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 think it’s simply a case of whether you meet the NICE criteria for prescribing it? It’s not necessarily anything personal.
i do feel your pain though as I’ve lost 12.5 stone on it last year. The price hikes are disgusting when you are only trying to better yourself and get healthy .
i hope you manage to get hold of some to continue your journey and a massive well done on losing so much already !

Surely half the point of taking WLI is to use the time when the "food noise" (a term which the manufacturers are using to blur the distinction between hunger based and reward based eating) is being medically managed, to adjust your lifestyle in toto.

Empty your fridge and cupboards of all the tempting, addictive type foods. Change the way you think about and talk to yourself about food. Learn how to make better choices most of the time. Listen to your body so when you feel the urge to eat, learn to pause and decide if it is really hunger, or is there something else emotional you are responding to. Learn what triggers your non-hunger eating. Can you replace the desire to eat with phoning a friend or going for a walk? Find other ways to respond to stress and emotional eating.

WLI are not intended for life. They are intended to allow all the above to be adopted as permanent lifestyle changes not being kept on a drug induced leash until you die.

My mother is an emotional eater who has been morbidly obese all my life. She is about 4'11, an arthritic old lady in her 80s and weighs about 16 stone. That is having lost 4 stone in the last year from a peak of around 20 stone (she won't admit exactly figures). She has lost that on her own (no WLI) with zero exercise due to her age, but by learning to listen to her body and only eat when she is hungry, not just because it is a 'meal time' or similar. I know it is easy to say 'if she can do it...' but honestly, if a sedentary woman in her 80s can learn to listen to bodily cues, most of the rest of us should be able to too.

Do you mean your HBa1c has gone from 55 to 19? Otherwise it doesn’t make sense. I work during an ICB and GPs are audited and monitored closely on their proscribing and if it’s not in line with guidelines they have questions to answer. Well done on your weight loss, and I agree it sucks but I can see the GPs position.

I understand op, have you truly put diabetes in remission though? Been through the second blood test etc.

I say this as someone who got taken off nhs prescription of metformin, similar weight loss on the GLP1, bmi 40 - 2 months later I was lucky not to lose my leg and it would have been called diabetic complication 😢 I’m sure the surgeon thought I was deluded.

Now I don’t know what to make of things. Mind I never thought I’d have to get anti depressants privately either 🙈 though least it isn’t cancer drugs I suppose.

OP, I can see how it feels unfair to you, it feels like a punishment for doing something about it yourself.

I read an article on this and the writer was in the same position and she said that by helping herself and paying for it privately, that now meant that she no longer meets the NHS requirements and therefore can never get it funded by them.

She said that it will affect a lot of users and that the only way to get it on the NHS would be to put all the weight back on again - and of course, have the 4 other specifications that the NHS are requiring in order to prescribe it.

I am in the same position, haven't started yet, but keep thinking about it, but now the price has gone up, it might not be viable. I only have 3 of the conditions required so can't get it on the NHS until the third year rollout.

If only it was that simple
The trouble is we the world over , have been relying on processed food for decades, and that food has been messed about with to make you want it

Ive gone from a size 16/18 to an 8/10 -( and at just over 5ft I was obese ) took about a year, keeping it off for coming two years now and it isnt easy to keep it off

I have had to ditch all the processed food - cant even buy a loaf of bread anymore. I have to be bloody boring and cook whole food from scratch

If I go somewhere , like a birthday party - Im all over the food. Minute I start with the wee cakes and sausage rolls and what have you - I over eat and feel sick - and yet two hours later Im hungry again

So now there are no meal deals, no cheeky Mc D's because I will over eat and be hungry again later - further over eating

As long as I avoid processed foods I can eat basically what I want - fill myself - Im not sat here feeling hungry 24/7 reaching for the snacks .

it really has been a journey learning what I can and cant eat - what will trigger me.

Im also lucky that I live very rural, we dont have take outs anywhere near us, certainly not one that delivers so I dont really have much option but to cook and Im also very lucky that I had to learn to cook from an early age and Im also lucky that I have the time to shop and cook

So we eat Chinese , Indian and Pizza and KFC style chicken and burgers and chips - same as everyone else - only I have to make it

If I went to McD, get a medium Big Mac meal - Id eat that - nearly all my needed calories in one sitting and be hungry an hour later. If I make a 4oz burger, shoved in a pitta bread ( the least processed bread I can get ) with all the onions and cheese and salad I could ram in, have a large potato cut into thick chips - air fried , Id struggle to finish it, would be half the calories and would keep me filled, I wouldn't be snacking to tide me over till the next meal time

And the truth is, I know that that medium meal McD's wouldn't fill a hole in my tooth, so id probably order cheese sticks along side or a box of nuggets and then go for a McFlurry - doubling the calories - and still be wanting fed again later

So my supermarket shop is mostly fresh food - no cake aisle, no biscuit aisle, no crisp aisle, no pre made meals, no pot noodles or jars of sauces , no jams, no sugar and most of all no white bread ( which I miss so much that I have a weekly treat of one crusty white roll a week, if I bought a loaf id eat the loaf so its one singular roll )

It’s still really new, in time it will be more widely available. It should be much easier to exercise now than it was at 21st, see if you can knock off a bit more before the course ends and build exercise into your life.

This, what were you eating before. Can't you carry on doing the same.

Can we please make it crystal clear this isn’t the GP’s fault? These are set criteria from a higher level, they haven’t “fobbed you off” or personally decided this.

This is a good one OP. I was just coming on to say well done you for sorting out your health and don't let anyone take your achievements away from you, MJ manufacturers and NHS policy decision makers included.

You did this. You CAN still do this. Don't lose hope - your health and your life are worth it!

I'm sorry, do you really think you should get it for free for the rest of your life to maintain a healthy weight? Ridiculous.

Exercise, eat healthily and try some will power. I'm flummoxed that so many people are using these drugs as crutches and intend on doing so for the rest of their lives.

It maybe wasn’t as common but some people were still obese. My mum’s
side of the family were all huge, even going back decades.

@NeatKoala I believe that telling anyone they are lazy, greedy, lacking will-power, scoffing, stuffing their faces are all attempts to shame people, so I will continue to refer to those that use such tactics and terminology on threads such as these, as fat shamers.

@FriendofDorothy you are absolutely right, the people who are fat because they have unresolved emotional trauma definitely need help. Do you think that the NHS should provide that? I became fat because I was abused as a child. You'll find that many fat people (not all) are eating their way through some unresolved trauma. I have diagnosed CPTSD and have suffered from PTSD too, also diagnosed. There is precious little help on the NHS for any of that. 6 x 30 minute counselling sessions and some anti-depressants - does anyone really believe that unpicks decades of abuse? I am really fortunate that I could afford 3 years of counselling and WLI. Amazingly I am a single parent who also works full-time - so fucking lazy, right! I am also really fortunate that I have the mental fortitude and space in my life right now to keep working on all those issues that relentlessly drive me to wanting to eat. I am slim these days and have been maintaining my slimness since January. I hope I can continue to do so.

My experience is far from unique. And it is far from being the only reason people are fat. Some have years of poor eating habits instilled from childhood (often due to poverty), some have just become depressed and food has become their only pleasure, for some the menopause has hit them like a brick and suddenly the pounds have gone on, some people are addicts in the same way that people become alcoholics, drug addicts, sexaholics, gamblers etc, some are genetically prone to T2 diabetes and the weight gain that often comes with that, some are bon-viveurs for sure who just love food and drink. And that is just what I can think of off the top of my head.

To simply state that it is a just a question of will-power and eating less and moving more is so ignorant, contemptuous and dismissive. I think it is the contempt shown for the struggle to not be fat that I find the most extraordinary in these threads.

A lot of people here don't seem to understand that Mounjaro also regulates blood sugar levels.

@Hakunatomato I haven't read the whole thread, but I reckon you could fill the MJ bingo board with the answers. However, the person to blame for the price rise is Trump. He's the one who forced EL to raise prices to make things fairer to americans.

Good for you and I completely agree re UPF. I’d really recommend a bread maker if you can, it’s so easy and it good bread. Bread rolls are easy to make. Or crosta and mollica wraps from the supermarket.

On a different note why can't people pay their GP what it's costing the NHS to get the drugs. So if it's £30 a week then patient pays that rather than paying profit for private companies.

The NHS isn't losing out costwise and gaining if it keeps the patient healthier, therefore reducing costs of later treatment

Id have thought a BMI of 46 would qualify.

@MargoLivebetter absolutely I think that therapy should be available to support people through managing trauma in a healthier way.

Just to be clear, I am not saying that I don't think medication shouldn't be available (for all sorts of things) to help people manage conditions, including obesity, but I generally believe doing the therapeutic stuff alongside is as important.

100% But then there are SO many experts here on MN that it's a wonder any of us ever have to reach out to a healthcare professional for anything.

The level of sheer ignorance related to obesity and diabetes doesn't surprise me though. Fat-hating is clearly a thing here on MN.

My GP prescribed for me and I only have diabetes. However my HBa1c was 61 and I have been on all the different diabetic meds without them getting levels down. It was not given to me for weight loss although I do need to loose weight and managed to loose 7 kilos myself the last few months before going onto Mounjaro. Diabetic nurse called me to tell me she wanted to put me on it and I believe our surgery is currently only prescribing to those diabetics who's HBa1c really is very high and other meds no longer work.

FFS she's a T2 Diabetic, she can just use willpower to get her pancreas to behave normally.

This is a medication primarily developed for the treatment of diabetes. Remember when people used to complain about the fatties stealing drugs from the diabetics???

OP were you on medication for T2 before Mounjaro? Are you under the care of anyone other than your GP for your diabetes? If so speak to the Diabetic team. They have different rules to GPs prescribing for weightloss. You could also try asking about semaglutide (Ozempic) rather than tirzepatide (Mounjaro).

Keep a close eye on your bloods if you come off and keep your GP or Diabetic Nurse informed of the changes as the impact may mean you become eligible for one or the other to manage your diabetes.

I'm currently about 3 stone overweight. About 10 years ago, at the same weight, I decided enough was enough. I stuck to 1200 cals a day, walked for 5 miles, and within 5 months I lost 30lb.

Predictably, I eventually put it all back on again. I blame wine mostly, and not walking enough.

I'm sick of it and now trying again. I am 2 weeks into intermittent fasting, which is yielding some results. I have my last meal at 6pm, and then don't eat until noon the next day. Cutting down the wine too. Eating salad, fish, eggs and chicken. I've only lost 8lb so far, but at 55 years old, it might be harder to shift this time.

But I do believe that with willpower we can all do it. But it's hard, isn't it? My major downfall is wine, I appreciate for others it's sweets or sugar.

Try following Eddie Abbew - he is inspirational, and has really helped me to see where I have been going wrong.

There are some absolutely disgraceful comments on here

Mumsnet, you should be ashamed

I pay for my MJ privately and will carry on, on it, until I reach a healthy BMI. Because already I have more energy, I can go for walks, swim, go to the gym and thats after only a few stone down. I do not eat processed foods mainly because of food allergies. I eat fruit and cottage cheese for breakfast, lunch is a soup and/or salad plus protein and supper is always cooked from scratch. It has to be at least 8 years since I last had a takeaway, a McDs etc. I love a subway salad no dressing when I am going somewhere. I now drink 3 litres of water a day (MJ risk of pancreatitis if you dont) What do I binge on then when not on MJ (because someone is bound to ask!) Nuts mainly, cereals, dates, dried apricots, cooked meats etc. basically whatever is in the house at the time. I am using my time on MJ to retrain my eating - smaller portions, eating only when hungry etc. so when I come off of it, I will maintain my weight loss because then I will be able to exercise as much as I want to. and I am on the lowest 2.5 dose.

I cannot believe the nastiness on this thread. I agree the GP cannot prescribe it for OP - but telling OP to use willpower/try eating less is beyond ignorant, and comments such as “buy some salad” etc are cruel and disgusting.