Misinformation?

[Beeswacks]

I’ve been on mounjaro for 8 months now, privately. My GP knows and is very supportive and talks very encouragingly about it, wishes more of her patients were able to take it.

My neighbour is a gp, nearing retirement age but still working full time. He found out during a discussion about my weight loss that I’m on MJ and started ranting about it, saying 1 in 5 of his WLI patients are having severe side effects and that I should be moving more and eating less, that’s the only way to lose weight.

I did a load of research online before taking them, spoke to lots of people IRL and online. I haven’t had any side effects beyond some constipation, and I feel healthier than I have in decades. It really feels like MJ is fixing something that’s been wrong since childhood, and other chronic issues have cleared up.

As well as being highly unprofessional, he’s just wrong isn’t he? I feel he’s projecting his disapproval onto me and possibly his patients. The only places I’ve seen these sort of statistics are on weird anti vaxx, anti medical treatment websites (my research was thorough), most of which is unsubstantiated nonsense by people who don’t understand risk and statistics.

I do understand there are risks involved, but being morbidly obese put me at higher risk. I’ve discussed this with my own GP who agrees and said that her experience with patients is overwhelmingly positive.

Why do people come out with rubbish about it? I know some people are so ingrained in the view that fat = lazy and stupid, but why spout rubbish about statistics that are easily proven wrong?

As someone who’s worked in the nhs for 20 years I can say that most Doctors still have their own opinions and bias on many things, they may not show it at work but they are human and will still have private views that are just as judgmental as the rest of us, your GP neighbour just shared his with you op.

Yes this is spot on, as someone who’s lost 6 stones on MJ without doing any form of strength training I was all soft and felt weak as a kitten, I started the gym 3 months ago working on strength training exercises and equipment and can see a marked improvement already. Wish I’d done it earlier in my weight loss journey.

Has anyone else noticed this tendency some people have to blame the drugs for everything.

as if they feel when they inject they are super human, and normal illnesses cannot occur, anything which does, has to be the drug which did it, and they are protected from all impacts of dieting on the body as well.

I see it very often, someone has a sore bit, they get a bug, whatever and think oh it must be the drug, um, you’re not super human on them, you still get all the normal stuff.

I wouldn’t be the slightest bit interested in a GP’s opinion of WLI, they’re just a GP, not a specialist, most GPs are woefully inexperienced in nutrition and related diet issues.

I didn’t, but he asked how I’d lost so much weight (he’s known me for 20+ years and has seen that for most of that I’ve been morbidly obese). I don’t mind being open about how miraculous I’m finding MJ, and I don’t care that people have opinions that I don’t share, in this case though I felt weird about his stance as a gp, and felt he wasn’t being truthful!

I work in a pharmacy and we have many people taking WLI. For some it works wonders, for others not. I personally would not go down that route but to each their own and I don’t think anyone requires my 2 cents on why I personally wouldn’t do it. Just because someone is a GP it does not mean they are right in every scenario. I do think he’s entitled to his opinion but there was no need to drill on at you like he did.
Next time he starts simply say “let’s agree to disagree on this point, I have made my decision so let’s speak of this no more” and then change the subject or walk off. You do you and good luck with your weight loss journey. :)

If he’s saying 1 in 5 of his patients on GLPs are having severe side effects, why would he make that up? Having said that, I think many GPs are woefully misinformed and I include my own in this.

Interestingly, my friend has a friend who is a surgeon. He had a bit of a rant recently about the fact he is operating on so many people who have pancreas and gallbladder issues caused by GLPs.

Most people taking GLP1s won’t need to see their gp about it, so maybe he’s seeing those who have gone because of their side effects?

I’m not convinced gallbladder and pancreas issues are solely due to GLP1 use, because both of those things are caused by weight loss - something which many more people are able to do because they’re taking GLP1s.

I read something recently that said that pancreatitis was an issue in early GLP1 research so it had to be added to the side effects list, but newer GLP1s aren’t showing any real increase in these problems beyond normal population levels, but I suppose that’s going to take time to confirm.

If you look at the SURMOUNT clinical trial which was the study which gained Mounjaro its licence in obesity, the rates of pancreatitis in the placebo and each of the 3 active drug groups were the same.

There were approx 630 patients in each of the 4 treatment arms (placebo, 5mg, 10mg and 15mg) and 1 in each group got it.

Gallbladder rates were also similar in each arm (though 10mg was a bit of an outlier).

You’ll also see COVID listed as a side effect because EVERYTHING that the patient reports has to be listed as a potential side effect, whether it actually causes it or not.

Next time he starts yapping on about it, ask him what he thought of the SURMOUNT trial! Evidence based medicine and all that.

https://www.nejm.org/doi/full/10.1056/NEJMoa2206038

Here is a link.

Telling an obese person they should be eating less and moving more as that's the only way to lose weight most certainly is misinformation. There's no wiggle room on that one.

WLIs clearly do help the majority of obese people who take them to lose weight, more of it than through diet and exercise. And those obese people who do lose weight through traditional methods are more likely to put it back on. If he disagrees with this, he is wrong. This is simply not an area where his lived experience outweighs the wider societal evidence we have.

It may well be the case that he's correct about 1 in 5 of his patients who are on it having severe side effects, notwithstanding he doesn't necessarily know about all of them, we don't know whether he's accurately counting. But yes, that might not be misinformation. So if he'd stuck to saying that only, he'd be arguably fine. He didn't.

I agree that it is not his place to comment on your weight loss and his experience with it. But let’s not forget that the use of this drug has exploded over the last few years and the company manufacturing it is making billions of pounds as a result.

In your neighbours working lifetime, which includes the earlier years when drug regulation was not as strict and drugs reps would sell their souls to get you prescribing their products, he has probably seen a great many “ miracle “ drugs come and go and had had to deal with the consequences of prescribing a new drug that has caused harm.

The internet is full of promotional material for these drugs. They basically sell themselves, and for the right patients the risk v benefit is obvious. But there is a real cost to the NHS from the side effect of rapid weight loss.In the same way that health travel is putting an undue burden on the NHS, WLI are causing an increase in acute pancreatitis and gall bladder issues. Slow steady weight loss is healthier but obviously difficult for many because we now live in a society who want instant results. In addition slow weight loss results in a higher failure rate because people give up when they don’t see results within a week or two.

Older GPs have experience, they have seen long term effects of drugs and are probably more cautious. They also understand the funding system. Yes, they want to reduce overall risk of some of the common conditions that obesity predisposes to, but at the same this may redirect funds from treating others who need funding now. Every emergency admission for pancreatitis or gall stones reduces the beds available for patients who have been waiting for surgery.

Fundamentally, weight is down to overeating. Even if you factor the many conditions that predispose to weight gain it’s all about eating. For the last 20yrs the medical profession have been banging their heads against the wall attempting to educate and warn people that overeating, particularly UPFs is bad for you. The response is usually complete denial and excuses, even more so now we have Google that validates any obscure argument.

Now we have a quick fix but we have no long term data of how it affects non diabetic patients. This is heavily glossed over by the evangelists and drug company. Hopefully there is nothing to worry about. I would love to use it but since having had a serious drug reaction that cause liver failure and already having gall stones I’m very reluctant to risk complications.

This is wrong and misinformed on so so many levels,

you genuonlh believe of the 40 years data on these drugs they don’t know how it works or impacts the human body and can’t extrapolate anything. Seriously you beleive this?

and what’s with the rapid weight loss, most folks lose 1-2 lbs a week.

i won’t go on, but your post simply tells me you’ve issues with the drugs or are ill informed. Take some time to understand before posting nonsense

Fundamentally, weight is down to overeating. Even if you factor the many conditions that predispose to weight gain it’s all about eating. For the last 20yrs the medical profession have been banging their heads against the wall attempting to educate and warn people that overeating, particularly UPFs is bad for you. The response is usually complete denial and excuses, even more so now we have Google that validates any obscure argument.

Denial and making excuses are exactly what the sort of person who continues to insist that eat less, move more amounts to useful advice is doing.

The problem is that we know telling people they should eat less and move more doesn't work. It has failed, hard, on a societal scale. Humans evolved for a world where overeating when you get the chance was actually a useful thing to do. Starvation has been an ever present threat for all our ancestors until about 5 minutes ago in the grand scheme of things. Anyone who thinks telling people not to do what thousands of generations predisposed us to do will actually achieve anything is in need of education.

I do have some sympathy for GPs who had to advise people on obesity before WLIs, and who have to do it now for those who can't access them. Because it's not their fault all they could do was give advice that had been shown not to work for the majority. They can, however, not say things that are demonstrably false to people who aren't their patients and who do have access to something that works better than advice humans don't manage to follow.

The drug was developed to treat diabetes. It has been used to treat diabetes until very recently and only introduced to the market as a weight loss drugs because one of the observed side effects was weight loss. There are a lot of drugs on the market whose side effects include weight loss but it would be wholly unethical to prescribe them for weight loss.

The guidelines for WLI are crystal clear and to meet the criteria you need to be very overweight or obese. Which fits the risk assessment that you are more at risk from your weight than from the drug. These guidelines are not randomly arrived at.

Most importantly each generation of these drugs has become more efficacious than the previous because they have been modified to amplify the effect for diabetics. So although the drug group as a whole have been around for 40 yrs the current generation are very different, and come with the potential to cause their own set of side effects.

As an example there are a number of aromatase inhibitors used in breast cancer adjunctive therapy. They all do the same thing but the side effects are very patient specific. Where one woman will have very few side effects with Anastrazole another woman will be crippled with joint pain while taking it but will be far more comfortable taking letrozole.

Also 40yrs is a bit of an exaggeration when the first GLP-1 agonist was licenced for use in 2005 so we only have 20yrs of data and the majority of that data is from studies on diabetics who take dose appropriate levels. The dose is increased until the diabetes is stabilised. If a dose of 2.5 stabilises blood sugar then that’s the dose they use. This is one of the reason weight loss in type2 diabetics is often not as dramatic.

What we don’t have is long term studies on patients who have a normally functioning pancreas. When you mess with normally functioning endocrine feedback mechanisms there may well be an as yet unknown long term side effect.

GLP-1 use as weight loss drugs have exploded in use and although a fantastic solution they are subject to potential abuse. Having had a serious side effect while taking a “miracle “ drug has made me cautious. After being involved in a clinical trial 35yrs ago and taking the drug for all those years, it was a bit of a shock to be recalled after 25yrs and informed that it could have damaged a heart valve. I now have regular monitory to look for possible damage.

Why d9 people post this stuff. At least google. You don’t need to be very overweight or obese, it’s 27 bmi with some minor health conditions and some pharmacies are now prescribing at 25.

Why isn't your GP providing it if you were morbidly obese?

I don't think you can say the other GP doesn't know what he is talking about, perhaps your GP is watching for side effects and sees you don't have any so isn't worried, your neighbour doesn't have access to your medical records, has seen problems in their patients and is concerned, neither is wrong. I think it is risky taking these drugs without medical supervision even if you have 'researched online'.

It’s utter nonsense that these drugs are putting a burden on the NHS.

Actually, overweight people are paying thousands of pounds each to get their weight under control. This will hugely reduce the cost of obesity-linked health problems to the NHS and society at large.

For the first time ever, people are losing weight in large quantities and large numbers and in a healthy way under medical supervision. Which is what was supposedly wanted, but seems to rile a lot of those who supposedly wanted it.

Because the nhs basically prescribes it to very few people due to cost.

You do know that a BMI of 27 puts you in the very overweight group and anything over 30 is classified as obese. Depending on your height, I’m 5’7” to reduce your BMI from 30 down to 24 ( upper end of healthy) would require a loss of 5 stone. I’m actually aiming for 25 and have another stone or so to lose.
I’d love to be able to use GLP-1 but past medical history means that they are not advised. I have no issue with people using them but my main fear are long term affects. There may be none but we don’t know that yet.

No, the NHS doesn’t prescribe these drugs for obesity.

They are prescribed privately - under medical supervision. But availability on the NHS is being rolled out very slowly.

Hopefully this will be addressed by the introduction of a tablet form which will be infinitely cheaper to produce.

I’m diabetic, so 20 years research applies to me, does that make it ok?

I was morbidly obese with lots of other risk factors, my gp discussed it with me but in my area there are hoops to jump through and at least 18 months waiting to jump through said hoops.

Unless you go down the illegal black market route you buy these drugs with medical supervision, and the gp is sent a letter going through all the details so it can be added to your notes.

Have you been injecting GLP-q1 meds for the last 20yrs. If you haven’t why haven’t you. This is where all the arguments being a long standing drug fail because the early agonists where just not as effective as the current injectable ones. Semaglutide ( Ozempic) was released in 2017. So again not the 40 yrs of use people claim. Other drugs in the family were tablet form and not as effective. Tirzetipine (Mounjaro) the latest and exhibiting another level of therauputic action is a very new drug in comparison. Just because Exenatide, released in 2005, causes no problems does not guarantee any other drugs in the family won’t. If they were the same there would be no point in their development.

Patients could see a small weight loss but not on a scale seen with Why have you not been offered GLP-1 drugs? Genuine question and somewhat surprised you haven’t. I have a lot of diabetic patients (t2) who have started using them. My friends husband was recently prescribed them much to my friends annoyance.
Is your diabetes under control since starting WLI. If it is I would ask your GP to consider prescribing it.