MoreLife ‘Weight Management’- waste of NHS Funds?

[JediKnightingale]

About a year ago I rang my GP surgery to ask if I could be assessed for my eligibility for one of the weight loss injections. I was told there was a wait list of over a year but they would add me to the list.

In November last year I got a call from someone at MoreLife saying they had gotten my referral from the GP and wanted to set up an appointment. I assumed this was an initial screening program for the weight loss injection.

Filled out a health questionnaire, asked about the injections and arranged a ‘convenient’ time for my weekly weight management zoom meeting.

The weekly zoom meeting turned out to be a 12 week 1.5 hour ‘course’. On asking about the injections on the first session we were all told ‘No weight loss injections are currently available on the NHS so stop asking about it’

Basically this ‘MoreLife’ lot must be squeezing the NHS for pots of cash taking 20 people per session (at 1.5 hours a time) telling us gems like - eat less, move more, chew longer, lots of red traffic lights on food is bad, eat more veg. But padded out with words like ‘mindfulness’ and ‘portion control’.

Homework tasks like food diaries and calorie counting FFS! We are a group of obese people who have all tried every diet under the sun and are desperate for help - which is why we all signed up for the injections. Being told to eat one less spud and go for a walk by a jolly 22 year old size zero gym bunny is insulting and not helpful.

It infuriates me that the NHS is pissing money on these weight management schemes. They had me on Second Nature a few years ago and that came with digital scales, a Fitbit thing and recipe books - all of which I already had. Weight lost: zero. What a huge waste!

Anyone else agree the NHS needs to speak to obese people and find out what we REALLY NEED? Surely -money spent on a proven medication is a much better use of resources?

I realise that some people my find these weight management things helpful - but our group is 90% weary, perpetually overweight, miserable and are only continuing because MoreLife say if we don’t complete the course IF the injections become available we won’t be approved unless we’ve finished their stupid, infantile course.

Playing devil’s advocate here, is it realistic for the NHS to pay for all those who fit the criteria and would like to try it ? And are the courses just about education or are they in part about peer support ? Personally I do much better with a friend to support me and who is in the same situation, is part of the aim of the groups to encourage peer support and had that been shown to increase the chance of people losing weight? I don’t know the answer to the question and am guessing.

I’m saying that as someone whose rheumatologist has written to my GP to suggest I am a candidate for Wegovy. I think GP seems to have ignored it and referrals to tier 3 are closed for a year currently. I wouldn’t take it if offered as I don’t think my pancreas is very happy after one of my rheumatology meds and I have read that Wegovy potentially isn’t sensible in those situations.

Whilst I see what you are saying OP I don’t think it is realistic for the NHS to pay for all those eligible in its current situation. I’d like to see these sorts of courses cover some of the newer research on how to reduce systemic inflammation and gut biome and see if any of that helps people to lose and maintain long term.

I've been part of a publicly funded weightloss program in my country. So far I have lost over 50kilos. This has included group food discussions, emotional coaching, VLCD, surgery and injections.
The more weight I loss the more I realise how many lies I was telling myself about my food an nutrition intake. I would say I had a healthy diet but in reality I had terrible relationship with food. The delays or programs to get to surgery and then medication has given me time to examine and change my relationship with food.
Could you use this program to help you work in your relationship with food and movement.

I agree with OP, and find it interesting that many posters offer the easiest comeback that it's her negative attitude that is the root cause problem.

I know this is an uncomfortable take but often it’s the negative mindset that is holding you back from making progress when it comes to obesity. It is a mountain to climb and one of the first steps to progress is acceptance, coming out of denial and looking at all your options. OP does have an option to pay for it herself but is not doing that either. Blaming everyone else

I too completely agree with OP.

Some of these comments have been down right rude. ‘Let me do the maths for you’ - uhm, stating the cost of an injection doesn’t compare to the cost of obesity in general on the NHS. While the classes might work for some, for many of us it’s been years of dieting, paying for courses and there can be medical - physical and/or mental - reasons why these methods just don’t work. The shaming “Why don’t you just try to eat less” narrative doesn’t help the majority, those with disordered eating habits and frankly, does me more damage as it’s demotivating and not the correct advice. When in a calorie deficit we need to do resistance training too, or muscle mass can be affected and cause worse issues down the line. Their advice is outdated.

Of all the NHS weight management programs there are in the UK only a small portion can refer for weight loss injections. In this week panorama episode they shared that they will only be able to help 50k people when obesity affects millions and costs more on the NHS.

I too was referred to a weight management group - my GP is in full support of the injections - but due to the lack of information, she had no idea they had no ability to offer referrals. They push the outdated eat less, move more - carbs are bad, low fat is good (wrong). If I wanted nutritional advice, it wouldn’t be from these old hats. I know exactly where I’m going wrong - but it doesn’t change my emotional attachment to food.

I had enough and paid privately for Wegovy. It won’t work for everyone (obviously) but for me it has removed the “food noise” and reduced my appetite. I will be happy to have my weight loss kick started for as long as I can afford to be on this (and I’m very privileged to do so in the first place) and ultimately will not be a burden on the NHS, with X/YZ health conditions requiring medication, surgery or going for extreme measures like weight loss surgery.

Again, to summarise. The weight management classes up and down the country may work for some - particularly those needing education on nutrition, food choices or who excel in a group setting - but they don’t for me and I wouldn’t waste my time or brain cells attending them, and that’s not factoring in my medical conditions and their lack of understanding on the impacts some disorders have on weight. One small example, if you have c-PTSD, you have an increased risk of developing obesity and cardiovascular illnesses as an adult.

Those kinds of groups are what thin people think fat people need.

Was your comment designed to do? Was it meant to be helpful?

Because you didn’t comment on the subject. Which was the courses.

Not sure what your MS medication has to do with this. As you said, you don’t understand it. So your whole ‘it just will power not rocket science’ has no meaning and holds no weight.

I don’t drink. I don’t get understand alcohol addiction. I don’t go on threads where people are wanting certain help from the NHS and trying to over come their addiction to tell them ‘it’s just will power, not rocket science. I can not drink so you can just not drink too’

I was a competitive athlete. Being over weight wasn’t because I didn’t know how to eat well, or how to cook or how to portion my food. I was grieving. And depressed. My PCOS (which is under diagnosed) the flared up. Which made the depression, exhaustion, the compulsion towards sugary food far worse. I last hair on my head and gained more in my face. I could even face showering some days. Never mind getting up and just going for a walk. PCOS is a metabolic disease. At it worst your Kody feels like it’s not your own. But I didn’t want more kids so couldn’t get and medication to at least reduce the impact on that.

It’s taken a lot of my own money and resource to readdress the PCOS which I am lucky to be able to put in. It’s taken longer to get over my mother’s death.

You are right. It’s not rocket science. Because it’s nothing like it at all. There is no one set way that works for everyone because it’s hugely complex and different for every person. A lot of the time, it includes underlying physical medical issues that the NHS doesn’t or can’t treat.

You, clearly, see over weight as less than you. Because you were picked on because of your mum. The fact that you, as an adult, blame your mum rather than the bullies, is an emotional response that you haven’t worked out how to change. It’s ingrained in you. To the point you think that post was relevant or helpful in anyway. So, you can understand how people have underlying reasons they may over eat. That are ingrained in them, that they can’t move past.

I am not sure the injection is the answer. But posts like yours don’t help anyone. It’s your attitude that means the NHS waste money on course. Because they assume overweight people are just thick and don’t have enough will power. Which isn’t actually helpful at all. Just like your post.

With regard negative and unhelpful comments about just use will power. I read once that South Korea has low levels of obesity. Apparently, if you put on weight there, those around you are very quick to comment and are not polite about it. This was actually deemed a big contributing factor in reducing weight gain. Cultural differences though, it might not work here and even if it did, we might prefer not to live like that. Now I'm sure posters will say people have been rude about their weight, but it's not the same level. Here it's considered rude to do so, in South Korea apparently, its not and so not uncommon for a stranger to come up to you in the street comment on your weight and give you diet tips. As I said, cultural differences though, maybe this wouldn't be offensive to a South Korean and would be treated in a similar way to a stranger quietly pointing out to us that we had food on our face on the tube.

Anyway, back to the question. I wonder if the NHS has run the numbers on these courses, and they work for enough people to make them worthwhile? You're just unfortunately not one of them OP. I asked earlier, can you pay privately for the injection?

@Kendodd Its not possible for me to pay for Wegovy as it’s nearly double Ozempic - I could have managed the payment for that but due to short supply it’s only (rightly) available for diabetics in our area.

Also, I was hoping for a proper conversation with a doctor about my options as I’m not even sure if the injections are right for me. The people running the MoreLife courses are not medically trained and therefore cannot provide me any useful advice.

Food addiction is seen as a joke - if someone is suffering with an alcohol, drugs or a gambling problem then they are deemed to be ‘worthy’ of being taken seriously. Would a drug addict find being told ‘drugs are bad don’t do them’ or ‘use a smaller needle and a bit less heroin’ helpful? No of course not.

Wegovy won't work for you long term because you are still in denial. Keeping a food diary for 12 weeks and getting advice is part of the assessment. Without lifestyle changes weight loss drugs are just a way to replace one form of disordered eating with another.
Beating any addiction requires a lot of effort, mainly from the addict.

@JediKnightingale with an addiction predominantly it would not be about medicating the addict it would be about helping them to want to abstain and stay abstinent? No one is shooting down food addiction but to say that the choices lay with you, and you can use the support available as tools to challenge food addiction and get emotional support to overcome the reasons why you want to over eat. An alcoholic is dependent on alcohol but they are expected to deal with the underlying reasons they drink to avoid going back to drinking.. they don’t just get given a tablet. You have heard of AA and Na meetings yes? When people are sober they are usually given a lot of credit for their hard work getting there.

@Kendodd some countries (China) have also put in things like pay related benefits to the weights of employees! And weigh them when they get to work! It’s taken really seriously because of the mukbang phenomenon getting really popular seeing a huge rise in obesity that they have never seen before. I won’t get started on it but there is a reason that it’s seen as rude here and it’s now more related to the body pos movement being rooted in fat fetism…

I’m not going to make this all about me but I think why some people can be harsh is do you know how hard people really have worked to try to change their life? I mean for me I am not at my goal yet but I have spent months and months working hard, a lot of mental energy, it’s been one of the hardest longest challenging things to do, to change my lifestyle. Not everyone is ready or able to do this. I don’t think Op is ready. But I don’t think it’s harsh for those who have worked really hard to be honest with people about what is involved here. It’s a lot of dedicated consistent effort. I can never get up in the morning and just not think about my food intake, it’s something I have to work at all the time.

Im not better than anyone else and I am sorry if that’s how people interpret it - but I’ve worked hard, and it just damn effort involved here! And if you aren’t ready that’s fine - there are ways you can get ready, keep motivated and keep moving on. There is support for you. Just be open minded

Currently doing the similar tips of things under Aintree hostel bariatric team.

Honestly, the online zoom meetings are awful. It's all calorie counting, suggestions for lots of lower calorie artificial sweetened food and they heavily advocate for not reducing carbohydrates at all. After the first two sessions I have started just offering a "example" when the course leader says so has anybody ever tried really hard to over come a big task/managed to lose any weight/fallen off the wagon. The first one I asked them what their views were on home made slowly fermented sourdough over shop bought white and the difference between insulin spikes after each type, the second session I asked why they were recommending shop bought jars of veg like sauerkraut when they aren't live, they have been pasteurised and so don't have beneficial bacteria, they had no idea what I was talking about. So now I offer up my tidbit and then crack on with my domestic jobs with it on in the background. I offer another tidbit up or ask a question towards the end and they are happy. I'm not actually listening to the crap they spout though.

It's funny though, I can actually manage to lose a lot of weight doing high fat low carb or even Keto/atkins. My problem is that I'm bipolar and so while I might stick to the diet great for 10 -14 weeks and lose 3 stone, I then go manic and am medicated with heavy duty anti psychotics and they are proven to interfere with your natural metabolism and you stock pile weight like a bear getting ready for hibernation.

Aintree hospital though, they ARE offering wegovy starting this spring. They told me this at my initial appointment last year, that the funding was just going through and they fully expect to start around march.

Also, I had a sleep study done and was diagnosed with severe sleep apnea. I knew I snored badly but I had no idea. It's been life changing. Pre cpap I had horrific GERD from the age of 22 and chronic sinus infections (7-12 a year) that often turn into pneumonia 2-3 a year. But I haven't had a single bit of heartburn or GERD since the first night in my cpap. My airways and sinuses are clear for the first time in my adult life. Not a single infection in 2 months and not even a runny nose! Turns out that as sleep apnea causes your airways to collapse , the collapse basically has a plunger/vacuum effect that sucks the stomach acid into your airways and sinus and it can be silent. So the constant infections were caused by acid and despite having seen 3 different ENTs it hasn't been picked up on. I've had surgery for gods sake and that didn't fix it, an an endured carousel of medications and treatments and it was all fixed by a cpap.

Everything I need seems rationed now.

To get six weeks of counselling I had to do either an online CBT course or a CBT workshop. I had to do at least ten sessions. They didn't help (either time) so that's when I go counselling. It took many months.

It sounds to me like this company is being used in a similar way. You have to do this whilst waiting for the treatment or assessment you really need, and again you're waiting months.

I am 18stone currently and I completely understand OP where you are coming from. These courses are usually led by really skinny people, who tell you to stop doing obvious things and start doing other obvious things, and fail to support you psychologically. I know not to eat certain foods. I know I need to exercise much more. I have health problems (heart, kidneys) so I can't do HIIT or anything like that, my exercise needs to start slowly and be built up. But the advice on how to do this, and what to eat which suits my illnesses is lacking.

So I start a new plan. I make reasonable goals. 2-3 lb, or a kilo a week, say. I start exercising more. The weight starts to drop off. But I get to a point where either I plateau or something big happens in my life. I grow despondent. I lose the will to carry on, and fail off the wagon. Then I find it difficult to get back on and pile the weight I lost back on again. The support I need is at the point I'm plateauing or when I fall off the wagon. But the GP doesn't get this!

I also don't like what the NHS terms as "healthy eating". I prefer a protein-rich diet and to reduce my carbs, which the NHS doesn't recommend.

I'm about to start another cycle of this with the nurse at my GP surgery because menopause is coming! So I am motivated to lose the weight but unless there's some sort of psychological support I am going to fail again.

Also if you have undiagnosed sleep apnea, it's almost impossible to lose weight no matter how hard you try as your body is constant panic mode. I stopped breathing 63 times a night for arrest ten seconds at a time.

That means I stopped breathing for 10 minutes in every single hour. No wonder my body was in panic mode. Interestingly, since starting the cpap treatment I've naturally craved much more healthy whole foods. AND I've lost 4lb in a month without trying, even over Christmas .

I'm not hoping for the injections, I'm hoping for a bypass. I have auto immune diseases and need to lose weight to have a knee replacement

@SunflowerSeeds123 I find its best to make exercise part of your routine. Nobody can be 100% motivated all the time, but habits/routine stick. I've been on a plateaus for the last 7 months or so, scales stubbornly stuck at 11 stone with the fluctuation of a pound or two up/down. But I still do atleast one swim or gym class a day (mon to fri), because that's my routine now, it's just what I do and I know it's good for me, even if there are no physical changes.

I think obesity is a very complex issue. We aren't anywhere near solving it, are we? It's actually getting worse, so you do have to question current strategy.

We aren't all stupid. Not all of us are as dumb as Homer Simpson, or Only Fools Trigger and his broom. Although I do know the UK Reading age is 9, not 11. Frightening.

But yes it's complex. I know more about carbs, fat, protein and foods generally than most, as always been diabetic, but I can't lose this stone I need to.

Btw Ozempic isn't even available to most UK diabetics atm. As a pp said there isn't enough historical data to make any conclusions on long term repercussions, but the fact is there's a shortage of ozempic, wegovy, etc.

I don't know what the answer is. But I can tell you for a fact that the current system is not it.

I don’t think anyone assumes others are stupid but if you know everything being taught but still choose not to follow any of it, how much of this is the responsibility of the patient not just the healthcare system?

If considering food as an addiction, are there any food addiction groups people can go to like AA? Self run by proper fat people (not just a few kg to lose) ?

The reason it's in place is partly because a percentage of you on the course WILL lose weight, and won't need further interventions. There's a lot of evidence that people lose weight better in a group environment with support, that's why it's commissioned.

In health you want "least intervention" first rather than going straight to a high level intervention.

You may have "tried" every diet under the sun but you haven't done it under NHS supervision. The responsible thing for the NHS to do is start on the bottom rung of weight loss services and get you to work your way up. If you can lose weight on one of those rungs before you reach Tier 4 which is surgery, great.

They’ve put you on this programme because it’s literally how you lose weight. If you listen, take it seriously and want it enough (rather than just being keen for a quick fix) you might just find it works.

Why didn't you like OverEaters Anonymous as a way to address the food Addiction problem, OP?

Is a week of Wegovy about £50 ? And it stops working as soon as you stop taking the injection, is my understanding. Or is there evidence that 10 weeks on injections leads to weight staying off for years afterwards?

MoreLife are no longer taking referrals on my area and they cannot get hold of any of the weight loss infections as these are all being covered up by the private sector.

Tbh they inferno more than the Tier 2 services nod.

I see the ill educated "all your fault" crew are out in force.

Try googling obesity and trauma - educate the stupidity out of yourselves.