this post was submitted on 07 Oct 2024
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UK Politics

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The availability of weight loss drugs on the NHS doesn’t mean people can give up healthy lifestyles, Health Secretary Wes Streeting has warned.

Experts believe drugs like Ozempic will play an important role in tackling the UK’s obesity crisis.

But Mr Sweeting told the Daily Telegraph it was in “everyone’s interest to play their part” and avoid overloading the health system.

“We don’t want to encourage a dependency culture where people think it’s OK not to bother eating healthily or exercising, because the NHS will pick up the tab and pay for their weight loss jab,” he said.

“People in this country have the right to expect top quality healthcare, but also a responsibility to look after their own health, so we’ve got to get the balance right.”

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[–] [email protected] 14 points 2 months ago* (last edited 2 months ago) (1 children)

From what I've read, GLP1 drugs can change how your brain thinks about food, and can cure the "addiction" to high sugar/fat foods. They're even being investigated for other addictions. https://www.sciencedirect.com/science/article/pii/S1043661824002573

[–] ghen 10 points 2 months ago* (last edited 2 months ago)

I'm taking wegovy, it's exactly this. I don't walk into the kitchen and open the refrigerator anymore. I'm building new habits that will stay with me without the drug, and I'm building new daily frameworks around food that I can look back on later without the drug. The change was immediate, in the first week, but building habits takes a while.

My food addiction stems from having periods of food scarcity in my past and current troubles getting good quality foods. I think it's something that doctors will be able to dial in later as to which psychological problems the drugs can help with best.

I also think that pairing this drug with therapy would be amazing as a therapist could help their patient reflect on the changes that are happening and give them the tools to build new habits while the drug is in effect

[–] hellothere 14 points 2 months ago (1 children)

Having many friends who work in primary care, this is a common view among professionals.

On a fundamental basis, it's almost impossible to outrun a bad diet, even some people with gastric bands manage to put the weight back on after a few years.

There are many social cofactors in people's weight - shit job and irregular hours make it very difficult to cook, multiple jobs, an inability to cook, cheap food being pumped full of shite, very little money, etc etc etc - which also need to be fixed.

But oxempic, and the rest, are the equivalent to a very effective hangover cure. Just cos you can drink 15 pints and pop a pill in the morning to feel better, doesn't mean you should, or that's it's healthy to do so.

[–] [email protected] 15 points 2 months ago (2 children)

I've obviously misunderstood ozempic, I thought it removed appetite? That would prevent the bad eating entirely surely not fix it after you eat a lot?

[–] [email protected] 8 points 2 months ago (1 children)

It reduces appetite and slows down absorption of food so you shit more of it un or partially processed, reducing your actual calorie intake vs. how much you shovel in.

What it doesn't do is reset the type of junk food you are eating. Eating junk food and you will be hungrier sooner with or without the ozempic due to the higher sugar content of the majority of junk food.

[–] [email protected] 5 points 2 months ago

No it really does change what kind of food you desire to eat. It was quite a surreal change for me when I discovered I was craving the juicy taste of a tomato for the first time.

I don't know if it is normal for others, but I have never ever had the actual desire to eat vegetables before I went on ozempic/wegovy.

Salty sausage, crisps, cheese, bacon, that was the only types of food I used to crave. Now I cannot eat bacon anymore, the fat taste in my mouth makes me queasy.

[–] hellothere 5 points 2 months ago (1 children)

There's a false premise here that people only eat when/because they are hungry, as in, they are in need of calories, and stop when they aren't.

They don't. People eat for loads of reasons, and many of us have really unhealthy relationships with food, e.g. we eat it we're sad, or bored, or to punish ourselves, etc.

Then there's calorie density, you may not even realise how much you're consuming. For example, a pint of beer has a similar amount of calories to a mars bar. You could quite comfortably drink 4 pints over an afternoon, consume 1000 calories, and then go out for a meal, in a way that you probably wouldn't eat 4 mars bars, and then have a meal.

[–] [email protected] 3 points 2 months ago (1 children)

It's just not the entire story. Ozempic/wegovy changes the way you feel about food.

I used to always want to eat a lot. And if there was candy on the table within my sight, like 80% of my mental focus would be on that candy, no matter how hard I tried to focus on something else.

Now it's more like, meh I guess I could take a piece of candy, and then I get lost in talking and forget to actually put it in my mouth until half an hour later.

It is definitely not just appetite suppression. I used to overeat a lot, even after feeling quite a lot of pain from beeing stuffed, I would keep eating. Now I forget to eat, if I don't have people around me going to lunch.

The soothing, rewarding pleasure of swallowing sugar, fat or salty food I used to need to feel good is just gone most of the time.

To some degree it feels like I have been set free.

[–] hellothere 0 points 2 months ago (1 children)

I'm glad it's working for you, I truly am.

But my point is that there are a variety of reasons, it will help some people with some of them, and won't help others. As you'll see in all the issued guidance, it's prescribed alongside diet and lifestyle changes. As in, move more and eat healthier foods, in lower quantities.

If that helps, awesome, I'm not going to bash people who need medication to function - as I literally am one of those people - but it's not a silver bullet.

[–] [email protected] 4 points 2 months ago (1 children)

It seems like the original criticism doesn't apply though, this actually is that good for many people and actually causes them to do the thing the politician was asking them to.

[–] hellothere 1 points 2 months ago

The comment I originally replied to was asking about removal of appetite. The point I was making was that appetite isn't the only reason people consume calories.

The jabs do not cause you to exercise, and losing weight without some level of exercise to build fitness is also not healthy.

The point Streeting is making is that you can't just eat to excess and expect, 20 years later, that the NHS can fix all your problems with an injection.

It's the same way that alcoholics are not given liver or kidney transplants, or smokers new lungs, because even if you did the transplants all the other problems (cancers, etc) would still exist.

Primary healthcare is really complicated because you're dealing with people who are generally speaking not at the worse bit, yet, and so patient's motivation to consider, let alone make, changes can be non-existent.

This in turn is what makes a preventative healthcare model so much harder to achieve. The best way to treat T2 diabetes is to not get there in the first place, but friends of mine routinely have conversations with patients where their likelihood of having T2D, or stroke, heart attack, etc, is very high within the next 5 years, and are met with blunt refusals to even consider something as trivial as a lower calorie butter/spread, and instead just demand a jab.

This is not everyone, but it is a significant proportion, and it's right the Health Secretary to remind people that while the NHS does exist, and will support you if you get there, that it's better for yourself to not end up there in the first place.

[–] [email protected] 14 points 2 months ago (2 children)

It seems like pandering to the Tory press. Getting more people to a healthy weight saves a lot of cash in the long run and frees up resources for other people.

However, I don't like the idea of Big Pharma gouging us on the price and, we do need to take more responsibility for our health. When I was in hospital in 2017 they didn't really know where to put me so I went in the leg wards. Everyone else had badly managed diabetes and smoked, so they all had nasty leg wounds that landed them in hospital and it was only going to get worse. Too many were still sneaking out for a smoke, including No Legs Mick who was being slowly whittled down to a nub. With a bit more care for themselves that entire floor of the hospital could have been largely cleared.

[–] [email protected] 11 points 2 months ago (2 children)

"Personal responsibility" has nothing to do with politics tho.

I'm all for personal responsibility for myself or.anyone else. But politicians in the public forum should be governing public resources/systems.

[–] [email protected] 7 points 2 months ago

If the nation is eating unhealthily look at food standards. Look at food costs. Work on policy that effects the quality of what they are able to afford to eat.

Don't just finger wag.

[–] [email protected] 4 points 2 months ago (1 children)

But politicians in the public forum should be governing public resources/systems.

That's it really - if the semaglutide injections cost £X but save £1.5X then buy it by the truckload.

This doctor reckons everyone with a BMI over 30 who has tried an failed to lose weight and keep it off should get it. There may also be benefits fir anyone who has had a stroke.

[–] hellothere 5 points 2 months ago (1 children)

But it’s not been peer reviewed, this study has not appeared in a scientific journal yet, and it was funded by the drug manufacturers. So are people getting a bit overexcited?

I mean, come on.

[–] julietOscarEcho 6 points 2 months ago (1 children)

This is frustratingly common. Who has the resources and incentive to run such studies?

Finding the same thing with evidence for the effectiveness of AI copilots. Everyone doing wonk on it has a finger in the pie. So in order to believe the research you have to trust the integrity and discipline of people you never met, not to mention trust a whole organizational to be culturally respectful of the scientific method (which probability near zero for a large corporate).

[–] hellothere 1 points 2 months ago

You fundamentally should never trust a study commissioned by the company who sells the product.

It's far too great a conflict of interest.

[–] [email protected] 4 points 2 months ago

To be fair, at that point it's a little late to quit smoking, and an addiction isn't something you quit overnight.

[–] [email protected] 14 points 2 months ago (2 children)

I climb to keep fit and because it's really fun. It's a moderately dangerous activity, but no one ever says I should consider the pressures on the NHS before I go and maybe fall off a boulder problem and break my ankle or whatever. I think this is just standard fatphobic finger-wagging, to be honest.

[–] [email protected] 9 points 2 months ago

I once read that sponsored skydives for NHS related charities end up (in total) costing the NHS more than they raise, because of how often people get injured in them...

[–] hellothere 7 points 2 months ago

The benefit of climbing meaning you maintain a level of physical fitness definitely outweighs the risk of you breaking a bone, or dying.

The issue with obesity is that it dramatically increases the risks of loads of other illnesses, many of which kill you very slowly.

[–] [email protected] 5 points 2 months ago (1 children)

"Depression Drugs shouldn't create a dependency culture"

"Blood Pressure drugs shouldn't create a dependency culture."

Idiots.

[–] [email protected] -2 points 2 months ago (1 children)

Well depression drugs are narcotics tho... Not sure about ozempic but seems to work like like a narcotic for boomers at least

[–] Corkyskog 2 points 2 months ago

Antidepressants are not narcotics. I have no idea where you got that from.