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.

Pretty much what I was trying to say this morning. ^

Where's the OP gone?

I'm glad to see the majority vote (and comments) think she is being unreasonable, because I am honestly tired of the constant support for WLI and them being celebrated as a miracle drug that makes you lose weight and stay thin.

No they don't. Only if you keep taking them for the rest of your life, and who on earth wants to do that? Why should this even be allowed?

You'd honestly have to have rocks in your head to want to inject yourself with WLI every week of your life to stay thin. As you (and many others have said,) other people who have any kind of issue or addictions get help with it, and then when they are better/improved/the issue fixed, the support stops, then you have to keep that lifestyle change going yourself, not expect support forever.

OP is being very unreasonable. Especially when she is expecting the NHS to fund said support. As many posters have said now, people need to take responsibilty for themselves and their own actions. Not expect to be propped up by others. Indefinitely...

GP has done you a favour. The effects it has on long term health are horrendous.

You've lost 5 stone, take a break, you know you can loose weight now so keep up what you're doing and see the progress.
It's not the be all and end all.
Use it as a starting boost and crack on or find the way to self fund. NHS can't just keep people on it forever and you've stopped the need for it by reversing your conditions.
And you're probably the 50th person this week going and asking the same, can't bend the rules for just one.

Some absolutely disgusting comments from what a really horrible , vile individuals.
God help them if they were ill or their family .

What a nasty bullying forum 🤬🤬

That's uncalled for and very rude towards the OP. Be KIND to others

People gain weight for various reasons, the OP has sought to help herself by looking at, and using Mounjaro which she has self funded, it is fairly recently that the NHS have approved this medication but only if you meet the criteria. The OP now, sadly for her dosen't meet that criteria. some others may but they will have to go along the weight watchers, slimming world route first or maybe gastric band surgery.

You are a vile horrible nasty bully .
Your foot seems to be permanently in your gob 🤬

@Howmanycatsistoomany its made me fit and healthy, thanks, and my point was exactly the one you're making that they need to make money, not healthy people, so I don't know where you're going with that one 🙄and it's mounjaro, not mounjaro

Wait, so you accept it's diabetes medication? The OP is diabetic. So presumably you support her having it?

"Diabetes is progressive - its not just about being fat so you get diabetes. It is Insulin resistance in T2 diabetes which means body doesn't react well to your own insulin (and so you need more for standard types and amounts of food) There is damage to Beta cells in the pancreas and eventually as the DISEASE progresses the pancreas can fail."

It's chicken and egg though - some people are more susceptible to insulin resistance and will develop diabetes, but some people bring on insulin resistance by becoming overweight and developing diabetes as a result - if they hadn't become fat in the first place, they wouldn't have developed the diabetes.

I think you misunderstand me. I didn't say that obese people gain weight or don't lose weight in a calorie deficit, however it's caused. I said that in response to a calorie deficit your body is programmed to return to its highest weight, but obviously that can only happen once the calorie deficit is over.

I don't really think what I said could sensibly be read otherwise, anymore than I read your post as saying that obese individuals never experience famine. (Presumably you accept that if a population that contains obese individuals then experiences massive food shortage, someone who went into that shortage 50kg overweight would take some time to stop being obese whatever their calorie deficit.)

Basically, we've evolved to protect ourselves against weight loss, not weight gain, and so our body doesn't know the difference between food scarcity in our environment moving us from healthy to dangerously underweight, and dieting (creating artificial scarcity, if you like) to move from dangerously overweight to healthy. Hence my statement "however it's caused". We don't have an internal mechanism that recognises when we are dangerously or unhealthily overweight because for the vast majority of our history the danger has been not enough food, not too much.

Firstly, well done on your weight loss!

Is it worth asking for a second opinion/referral to a consultant?

Because if we took on Mounjaro at NICE guidance it would take over 20% of our appointments. Who is going to see the 20% of patients we suddenly can't and who will pay for that? Each appt can only be used once.

You will have been eating less so just keep eating less and exercising more and your weight will continue to come down. You will only put weight on if you eat more and exercise less.

Perhaps you should look up the cost of treating the effects of long term diabetes and weigh that against the costs of prescribing a drug that is very effective at controlling blood sugar when other drugs like metformin can't.

Blindness, lower limb amputations, necrotic foot ulcers, infected bed sores, all pretty costly to the NHS.

and it's mounjaro, not mounjaro

and you're telling me off for a spelling mistake? 😂

Mounjaro did not make you fit and healthy; it helped you lose weight. So you might be healthier, but it did not make you fit. Contrary to what some people on this forum believe, it's not a fucking miracle drug.

The trouble is mounjaro doesn’t reset anything. At some point you will come off it and you will need to figure out how to maintain. I am also 16 stone and exactly in the same boat. Instead of going for continued weight loss I intend to try and maintain which in theory should be easier

It’s up to you now to take the lead and be strict about what you eat. The GP can’t change the guidelines. In a few years it will become more available to you.

I have the food noise. I have an addictive personality, and have to use my willpower every day to overcome it - I obsess and am also prone to depression.

It's a long standing joke in my family that we'll finish breakfast and I'll be planning lunch and dinner, while baking a cake for later. I still have to use willpower to not just stuff it all in my face, and I have to use that willpower every day. I am greedy and I love cheese and bread and cakes, but I absolutely know that I will be less fit and more likely to be depressed if I get fat again.

I'm really sorry you will struggle without MJ and are frustrated at the price rises.

But it's unlikely the cost to the NHS is only £30 - I'm interested to know where you saw this info? The contract between Eli Lilly and the NHS is confidential - but I'd expect they'd be paying more like 80% costs of a new product like this, rather than 20% that they might agree for something generic/off patent and there is competition as other companies can also produce it.

Don't know if it feels any less frustrating - but it really is not going to be that cheap and unfortunately so many people need the help so they have to have a cut off line. Frustrating you don't meet the criteria but GPs do have to follow the rules on it.

19 is a normal HBA1C, 48 is classed as diabetic so 19 is normal

Vegetables salad and fruit all break down to sugars. Sugar in the bloodstream releases insulin and the purpose of insulin is to store fat but you obviously don't realise that that is the reason your diet didn't work or you would not have stated that so you are ignorant too.

The only diet that will help you to burn off stored fat is a diet that does not release insulin. You cannot store fat and you burn fat only when insulin is not released. Heaps of salad, fruit and vegetables all metabolise as sugar. This is why they feed it as fodder to store cattle to get weight on them. If you want to burn fat, you need to eat meat, eggs, butter, animal fat and small amounts of dairy.

Clinical Nutritionist here - most people can reverse T2DM and other related conditions like fatty liver, without medication, but it's tough. Just saying 'eat less and move more' is not enough. Behavioural change is key and that involves addressing the triggers to overeating.
Low carb diets and 5+2 are worth trying. Don't give up the achievements you have earned already. You have already reduced your risk of several cancers by reducing HbA1c.
Still not convinced that weight loss jabs are risk free long term, but they can give a really good kick-start to someone by showing what's possible.

and yeah, pharma companies do need to make money, so they can develop the next Herceptin, Kadcyla, or Rituxan, or Humira.