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.

I agree with the GP, you should not be funded now that you don’t meet the criteria.

You need to take responsibility for your health now that you’ve been able to eat well and lose weight with the help
of the injections.

But MJ users ARE exercising and eating healthily. Don’t you see that? It’s just MJ stops the intense cravings and blood sugar fluctuations that would normally sabotage this.

and guess what - I absolutely know how to eat healthily and I exercise regularly. It’s so patronising for people telling obese people to just eat better and move more. Like, no shit Sherlock 🙄

Your GP can only prescribe within guidelines though, they literally can’t prescribe it you?

Well done OP and sorry that you have received such ignorant replies. The situation is shit, but not really the GPs fault. Their hands will be tied. Can you afford Wegovy? It is cheaper. Will the GP prescribe Metformin? Good luck

When you say battled the food noise what does that mean? Because the only way to 'battle the noise' and keep gaining weight is to keep overeating. It's not the 'noise' that makes you fat, it's the food. You are literally saying that you couldn't stop overeating without medication, that you had no control over your behaviour, and that you couldn't be expected to.

I am glad that the medication has helped, this is obviously a brilliant thing. But should we be accepting the message that adults cannot be expected to have self control? I'm not sure we should.

Surely after a year the new habits the drug supported you to develop are well and truly embedded? You have worked so hard and seen amazing results- why do you assume that without the drug you will just go back to your previous ways? You can do this.

Bloody hell there are some nasty opinions on this thread!

My weight gain is mainly due to my clinical depression and poor self esteem, which both stem from being bullied as a teenager at school, and my mum not being willing to step in and help me with that. I have struggled with my weight all my life - I even asked my mum to take me to the doctor, to ask for a diet (I was a kid - I had no idea how else to go about finding a diet, and this was decades before the internet, so I had few other resources) - and she refused. She offered me no help whatsoever.

Depression and weight gain were a vicious circle for me - the more weight I gained, the more depressed I became, and the more I ate - I think that, deep down inside, I believed that the weight would protect me from the world - which of course, it didn't.

PND after each of my three dc were born didn't help. Then knee pain - and the GP refusing to prescribe me any painkillers for them, so that I could carry on walking the kids to and from school and not gain any more weight.

As I said earlier, I was diagnosed with type 2 diabetes, and prescribed dapagliflozin, but refused mounjaro, so I have had to tackle it with dietary changes. I wish I could 'walk five miles a day' - but sadly due to long covid, I'm now disabled, and can't walk more than a few metres. I am self-funding physio, in an attempt to improve my health and maybe reduce the problems caused by the long covid, but now have a damaged hamstring, and two torn rotator cuffs in my shoulders, so it seems like every step forward I try to take knocks me back two steps.

So no, weight loss is NOT always as simple as 'eat less, walk more'. I bloody wish it was.

Please, before you judge overweight people so unkindly, stop to consider that we are still people, with feelings, and do not deserve your nastiness. I have shared my story in the hopes some of you may stop and think before judging overweight people.

Mounjaro is licenced to be long term / for maintenance. Not sure why people keep saying that is not correct. There seem to be some ill informed people around.

Ive been on a diet for thirty years....I've been thin and fat. Even when I'm thin, I still think about food constantly. It's honestly quite tortuous. If you haven't experienced it, I'm not sure you can imagine it.

Are you 4'10"?

You are forgetting the clinical and admin staff cost of running the clinic - it isn't just the medication. We reckoned as a practice that if we offered Mounjaro to everyone who met the NICE criteria, it would take up over 20% of our current appointments.

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.

£30+ per week is not a cheap drug especially if that’s for life.

These drugs are simply unaffordable for the NHS to provide them to whoever wants them. Which is why there is a very high bar to accessing them on the NHS.

@Hakunatomato I don't understand why you paid privately in the first place? If your HBA1C was so high and your other diabetes meds weren't working, then your GP could have prescribed under the clinical guidelines.

I have T2 diabetes. I was on 2 different meds but couldn't get my HBA1C down, and my GP prescribed even though I wasn't obese. This was last year. My last HBA1C showed a significant drop in my levels, almost back to the non-diabetic range - and hopefully my next one will be even better. My GP has assured me I can stay on MJ if it means I can control my blood sugar.

I know it's too late now, but if you'd gone to your GP in the first place then s/he could have prescribed. Now they can't because they are not allowed to. The issue is with the regulations - which are there to protect patients - not with your GP.

stop calling people making valid point "fat shamers' would be a good start...

explain to me why that good advice isn't working
because people need to act on it, not just decide to ignore it?

Surely it is understandable that a fat person would really want that medication!
but it doesn't mean they should pretend it's a miracle cure and want to stop doing any of the work.

At some point, people need to take responsibility for themselves, and accept to not over-eat and ideally being more active - even if weight loss is 70-80% diet, 20% exercise if that.

Waiting for a magic pill to do all the work is not helping anyone.

I understand your point, OP.

you (likely) would have been eligible when you started, and as we know, Mounjaro is a treatment, not a cure, so there is a risk of relapse without the treatment.

i feel for you 😥

I would also like to ask - does it actually MATTER how someone loses the weight and maintains that weight loss? If they need WLI to achieve it - what's the problem with that? Isn't it better that they DO achieve and maintain the weight loss - or would people prefer for them to stay obese?

The NHS benefits if fewer people are overweight, and needing treatment for the myriad of conditions that obesity can cause - frankly if that weight loss is achieved through magic beans, why does it matter so much to some people?

It seems as if, not only are overweight people judged as less worthy of respect, but there is also a hierarchy of worthiness for people who have lost weight, and you are only considered worthy of respect if you didn't use WLI or medication!!

Can't people just be glad that people are losing the weight??

Well it is intended to be for life for thoseT2 diabetics who need it to control their blood sugars. I didn’t think I would be, but the Dr recently told me so.

To all those saying that people could/should lose weight by dieting and exercise - the thing is though, it actually doesn't matter, does it?

The facts are that obesity has increased over the past few decades, that the healthy eating and exercise messaging hasn't worked, and that these drugs do work. So whatever your views on what overweight people SHOULD be doing, they're by and large not, and aren't about to start just because you tell them off.

Personally I see nothing wrong with taking the drugs and using them long-term if needed, but even if you do, it's a question of pragmatism vs principle, and it's very clear that the principled stance doesn't work. Whether you morally approve or not, it's demonstrably better to enable wider access to the drugs.

I think some people just enjoy telling others what to do and judging them for being "greedy".

Are you a medical professional with experience in research in this area? Or just a fatphobic?

But why do you think you’re special? There are guidelines and you don’t meet them. We all want it free on the NHS, but we have to pay or go without if we don’t meet the criteria.

But when you're thin, you're eating less, right?
Proving that it's not the noise, it's the food. You can live with the noise and not act on it.

I'm certainly not fat phobic.
I'm overweight myself.
Could I walk 3 miles a day if I'm not in work, yes if I could be bothered
Do I really need 3 biscuits with my tea, no but why the hell not?
Do I need 2 glasses if wine at night, no, but what the hell.
There, 600 extra extra calories, on top of 3 square meals.
It's not rocket science

no one is denying the right of the OP to use medication, just saying she can pay for it herself now.

In an ideal world, the NHS would support EVERYTHING and in timely manner, that needs to be supported, from dental work to cancer treatment. We all agree on this.

Sadly, it's not an ideal world. The OP can pay for the medication, because the choice could be, now that the weight has been loss, to not even take it and do the work to maintain... People like the OP are not, and should not, be the current priority, when other patients need a lot more help!

A kid can't make his teeth not need braces, you can however do the steps to not regain the weight you've lost...

Food addiction is fairly unique as you still have to consume food. You can’t remove it from your life altogether like an alcoholic can remove alcohol (not that I’m saying recovering from alcohol addiction and remaining sober is easy). Food is necessary, which makes it a complicated addiction to tackle.

In my experience and it is only my experience, it has taken strict discipline to
lose and maintain my weight. I have to record and measure everything I eat because if I don’t, old habits come back. The minute I eat something ultra processed, the cravings return. If I eat only whole foods they go. So it’s the types of food people eat that drives overeating and it is all consuming for many. The thinking that everything in moderation is ok doesn’t work for me, at least not in the long term.

I’m not saying that’s all that drives obesity, but I do think there are a lot of conflicting messages out there. It’s hard to lose weight and even harder to maintain it.

Your GP is forcing you to overeat? Report him!