Obesity as a Disease - Medication

Honestly, going on diets is half the reason overweight and obese people are in that situation in the first place.

People need to do their research before going on these drugs, but also those in the "just eat less" brigade also need to do a bit of reading before they make comment. The simple fact is that our bodies are not designed to lose weight - quite the opposite. Our bodies are designed to hold on to extra weight. All the scientific research has concluded that calorie deficit diets will result in losing fat in the short to medium term, but for 90% of people, the body will respond by reducing the metabolism, increasing hunger hormones, reducing fullness hormones and increasing dopamine reward for high calorie foods until it has brought you back to your original weight (and in most cases, a little bit more). The cycles of diet - regain - diet - regain - diet - regain overtime in being overweight or being diagnosed with Obesity. There are other things at play of course - sedentary lifestyles, changes in food production so that you get a higher dopamine release or less fullness hormones for certain foods. But the diet-regain cycle is a large part of it.

It is absolutely correct to say that the long term effects, if any, of GLP1 drugs on non-diabetic patients has not yet become apparent. However, it's not correct for people to say these are new drugs. They have been prescribed for weight loss for ten years, and for diabetes for twenty years. As Johann Hari succintly put it (and I'm paraphrasing) "if GLP1 drugs gave you horns, the diabetics would have horns already".

What we definitely do know about is the long term effects of Obesity. With all the recent body positivity movements (and nothing against them as long as the person is healthy) people can bury their heads in the sand regarding the real effects on your health that Obesity causes. If the GLP1 medication allows you to lose 10% of your body weight, you reduce your chances of developing Type 2 diabetes by 90%, heart disease by 70% and all cancers by 40%.

Of course everyone should try diet and exercise first. Perhaps you are one of the lucky 10% where your body adjusts to weight loss and you are able to maintain the weight loss long term. But if repeated attempts to maintain weight loss through diet and exercise have failed - not only failed, put you in a worse health position than you started - medication should be an option. And it shouldn't only be an option for the rich.

Ozempic is approx €140-150 per month for the 0.25 up to 1mg pens. It only goes up to 1mg as it is the brand name Novo Nordisk put on the medication intended for diabetes patients. 1mg is the therapeutic dose for diabetics, and therefore it doesn't come in higher concentrations.

Wegovy, which is the same medication but a different brand name (intended for obesity patients), is also now available here. I've heard varying prices for the higher doses (1.5-2.4mg) with some pharmacies charging €250 for the highest dose.

Mounjaro, which is a slightly different medication and made by Eli Lilly, is also available here. Pharmacies here are a complete rip off. €220 for the starting dose moving up to over €300 in some pharmacies for the highest dose. It is much better value to order it from the North. I get mine from Corrys chemists, which charge approx €180 for the starting dose and it goes up to €220 for the highest dose. That includes the €20 for next day DPD delivery. However, I believe Corrys are not taking on any new patients. Belcoo pharmacy are also similar value, and I believe are still open for new business. Drop them an email.

Saxenda I believe is around €250 a month, if you are paying for it out of pocket. If you meet the criteria (BMI 35+) you may be able to get it on the drug payment scheme, thus only paying €80 a month. If you are paying privately I would choose to go on one of the other medications. Wegovy and Mounjaro are cheaper, are once a week rather than daily injections, and have better weight loss results.

As for my own progress, I swapped from Ozempic to Mounjaro at the start of March this year. Weight loss has started again, since plateauing on Ozempic for eight months. The weight loss is slow though - I have 11lbs over 12 weeks. Still, slow and steady will win the race. I have titrated slowly upwards and am on 8.5mg at the moment. I may stick on that dose for another 2-3 weeks if the weight loss remains steady. I have a bit of leeway to move upwards as the highest dose is 15mg. That said I'm hoping I don't need the highest dose as €220 a month is a bit spendy.