To ask GP for a weight loss aid?

[BigMamma613]

I'm "5'2 and 13 stone, obese.

I was a normal weight until 2 years ago when I was put on nortryptiline and propanolol after developing chronic migraine.

My eating habits haven't changed but my weight has ballooned and I just can't lose it. I'm not eating a load of rubbish either, it just won't shift. I do adequate walking but can't do high impact exercise due to another issue.

I feel like the meds have impacted my metabolism. Is that a thing?

I'm getting pain in my knees which I've never had before and I know it's the excess weight causing it. I can't climb a flight of stairs without being out of breath or keep up with my child. I'm so unhappy with the way I look.

Would I be unreasonable to make a GP appointment and ask them to consider prescribing a weight loss aid like Orlistat? I know about the side effects and the orange oil (eek) but frankly I'd gladly suffer it than feel like this.

I can't afford saxenda or any of that fancy stuff you can buy through the pharmacy at £200 odd a month.

Will the NHS help me? Do you have any experience of NHS weight loss support?

You can get the ‘fancy’ stuff on the NHS now, providing you meet certain criteria. Wegovy has been approved for weight loss on the NHS since September 2023
https://healthmedia.blog.gov.uk/2023/09/04/accessing-wegovy-for-weight-loss-everything-you-need-to-know/

of course it's sensible to discuss this with your physician and the reality is maybe the medication you are on causes water retention insulin resistance and weight loss medication may not be suitable. especially something like orlistat which may affect the medication absorption.

You can often self refer to the nhs weight management service in your area. Have a look online and see what options are available for you

Yes ask to be referred to a weight management specialist as well as asking your Gp for oristat/ xenical same drug? I am being referred to slimming world 12 weeks free ( in fact logging on today)

I think Orlistat is £50 a month through boots pharmacy or Asda doctors. Your GP will likely make a referral to the weight management team which can take months.

Are you still on propranolol for you migraine?

You will not lose weight on this drug and there will be no point in trying a different weight lose drug while still taking the propranolol for your migraine. It reduces your metabolic rate and increase weight gain. Sorry, I know it's hard.

I'm also a chronic migraine suffer. Propranolol made me put on 2 stone in weight, same with most who take it. If you still need to take a medication to control your migraines but want to lose weight you could ask to switch to something like toprimate. It is used as a weight lose drug as well as to control migraine and epilepsy, it maybe more suitable for you. It is a hard drug to take, I'm just titrating back onto it myself and can cause quite a few side effects. Please feel free to PM me if you have any questions.

You’re definitely not overweight enough for them to prescribe weight loss injections but they may offer healthy eating advice.

OP has a BMI of 33. Wegovy is prescribed with a BMI of 30 and over.

OP here.

So I have an update. I'm now 2.5 stone down thanks to mounjaro (privately perscribed and funded). I feel so much better. I can climb stairs without my knees hurting, I can walk so much further and have a ton more energy.

My GP was happy to perscribed the orlistat, surprisingly, but I decided not to proceed with that.

MigGirl

Its very interesting you mention the propanolol lowering your metabolic rate, I actually thought it might have been the Nortryptiline, so it turns out it was the propanolol! Or maybe even both?

Chronic migraine is the pits I'm so sorry. Have you ever tried botox? I get head and neck injections every three months (NHS) and whilst it helps a bit I'm suffering a bit atm as I'm titrating down on my propanolol and nortryptiline with a view to coming off, and having more migraines as my body adjusts to the lower doses.

I've always had topiramate in the back of my mind incase they ever stop the botox.

I'm down to one 10mg propanolol in the morning now and hope to be off it completely in the next few weeks. The nori will take a while.

My referral to weight management took 2 months- depends on where you live!

Op I'm on botox at the moment, have been for about 3 years. Unfortunately it has suddenly stopped working. Am now adding toprimate back in again. It's totally pants isn't it, I've always struggled with my weight as a lot of drugs have weight gain as a side effect. But most migraine suffers I know have put on weight with propranolol.

I'm on the weighting list for the new injections but can't get my NHS trust to fund them at the moment. Thinking of going privately right now.

If you do, there's a running series of threads for us MJ users which is incredibly supportive and helpful. It has helped me no end.

With all of the evidence emerging of how beneficial these meds are for a variety of health conditions, obesity aside, I think it's just a matter of time before they're made more accessible. Unfortunately as you well know, there's nothing quick about our NHS 🙁

I'm not particularly wealthy but have been able to afford them quite easily by cutting out all of the pricy UPF's I would buy on the weekly shop.

How are you doing on the topiramate? I hope the side effects aren't too bad. I remember reading something about the effect it has on your memory, making you forgetful and a bit zoned out?

I think someone mentioned above topiramate. Side effects weren't for me in terms of brain fog, mood etc but in the first month I lost 15kg, I felt awful the whole time but the weight fell off. I do look mildly gaunt in photos from that time. It did all go back on within a couple of months of me stopping though but I wasn't being at all careful and had gotten accustomed to eating a ton of cake every day and still being skinny. If I had been eating sensibly when I stopped it would likely have been fine.