Opinion piece on the use of obesity drugs

[Midnattsol]

I found this opinion piece interesting, as it uses some of the same arguments as ME/CFS proponents about a condition being complex, biological and chronic.

It's about obesity and how despite there are drugs that are helpful, and found to be cost-effective, it's still moralism that lies behind guidelines (and how this affects people unable to buy drugs for themselves the most)

Since fatigue is also seen as a moral failing, will it be similar for us if a drug is developed?

When your wallet decides whether you get treatment

 

[BrightCandle]

I maintain the only way most of us will get treatment in our lifetimes is the drug that works is available from Indian and Chinese generics, because the chance it appears on the NHS seems slim to none. It will be a fight at every stage to get anything approved and the stigma and disbelief in medicine will mean it will take decades to go from recommendation to something your doctor would actually prescribe. Right now none of them even know anything much about the disease at all to recognise, diagnose and ultimate then apply treatment. We need many wins to happen against a prejudiced system before a drug could possibly be effectively rolled out. We are very far from being ready for a breakthrough to quickly be deployed to save lives.

 

[Kitty]

the chance it appears on the NHS seems slim to none. It will be a fight at every stage to get anything approved and the stigma and disbelief in medicine will mean it will take decades to go from recommendation to something your doctor would actually prescribe.

I can't agree. There's no reason a drug wouldn't be prescribed if it had a reasonable safety profile and showed enough benefit to justify its cost. A NICE recommendation after successful trials is likely to take time, but not decades.

As for attitudes, all that's needed to begin transforming the picture is evidence of disease modification by a drug. It's also evidence of disease, after all.

I'm not suggesting it's going to be straightforward, nothing ever is. I just don't accept the notion that good trial results would somehow be denied because of institutional prejudice.

The opposite seems more plausible to me: That a treatment emerges, is adopted without much fuss, and the medical professionals involved have remarkably little (if any) awareness of the history.

 

[Utsikt]

Since fatigue is also seen as a moral failing, will it be similar for us if a drug is developed?

When a drug works, it will have «proven» than ME/CFS is a real disease that isn’t maintained by behaviour, which obesity also struggles with because of some anecdotes of people «pulling themselves together and losing the weight» - as it’s often portrayed.

I also think the financial calculation is easier for ME/CFS because a lot of the state’s cost from obesity goes through long term complications. The benefit from treating ME/CFS will be more obvious - people get back to work and education.

 

[Arnie Pye]

I haven't kept up with info about obesity drugs. Do people have to pay for them in England, or does the NHS pay under certain circumstances?

 

[Kitty]

Do people have to pay for them in England, or does the NHS pay under certain circumstances?

They're prescribed by the NHS to people over a certain BMI threshold. There might be exceptions to that if there are other risks, but broadly it's about how severe their disease is.

 

[Midnattsol]

When a drug works, it will have «proven» than ME/CFS is a real disease that isn’t maintained by behaviour, which obesity also struggles with because of some anecdotes of people «pulling themselves together and losing the weight» - as it’s often portrayed.

I also think the financial calculation is easier for ME/CFS because a lot of the state’s cost from obesity goes through long term complications. The benefit from treating ME/CFS will be more obvious - people get back to work and education.

Another thing that makes the calculation easier for ME/CFS is that there are fewer of us, as an argument against providing obesity drugs is that the cost will be high as so many would fulfill criteria for them. But that said, people do become disabled and off work for obesity, and can be able to work again when the weight is reduced.