mild diarrhoea on Day 3 every week. I have to carefully plan around that.

I rarely feel hungry, which you'd think might be a good thing, but I have to force myself to eat in order to get enough nutrients and I then feel nauseous and can't sleep properly. I'm constantly cold as I'm now slim, with a BMI of 21. I really don't see how I'm going to get through winter, especially as I'm an open water swimmer. I'm seriously considering buying a wetsuit as I don't think I'll be able to swim otherwise.

For me, the side effects are worth it because my blood sugar is under control but if I didn't have diabetes then I'd never have gone down this road. I was slightly overweight but would much rather have lost without resorting to medication.

And as others have said, anyone who would prescribe to you would be dodgy. Don't risk it.

I don't think people really appreciate the risks involved with any prescription medication. There are risks and they need to be balanced. Don't take the risk unless you really appreciate that risk and are prepared for the potential risks to materialise.

If you work out at the gym you won’t lose muscle mass. It is when people just diet and rapidly lose weight without actively building muscle that you have that problem

Does micro dosing mean you take a smaller dose than you needed to lose weight but enough to kerb the food noise making it easier to make good choices?

I disagree. There is nothing to suggest the OP has any difference in her GPL-1 production that someone with a BMI of 30.

the fact that one person is super restrictive with enormous effort, goes to the gym 5x a week, goes on a series of diets all their lives, engages in all sorts of extreme behaviours to stop putting on weight and suffers with mental health fatigue from the effort required doesn’t mean they are somehow better able to maintain their weight than the person with a bmi of 30 who does little to reduce it and eligible for WLI

not all obese people have ‘tried everything’.

it seems crazy to me that someone who started at bmi 30 can get to a bmi 20 on WLI and is able to continue to maintain it with support of the medication whilst someone who has frankly had to go through unhealthy and intolerable behaviours all their adult life to maintain a low weight gets told that if they are living such a ridiculously extreme life they have a mental health condition and shouldn’t be able to take the med.

I’ve the same BMI and through nefarious methods I took one dose of 0.25

it helped me cut my hunger and lose 2.5kg in 2 weeks, which then allowed me to get back into better habits

TBH it was just the same as going keto, which I’ve done for 8 years on and off, but been in an off phase and going forward I’ll just stick to that

And licensing is not the be all and end all.

Many, many drugs are used off licence for other indications but with a historical or theoretical basis. Most doctors will prescribe off licence plenty of the time- they might not even know it because it’s been done for so long it’s become standard practice. It’s often not worth the drugs company time to go back and reapply for licence change. Especially once drugs are off patent.

those suggesting prescribing within licence is the only safe or effective method of using drugs are wrong.

Not to say that automatically opens up the arguments for WLD to be used for those at normal BMI but just that ‘licensing’ gets used on here like it’s totally black and white.