Obesity as a Disease - Medication

It's exactly that Barry. And you can either be born with lower levels of the fullness hormones, or you can end up creating that environment for yourself. It absolutely floored me when I listened to Dr Carel le Roux talk at a seminar (it's on Youtube) about how dieting effects hunger and fullness hormones. That basically, every time I dieted, every time I started to reduce my calories, I was actually making everything worse. And it all makes sense now. I was always slim, and never dieted, until I went backpacking one year and put on 10lbs from eating takeways and going everywhere in a van. So I joined Weight Watchers for the first time, to lose those 10lbs. Which I did. Until I put it back on and another 2lbs. Every time I did this, I was actually ensuring that my body made more hunger hormones and less fullness hormones, and worse, reducing my metabolism.

I don't think I had a huge problem with feeling full before, but the feeling of full on Ozempic is entirely different to anything I've ever experienced. The only think I can compare it to Christmas dinner, where you see nice food or desserts but you literally can't fit another bite in. I would always try to finish a plate of food, eating slower in order not to offend the food maker or worrying that I would feel hungry later on. On Ozempic I would get two thirds through a normal portion of dinner and my brain would literally bring the shutters down. Same when I had two or three biscuits. Even if I wanted another, my brain would just go "that's enough, let's find something else to do".

It's all been a revelation. This whole thing of eating too much being a "sin", and the only way to atone for your sin is the penance of diet and exercise, at which point you would be redeemed, is farcical. It's like people looking at Ozempic and seeing it as a "get out of jail free" card, like you should be allowed to be slimmer unless you have served your time. It's really opened my eyes.

I wouldn't worry to much Padraig Mor. Yes, some people get appetite suppression on the 2.5mg doses but for most people there's no effect until you get to the therapeutic doses (7.5mg and above). These doses at the start are just to get your body used to the medication.

That said, for about 20% of people, these medications will have no effect. I knew this before starting and made a pact with myself that I would take them for six months. If I lost more than a stone, I would stay on it. If I lost less than a stone, I would come off it. It's too expensive to keep on the medication for life if it is only going to make a marginal difference to my weight (and therefore health).

That's right. Ozempic came with four disposable needle heads in each pack, but that's because Novo Nordisk produce needles. Eli Lilly do not, so if you get Mounjaro you need to purchase the needle heads separately. Some pharmacies here are expensive - €30 or so for a box of 100. Again, the North is cheaper. Corrys sell their boxes for £8.

Please don't advertise online sales of Ozempic. Not only is it hugely dangerous, it is also illegal. Whatever is sold from that "Canadian pharmacy" will at best do nothing for you, and at worst will land you in the hospital.

23% of adults in Ireland are obese - not just overweight like, I mean with a BMI over 30. Even if a person only has to pay €80 a month, that means the HSE has to make up the difference, which would be another €100 a month. That's a potential outlay of €1.2 billion every year. €1.2 billion.

Now, obviously not every obese person is going to take up the shots, but say half do. That's still €600 million every year. And these are life long medicines. You can't come off them or the weight goes back on. So the HSE know that this will be a yearly outlay.

Another concern for the HSE that the point of putting these drugs on the DP scheme would be to ultimately save the HSE money in treating obesity related diseases. Thus saving money in the long run. However, you'd have to trust that people would continue to inject themselves, every week, even when they are at their goal weight. I can see so many people coming off the drugs because they feel like they are "better" and then putting the weight back on. Therefore costing the HSE for the initial year or two of the drug, and then still costing the HSE hospital costs in the future.

Then, lastly, they'd be at the mercy of the drug companies. If the prices go up, so do the costs to the taxpayer. If they take the drug off the DP scheme, lots of people will stop using it and then every penny spent subsidising the drug to that point will be a sunk cost.

I know it's heartless, but if I was the HSE, I'd be waiting another ten years when some of these GLP1 drugs come off patent. Even before then there are oral drugs being developed that they think will cost around €10 a month. That will be a gamechanger. So I expect they'll play a waiting game.