TRIGGER WARNING - TALK OF WEIGHT LOSS AND FOOD RESTRICTION
A game changer we are told.
Like statins for slimming!
Aaand they're clinically proven, safe and effective!
Sure, you definitely want that in a drug...
Of course, it depends on how you define proven, effective and safe. Let's consider the following:
1. These drugs (Wegovy and Saxenda) made by Novo Nordisk, suppress hunger and appetite (amongst other things) to cause weight loss. They fit perfectly into the 'we need to eat less and move more' way of thinking [eye rolling permitted].
Did you know they have NOT been tested on a representative sample of people? Folk with diabetes, high blood pressure, depression or prior weight loss surgery were not allowed to participate in the studies. Considering folk in larger bodies, who are essentially being targeted with this drug are more likely to have type 2 diabetes, high blood pressure and depression (as a result of weight stigma NOT fatness), this concerns me. Are Novo crossing their fingers and holding breath as they see the cash rolling into the bank?
2. No-one knows the long term effects of taking these drugs. NO-ONE. Not even Novo because the studies (that they funded and wrote up themselves) don't go beyond 2 years. 2 years is the absolute bear minimum for a weight loss study, that no-one seems to want to exceed. Yet they have the audacity to claim these are proven safe and effective.
3. Yep you're right, that funding does sound dodgy. There have been HUGE conflicts of interest.
But money can be very persuasive. Maybe that's why NICE and the NHS appear to have glossed over the limited data and conflicts, when they approved entry of these drugs into the UK. Provided by a company worth over $325B.
And lets not forget Novo Nordisk sponsor our (UK) ob*sity and weight management training courses for healthcare professionals , where they also promote their weight loss drug.......Funny they 'forgot' to disclose that.
4. They claim you COULD lose 10% of your body weight. Now what they aren't telling you here is the participants who took the drug, also dieted. As did the placebo group; they all had to reduce their Calorie intake and do at least 150 minutes of exercise every week. Waddayano....both groups lost weight.
Now for a drug to be approved for weight loss, it must produce a minimum of 5% more loss compared to the placebo. Wanna know what the % difference was between the trial and placebo groups? Less than 0.5%.
Let me explain - at the end of the Saxenda trial, the folk who were left (because there was a massive drop out rate), had lost an average of 8% of their body weight. The placebo group (i.e. the folks who just dieted) had lost an average of 2.6% of their body weight. So the difference between the two groups, if my maths are correct, is 5.4%. That's just 0.4 % above the minimum, yet we are being sold the 10% cos it sounds better.
Now when you also consider 80% of the Saxenda and 90% of the Wegovy trial participants experienced dreadful side effects (diarrhoea, nausea, vomiting, abdominal pain - hence the high drop outs), and 10% had serious adverse events (including major gall bladder issues and pancreatitis), that's a hell of a lot of unpleasantness and risk for such little return.
Plus they can't tell us how much of the weight loss was due to feeling bloody awful and how much was actually due to the drugs pharmacological action.
But hey it's worth it...........you'll be thin in the end!
Errrrrr.........Novo Nordisk have not exactly been transparent when it comes to outcomes. Specifically weight regain. They don't want you to know that weight regain can start to happen with 12 months, when you're still taking the drug.
And weight regain occurs especially rapidly when the drug is stopped. Oh and there were no significant improvements in blood sugars, lipids, cholesterol etc. in case you were wondering. But Novo say it's effective!
And what this weight regain means is this approach using a fancy injectable pen is NOT miraculous or game changing. It's no different to any other effort to manipulate the body. Because the outcome is contributing to weight cycling (and all the consequences that brings) and eating disorder development. Never mind increasing the risks of developing thyroid cancer, pancreatitis and diabetes.
And as I listen to the narrative from users, I'm saddened by the celebration of starvation.
"Four bites of dinner and you’ve had enough"
"I hate food now"
I am yet again observing the glorification of disordered eating. Restrictive eating is seen as something to aspire to. It feels like we have gone back to 2009 when "nothing tastes as good as skinny feels"
No-one is talking about the long term implications of starvation - emotional and psychological harm, sleep problems, an inability to concentrate and focus. Poor memory, hormone disruption and of course nutritional deficiencies.
My professional opinion is (and with my lived experience), I am worried these drugs will cause more harm than good; that the individual (not the drug) will be blamed when the weight loss is proven unsustainable. The numbers of folks with poor body image and eating disorders will rise and for those in recovery, it might become harder for them.
And the scary thing is, I doubt it will be long before we see these drugs being pushed as a cure for eating problems like binge eating. It's the perfect business model - make a product that creates another problem so more people come back to you to fix the problem. Sound familiar?
NOTE. If you have taken weight loss drugs, are on them now or thinking about starting, there is absolutely NO judgement from me. I get the desire to belong and to want to feel better. Feeling out of control with your eating is horrendous; to feel you have no other option and are trapped; to find a stop button can be life changing. The stigma of living in a bigger body in this country makes it feckin hard to not want to shrink your body. And these drugs are marketed on the basis of this. And yes they are damned convincing.
So my advice is, please do your homework. You have a right to choose what's best for you....just maybe take off the rosy spectacles when reading their claims and promises. Be gentle with yourself. And consider for the drug companies, profit is their highest priority.
These drugs will be available through the NHS for a maximum of 2 years, for folk who meet the required criteria, as confirmed this week by NICE.
Pharmacies are also putting systems in place so you can buy them (with a prescription) when they are given the go ahead.
And Wuh Wuh (WW who don't like to be associated with diets any more, now 'Wellness that Works') have just bought a digital telehealth company for $132Million so they can offer these drugs to their subscribers.
I have no idea how robust the assessments for prescriptions will be (especially the online ones proposed) but I can be pretty confident in saying their eating disorder assessment will be woeful.
I'm trying to comprehend where the government is going to take the money from to fund this, in a system where we can't support our current patients and health needs. I'm expecting due to GP workloads, the assessments will be carried out by folk other than doctors?
I guess we have to see watch this space, but I'm worried. Are you?
If you'd like to understand more about how these drugs work, the studies that took place and discover what we are not being told, please plug your ears in to my podcast Cake Over Keto, Episode 18 - The Truth About Weight Loss Drugs.
Part 1 LISTEN HERE
Part 2 LISTEN HERE
Thanks for reading this,