Extremely hacked off by GP. Won’t prescribe Mounjaro

[Hakunatomato]

I have been self funding Mounjaro for the past year, and have a debt on credit card because of it. As a result, my HBa1c has gone from 19 to 5.5. I have lost almost 5 stones, now down to 16 .stones so effectively I have put my diabetes into remission as a result. I can no longer afford it because of the price rises and have asked my GP to start prescribing it. Their response is that because my blood sugar is now nearly normal they won’t do it, despite me having a bmi of 46. When I finish the course I have I now have to watch my good work go in to reverse and watch my health decline. All for the sake of the £30 a week is would cost my GP at wholesale NHS cost. If I put the weight back on again and wait while my blood sugar levels rise and I will have to apply again. I am so pissed off.. The relatively small cost as opposed to what the bills will be when my Diabetes returns doesn’t make sense.

Fair enough, you're answer is kinder and better than the other one. Thank you

Actually GPs are not following the clinical guidelines, which are to prescribe to anyone over BMI of 30 or 27 with certain risk factors. That’s the current clinical guidance. GPs are following local funding guidelines which are about restricting the costs, given that 28% of the population have a BMI of over 30 currently - that’s 15million people (data from gov stats/ons). It’s simply not affordable, and then there’s the additional folks with BMI 27-30 and risk factors that would also be eligible. Not sure of those numbers. Currently I think I read that 1.5million people are taking it privately in this country - so 10x that number would be eligible!

My mum wants to get on WLI - her BMI is 35 and that’s having a huge impact on her health. But her GP is restricting it to those with a BMI of over 40. Personally I don’t think she does enough to help herself - I see all the unhealthy food she keeps in the house and the frequency which she opts for take away - but I also think it would be very beneficial in helping her to change her lifestyle and reverse all the negative health impacts obesity is causing. Almost certainly saving the NHS overall if you were to do a cost benefit analysis. I also have my own complex issues with weight loss and am very sympathetic to just how hard it is to lose weight and maintain a healthy weight. I thought I had it nailed in my 20s/30s having always been slim but perimenopause changed things!

People who were obese and lost weight being ignored on here too if they don’t follow the narrative

@Hakunatomato What do you mean when you say your HbA1c has gone from 19 to 5.5? Do you actually mean blood glucose levels? As an HbA1c of 19 even would be extremely low. Do you have T2DM? If so, what treatment are you currently on? Prescribing guidelines are different when using for T2DM and it’s not a first line or even second line choice - you’d need to show your diabetes is not controlled on other medications first.

You could consider a switch to Wegovy? Though I wouldn’t necessarily recommend that if you’ve only been affording Mounjaro by utilising credit.

But when that line will effectively cost more in the long run it doesn’t make sense. The NHS goes on about money shortages then you see this type of thing and you realise why.

I have witnessed some of the most wasteful ill thought out practices I have ever seen which don’t match the rhetoric of a “company” being short of money

@CagerUmbonate I suspect OP means the HbA1c percentage is now 5%, which would be a normal reading.

I have lupus and RA and honestly it’s irrelevant. As are your health problems. If you haven’t gone through when they’ve gone through … don’t speak on it .

And how do you then expect them to keep the weight off if they needed them for their body to function properly? Every fat person knows how to eat healthily.

OK but where is the NHS going to magic up the money to buy all the Mountjaro required to treat all obese people who request it? Should they prioritise obesity over cancer treatments? Stop all heart surgeries? Transplant surgery? With a publicly funded healthcare system, unfortunately, there has to be a line.

Why not? Why can't people who haven't experienced things not give an opinion? That's just silly. Like saying that people who aren't parents shouldn't be able to say anything about children or parenting (i know, not a good example but it's the principle).

Everyone can lose weight with willpower. There are no fat people in war times and famine.

I say this as an overweight person myself.

If you eat 1200 cals a day, and walk 5 miles a day, the weight will FALL off you. I have done it. You just need the willpower (hard, I know).

did you ask your GP for it when you were 5 stone heavier?

I'm also type 2 diabetic, I don't tolerate metformin well and am now on dapaflagozin which isn't much fun either. But I don't come under the guidelines for anything else.

I've lost 5 stone by low carbing. Once you take processed carbs, and high fat UPF's out of your diet that "food noise" disappears. It's a lifelong commitment, every day is a battle but I just have to get on with it I guess.

I don't understand why you would almost shrug your shoulders, blame your GP and say they're to blame if you put the weight back on because they won't prescribe MJ to you? Surely the fact you've spent hundreds of pounds already on the injections, and lost weight and realised you CAN do it, is enough of an incentive to keep going without the MJ? I say this as someone who's lost 6 stone and is almost permanently thinking about what I can eat, what I can't eat, what's for dinner, avoiding the break room at work as there's cake in there etc etc so I'm not unsympathetic to how bloody hard losing weight is!

There are strict criteria for MJ prescriptions - you have to have 4 comorbidities, not just BMI. If you don't meet them, be thankful, not resentful. Or switch to wegovy, which is cheaper than MJ.

As a fellow fat person. I agree.

I totally agree with you Nutella. I love food, think about food all the time, but I also know that if I eat more calories than I burn I will put on weight. I dont want to be fat. I fill up on healthier food, I "save" calories for when I can enjoy them.
People eat food that causes cravings for more but they choose to eat that food. I stopped eating pringles as I found it very difficult to limit how much of them I ate (it really was a case of once you pop you just cant stop). Instead of putting myself in that situation, I just dont buy them anymore.

People were not obese like this years ago so something that is happening now is causing the crisis. I suspect it the availability of UPFs but breaking the cycle of eating them would help. I know when I eat them I rarely feel full for long and end up craving more rubbish.
I would love to know (and not from a judgey perspective) but what are people eating who have all this food noise - it cant be healthy food so the craving must be for upfs.

This is such a ridiculous and ignorant take, and shows a total lack of understanding and empathy.

Firstly, the weight loss jabs don’t curb cravings in my experience.

Secondly, the causes of obesity are complex and it isn’t just a case of “stop scoffing” and “stop choosing to be unhealthy” and “just use willpower”.

@pinknailvarnish1 how overweight are you? because honestly I am sick and tired of the kind of "helpful advice" of just eat less and move more. I know this. I am not an idiot. but my brain overpowers my willpower every. single. time. I am glad you have lost weight but using the tired old starving children in africa/wherever scenario, arent we past that? MJ affects your brain. thats how it works. it affects your brain so the food noise goes away. when I have lost another 6 stone then perhaps I too will be able to go on 5 mile walks every day.

Because if you’re saying oh you just need to do this or that … which was the case with the person in speaking with… you don’t know! You don’t know what you’re actually talking about. You don’t know what they just need to do or what they don’t. Because you haven’t been on their shoes. Can you say they shouldn’t be entitled to a prescription? Yes. If you’re an arse yes you can. But can you say what they just need to do or feel or be … I mean, I guess you can … but if it’s based on you having zero experience of being in that position … I think you’re an idiot for thinking you can speak on something and someone you have zero experience of being! And I think that’s fair.

The problem is that if you don't meet the criteria your GP practice will be unable to claim back what they spend on your monthly MJ and therefore will be paying your £30 prescription from their own funds. And if they bend the rules for one person they should bend them for everyone.

Funding is so low for GP practices at the moment they are struggling to keep going. I work for one and as staff are leaving they aren't being replaced as funds are so tight.

Patients often forget or don't realise that GP Practices are privately run businesses who have to balance their books. Most of their income comes from funding via NHS England and this has been cut by a huge amount this year.

There's no reason coming off it should reverse all your hard work. Mounjaro hasn't made you lose weight; it's been a tool to help you lose weight. You don't just regain because you stop. I've been off it completely for 9 months now and I lighter than when I stopped. It's a myth that you pile on the weight.

Focus on maintaining for a little while, while you get used to not being on it.

I have lost 6 stone on it despite dieting for years. I have severe endo and its stopping me craving sugar constantly and its improving the inflammation from the endo.

I have been maintaning for 4 months on 10mg but now I will either have to go down to 5mg or go off it! I wish the nhs would open their eyes to the benefits to people who have self funded and offer some support! Even if it is just subsidising it!

Well I think youre a condescending person with a chip on their shoulder about obesity. Who think they can make horrid comments to others about how they have no right to an opinion.

YABVU. Keep the weight off with diet and exercise

What you're saying, basically, is that it is the excess food that's the problem, but that you are unable to stop overeating without medication. You've got no choice but to overeat. It is physically impossible for you to say no to food.

Do you think that's a message we should be giving people - that self control is only possible with medication and it's unreasonable to expect it otherwise?