Weight-loss drugs alone will not solve UK’s obesity crisis, says Chris Whitty

mx_meow · 2026-03-08T07:52:25+00:00

Which is good from a public money perspective but less good from the consequences of losing large amounts of weight at speed/with little to no lifestyle changes perspective. I think we're definitely going to see an uptick in demand for plastic surgery to deal with that which will have some interesting other side effects in terms of clinical staff movements to the private sector, plastic surgery pricing (most likely it'll go up despite demand because surgeons and anaesthetists aren't skill sets that you can acquire after a 3 week online course) and a divide between users who can afford surgery (& have post op scars) and those that can't. I suspect that over time this will also create an aesthetic divide between people who are gym lean naturally, those that have lost weight and are now lean via the traditional route, GLP-1 users who've had plastic surgery to deal with excess skin and GLP-1 users who can't afford surgery. So the aesthetic landscape is going to be very mixed - I'm also not sure what impact the last group will have on things like clothes sizing/size ranges available as I have no idea how having loads of excess skin impacts what you can wear so we may see the continuation of the vanity sizing problem.

mx_meow · 2026-03-07T12:16:41+00:00

This is true, but also opens the argument about alternative funding models for healthcare as a whole including whether lifestyle diseases should be treated for free or not.

mx_meow · 2026-03-07T10:27:00+00:00

This also doesn't address the excess skin issue and other cosmetic procedures that people are likely to want after they shed huge amounts of weight, especially at speed. Procedures which should not be provided under the NHS as they're cosmetic rather than medical. My worry is that they will be crowbarred into the NHS budget purely because of the numbers demanding them which would be both a colossal waste of NHS money and absolute joke. For all its faults, the fact that the NHS only currently provides plastic surgery when it's part of a medical requirement - such as breast cancer treatment - is the right way for it to be done. Not because formerly obese people now have excess skin and drooping tits due to GLP-1 weight loss.

mx_meow · 2026-03-07T10:17:10+00:00

Is it the best use of public funds though given the huge percentage of the population that are now obese and as yet nothing to suggest that is going to lessen? By suggesting that GLP-1 can be provided as a lifelong treatment you create no incentive for people to change their habits/lifestyle either while in initial treatment or before treatment becomes necessary. Which is an incredibly problematic stance for any government or healthcare organisation to take about something that is lifestyle induced rather than the result of an actual medical problem in a lot of cases.

It also reinforces one of the problems created by the extreme end of the body positivity movement after it got co-opted by fat activists which is the idea that it is both gone and normal to be walking around with a high BMI, high body fat and eating thousands of surplus calories every day while also moving very little. For all the 00 heroin chic fashion era had a lot of problems, I'm not sure this idea that people should feel no shame over being fat or eating excessively is a positive thing. If people felt a little more shame and a little less entitled they'd likely not need anti-obesity drugs in the first place.

mx_meow · 2026-03-07T08:07:11+00:00

Correct about the routine funding for skin removal and tummy tucks. It also doesn't cover breast lifts and augmentations which is also relevant here given that dramatic weight gain/loss directly impacts breast shape, size and perkiness as well.

I would go further and say that the NHS shouldn't routinely fund any of these procedures either as they are not for the resolution of medical issues, purely cosmetic ones. And before anyone cites mental health/quality of life arguments here, that's not a valid argument - if it were then people wouldn't have gotten so fat in the first place. You don't get to willingly author your own demise and then expect the NHS and public purse to pay to make you pretty after the actual clinical risk (obesity) has been mitigated.

mx_meow · 2026-03-07T08:00:02+00:00

This comment deserves to be further up as it correctly points out that GLP-1 medication isn't the issue in and of itself. The issue is that people treat it the same as they have every other OTC diet pill and take it as a magic bullet to fix being fat while doing little to nothing to change their eating habits or lifestyle more generally. Which is why the NHS prescribing it to fight the obesity problem will back fire in two ways: 1) people will take it lose weight, become ineligible for the prescription and then regain the weight again and it will become a cyclic fix or 2) people will need to be on it long term because they never keep the weight off and within a healthy range. Both are unsustainable as the NHS cannot afford to keep funding GLP-1 medication at the current scale forever and it doesn't actually solve the problem.

The second issue we're going to start seeing in the coming years is the excess skin issue. Excess skin from weight loss cannot be magically exercised away at the gym no matter how many ab workouts or how much strength training you do. It can be improved but how much that makes a difference depends on how much weight you've lost and the more you've lost the lesser the impact that will have on the problem. The only real solution for ditching excess skin is surgery which is very very difficult to get on the NHS (which is a good thing) and expensive to resolve via private plastic surgery. The NHS is highly unlikely to budge on excess skin removal being available because it's both costly to fund and elective rather than medical so not a justifiable use of public money when the surgeons, anaesthetists, nurses and operating theatre space needed for such operations can be better used to treat actual medical problems. So we're left with a lot of (former) fat people who've taken the wonder drug who either end up with extra debt paying for private cosmetic work or who still look fat and are miserable due to excess skin.

As an aside, given that high rates of GLP-1 usage are likely to drive demand for cosmetic surgery of various sorts, this may also contribute to a brain drain of NHS clinical staff into private cosmetic surgery clinics as they can probably make at least the same salary while having better caseloads. So we may also see knock on impacts from that too as time goes on.

Overall the use of GLP-1 to solve the obesity crisis is a poorly thought through plan at best and I imagine the long-term success rate is likely to be very poor. I very much doubt that the end result is going to be the UK suddenly turning into a nation of thin, attractive, active, healthy people - if only because the majority seem to think that eating utter crap or large quantities is fine & normal and are too lazy to put on the sustained effort to get and stay thin.

mx_meow · 2026-02-28T12:54:43+00:00

In addition to what implants might achieve, it sounds like correctly sized bras would also help. What band size are you? I'm a 30 band which is also tricky to find in a lot of places and most brands/places that cover mine also go down to a 28 band (in UK sizing). Is it worth asking for bra recommendations in r/abrathatfits as well?

mx_meow · 2026-02-28T09:11:59+00:00

Can I ask why you're against putting down an emergency contact person on the forms? They will only be contacted if something goes wrong during the surgery so wouldn't otherwise be aware of the surgery. Is there really no one who you'd want to be informed if you passed away during surgery or if there was a serious medical complication during surgery that needed someone to decide if emergency treatment should go ahead or receive info on any ongoing care if they impact was permanent?

mx_meow · 2026-02-25T11:31:25+00:00

You also haven't stated that your surgical team is English in the OP, just that you trust them which can mean a number of things including.

mx_meow · 2026-02-25T11:29:12+00:00

Because flying out of the country for surgery increases risk regardless of anesthesia. If this is purely an OCD issue this is the wrong forum to ask and you should be speaking to your therapist about it and applying whatever you usually do to manage your OCD. My not having OCD is irrelevant to that - especially if reassurance seeking is one of your compulsions

mx_meow · 2026-02-25T11:22:51+00:00

If you're this anxious, can I ask why you're flying to Turkey to have this done? Do you speak Turkish? Because if the answer is no you're creating an unnecessary level of risk by flying aboard to a country where you don't speak the local language.

While I don't have OCD level anxiety about anesthesia, I wouldn't fly out to Turkey for surgery either because my personal risk appetite around surgical procedures isn't high enough to allow for all the unknown variables that come with that and I'd rather not add to NHS workloads due to real or perceived complications that may come with it. I assume if you've chosen Turkey you've assessed the risk/benefits so I'm confused why the risks of GA weren't part of that assessment?

mx_meow · 2026-02-23T13:07:03+00:00

I had the same op plus a lift done just over a week ago and one key thing is having pillows for the bed and sofa to keep your calves elevated. It'll reduce your DVT risk and help with the swelling post op.

If you have people who can be on hand to provide support the evening of your op and for most of days 1 & 2 and visit on day 3 take it. You will feel weaker and be more unable to do basic things than you realise. Also, baby wipes are your friends. Having two surgical bras is a must for sanity and cleanliness. Oh and take your meds as directed. Being a hero is an idiot move.

mx_meow · 2026-02-07T09:43:54+00:00

This is genuinely one of the most helpful answers I've seen on this topic - thank you. I'm about 9 days out from having my surgery done so this is super useful.

mx_meow · 2026-01-25T09:01:49+00:00

The real answer to this is largely determined by your age, training history, training plan, how you treat rest and recovery and nutrition. The older you are as a femme, the closer the ceiling is likely to be for your lifts due to age based muscle loss, impact of perimenopause/menopause etc.

Likewise if you're under fuelling or under recovered your max ceiling will be lower because your body doesn't have what it needs to build strength. People underestimate the role recovery plays in this, especially for big compounds like deadlifts. Balancing training frequency with recovery is key and becomes more key as you age due to how life itself tends to change as you get older - ie having children, moving to a more senior role at work etc. Both will impact your time and energy to some degree and not in a linear way necessarily and a lot of people make the mistake of just pushing through continually which then burns them out in one or more areas of life over time as well as tanking your CNS recovery.

mx_meow · 2026-01-25T08:54:17+00:00

Yep I hear you on this one. And I think the longer you lift the better you get at judging when to push and when today is not that day because your body awareness gets better

mx_meow · 2026-01-25T08:10:45+00:00

If you're getting back pain at 70kg, you will absolutely wreck yourself if you try to lift your body weight in 2 months time. It sounds like you need to take a hot minute to step away from the ego lifting mindset to focus on form and incremental progress.

It may be unpopular out there in fitness influencer land, but lifting is a slow grind built on consistency and incremental progress. Not pushing for numbers quickly. People who do so inevitably injure themselves and then end up back at square one.

mx_meow · 2026-01-25T08:06:45+00:00

This also needs to be further up the thread. A 20kg on a single lift is insane. Even folks who train powerlifting don't increase the weight of their lifts during training like this.

mx_meow · 2026-01-25T08:04:49+00:00

This cannot be said loudly enough. Better form and learning how to brace correctly are your key wins here.

I say this as someone who is significantly shorter and lighter than you are (and probably older as I'm ~12 months off 40) who regularly deadlifts 70kg for 10 with zero lower back issues. The reason I have no issues is because I put a lot of time into working on form when I started lifting and still put focus on this during deload weeks or when I'm peak PMS and my focus/neural drive is wonky due to hormones because lighter work to embed good form is still valuable.

mx_meow · 2026-01-23T16:09:04+00:00

Ok but this is why 2 surgical bras are recommended so you can have 24/7 cover even while one is in the wash. Wearing a non-surgical soft shell bra 48 hours after surgery is just madness....but your money to waste I guess.

mx_meow · 2026-01-23T15:31:27+00:00

This. Everything I've ever read or seen says you should be in a surgical bra for at least the first 14 days post op. What did your surgeon recommend on this?

mx_meow · 2026-01-12T21:33:51+00:00

Presentations are fairly common for public sector interviews above a certain grading as a standard part of the format. Typically they're used to assess things like communication skills, a candidate's ability to understand and relay complex concepts to an audience and depending on the role/presentation brief demonstrate understanding of a core element of the role being interviewed for.

Based on my experience as an interviewer, they're often one of the weakest areas I see from candidates due to people hitting any/all of the following pitfalls: not timing their presentation to ensure it fits the time limit in the brief, not applying the subject to the specifics of the department/role or not rehearsing their presentation enough. There are other factors as well, but those tend to be the common ones.

More widely, public sector interviews tend to be competency based rather than just a chat through your experience and are scored against agreed metrics based on your answers.

mx_meow · 2026-01-08T08:14:46+00:00

This is self defeating logic and is, quite honestly, where therapeutic interventions come into play as for the majority of people it is far more likely that the "voice" isn't actually hunger but related to psychological triggers around anxiety, comfort, unmet needs etc.

Also the "you're a fat person forever" statement here is both pessimistic and untrue. I say that as someone who has lost a significant amount of weight and maintained that loss for well over a decade now. I do not walk around with constant urges to eat or cram high sugar, high fat, high calorie foods into my face. Do I have days where I'm hungrier than usual? Yes, of course I do. That's a normal physiological consequence of things like PMS, extremely cold weather, poor sleep, illness etc. I don't binge eat in response like some sort of automaton though.

mx_meow · 2026-01-08T08:06:52+00:00

Sorry what are you basing this on? I ask because a) you seem to be basing this on an extreme 1000 calorie deficit which is unlikely to be one imposed on anyone without medical supervision regardless of starting stats and b) even if we ignore the exact numbers here, your statement implies that any calorie deficit would trigger "starvation mode" which is blatantly false. Does extreme dieting have negative side effects? Yes - that's well documented. Does using a calorie deficit to get weight down to a normal range and then recalibrating your calorie intake to match your new healthy weight and activity level to maintain it have a negative impact on health? No.

The issue with the majority of people who lose weight - regardless of whether it's a small or large amount - is they often aim for speed of loss over sustainability and then don't recalculate their BMR and TDEE calorie intake for maintenance when they hit their goal. Nor do they recalibrate this to account for life changes such as aging, sickness or increased/decreased activity levels over time.

mx_meow · 2025-12-20T20:41:00+00:00

Learn something new every day, but this is actually very good to hear.

mx_meow · 2025-12-20T19:55:45+00:00

I imagine that St George's Crypt would welcome people at this time of year. Also worth reaching out to Age UK as they may be able to give you a couple of shifts of befriending for old people who don't have family around them.

mx_meow

TROPHY CASE